The International journal on drug policy
August 1, 2026
Myfanwy Graham, Yimin Ge, Rosalie Liccardo Pacula et al.
1 citation
An estimated 19% of adults in Canada, the United States, Australia, and New Zealand have used psilocybin, LSD, MDMA, or ketamine at some point in their lives. Psilocybin was the most commonly used substance, with lifetime use highest in Canada (16.3%), followed by the US (13.0%) and New Zealand (12.1%), and lowest in Australia (7.8%). Among those who had ever used a psychedelic, 10-20% had asked their medical provider about medical use, and over a third of past-year users reported experiencing an adverse health effect. Past-month use was low across all countries. Consumer interest in therapeutic use has outpaced clinical trials and therapeutic provisions, and many people use these substances outside regulated pathways, which may increase the risk of adverse events.
The International journal on drug policy
July 1, 2026
Alex K Gearin, I Glenn Cohen, Albert Garcia-Romeu
1 citation
The revival of psychedelic medicalization is often presented as a story of scientific legitimacy and neurotherapeutic promise, but the sensitivity of psychedelics to environmental conditions has encouraged research on music, therapy, setting, and other contextual factors. This article examines how regulation actively shapes atmospheres of consumption for substances that alter affective and sensory perception. Debates over drug-centric versus therapy-centered models are situated within the broader issue of how law shapes contexts and settings of psychedelic consumption.
The International journal on drug policy
November 1, 2025
Liam O Jarvis, Alexander H Jack, Niall Galbraith et al.
1 citation
The UK public holds a neutral, slightly negative attitude toward psychedelic-assisted therapy (PAT) for depression, based on a cross-sectional survey of 951 adults. People who were younger, male, had used recreational drugs, and reported greater subjective knowledge about psychedelics were more likely to view PAT favorably. A history of depression itself did not shape attitudes or change how personal characteristics related to them. The findings suggest that low familiarity with PAT and concerns about its safety, efficacy, and social acceptability may explain the overall neutrality, highlighting the need for clear scientific communication to inform public understanding.
The International journal on drug policy
August 1, 2025
Ilze Mj Thoonen, Saskia J Rietjens, Arjen Koppen et al.
1 citation
From 2014 to 2023, the Dutch Poisons Information Center saw a significant rise in poisoning events involving psychoactive drugs among adolescents aged 13-17, with a 14% annual increase. Cannabis-related poisonings more than tripled, especially from edibles; MDMA poisonings doubled; and reports of the synthetic cathinone 3-MMC rose from none to 24 cases. The variety of new psychoactive substances also expanded, from 1 type in 2014 to 13 in 2023. The authors note that the toxicity of many new substances remains unknown and call for more education and legislative action to address the trend.
The International journal on drug policy
November 1, 2024
Rodolfo Olivieri, Luís Fernando Tófoli
1 citation
In mid-20th century Argentina, psychoanalysts Luisa de Álvarez de Toledo, Alberto Tallaferro, and Alberto Fontana combined psychoanalytic therapy with psychedelic substances such as LSD. Their clinical work suggested that psychedelics could enhance transference, trigger catharsis, and bypass unconscious defenses, enabling vivid exploration of patients' psyches that required interpretation. Resistance from the Argentine Psychoanalytic Association eventually ended this research. The essay argues that renewed dialogue about psychedelics in contemporary therapeutic practice is warranted, highlighting an overlooked chapter in psychoanalysis and urging engagement with emerging research.
The International journal on drug policy
July 9, 2026
François Gagnon, Anne Philibert, Benjamin Carignan et al.
Most Canadian adults are unfamiliar with the proliferation of illegal psychedelic retail stores selling psilocybin, DMT, and related substances, with 79.1% unaware of the stores and 80.3% unaware of the products sold. Among those with some familiarity, perceptions of risks and benefits coexist, with ambivalence being the most common stance. Respondents were equally divided between closing the stores and maintaining the current unregulated status quo. However, 66.6% supported authorizing sales under a regulatory framework, even among those with no direct exposure to psychedelics. Large majorities favored public health protections over fiscal considerations, product restrictions, promotion limits, and caps on store numbers. Public support for legal regulation appears receptive but not fixed, potentially shaped by the regulatory framework's features.
The International journal on drug policy
July 8, 2026
Laetitia Vanderijst, Jean-Luc Faillie, Thibault Mura et al.
Imperfect blinding is a common issue in randomized trials, not just in psychedelic research, yet it is rarely assessed outside this field. In mental health, uncertainties from imperfect blinding combine with those from patient-reported outcomes, which are often viewed skeptically despite clinician-rated scales having their own limitations. Maintaining reasonable doubt about treatment allocation, not perfect blinding, supports placebo-controlled designs. Expectancy bias in psychedelic trials may lead to a 'lessebo' effect—a negative placebo effect from expecting to receive a placebo—driven by disappointment rather than pre-treatment expectation alone. The authors argue for shifting focus from preserving imperfect blinding to mitigating disappointment through structured psychoeducation, therapeutic alliance, and realistic preparation, which would improve ethical rigor and clinical usefulness.
The International journal on drug policy
July 1, 2026
Salim Mezaache, Liselotte Pochard, Hélène Peyrière et al.
Use of ketamine analogues, substances structurally related to ketamine, is increasing in France and poses significant health risks, some potentially exceeding those of ketamine itself. Analysis of 56 cases reported to the French Addictovigilance Network from 2017 to 2024, predominantly involving 2-fluorodeschloroketamine (2-FDCK, 52%) and N-ethyldeschloroketamine (O-PCE, 38%), showed that most users were men (93%) with an average age of 32.1 years. Adverse effects were mainly neurological and psychiatric, including dissociation and impaired consciousness. Serious cases accounted for 61%, including 11% deaths. Four user profiles emerged: recreational experimenters, self-medicating individuals, regular users, and those unintentionally exposed, often in chemsex contexts, which was frequently linked to distressing experiences.
The International journal on drug policy
December 1, 2025
Tereza Dleštíková
Psychedelic-assisted therapy (PAT) may help people stop committing crimes by promoting identity transformation and personal meaning-making. Drawing on psychedelic science and desistance-focused criminological theories, the paper argues that when administered ethically, psychedelics can enhance self-reflection, emotional processing, and inner insight—mechanisms that support sustained behavioral change. Because many justice-involved individuals experience trauma, depression, and substance dependence, PAT could be a particularly relevant intervention. The paper recommends community-based, post-release settings rather than correctional institutions for PAT delivery. It acknowledges that causal evidence on recidivism outcomes is lacking and calls for carefully designed pilot studies. Using Czechia as a policy context, it offers a roadmap for research and implementation, positioning PAT as a complementary component within broader rehabilitation and reintegration strategies.
The International journal on drug policy
June 1, 2026
Juan Carlos Mendoza-Pérez, Keith J Watts
Poppers (alkyl nitrites) are widely used among sexually diverse men in Mexico to enhance sexual pleasure, yet research has focused on risks like HIV transmission. This mixed-methods study of 358 sexually diverse cisgender men who had used poppers found that use is a positive embodied practice intensifying sensory arousal and expressing agency, often partner-mediated and embedded in negotiation and intimacy. Dating apps normalize poppers use, facilitate access, and help filter for compatible partners. Findings challenge risk-based narratives and support pleasure-centered harm reduction approaches that recognize relational and digital contexts.
The International journal on drug policy
November 1, 2025
Deirdre Mongan, Nicki Killeen, Seán R Millar et al.
Hexahydrocannabinol (HHC), a semi-synthetic cannabinoid sold openly in Ireland as a legal cannabis alternative until July 2025, has become a prominent feature of the Irish drug landscape. Among 2,314 adults who had used drugs in the past year, 36.2% reported lifetime HHC use, 33.5% past-year use, and 17.8% past-month use. The main reason for first trying HHC was its easy availability in stores, with 62.4% obtaining it from high street shops. Negative consequences were reported by 89.9% of users, including anxiety or panic (14.7%), faintness or dizziness (13.4%), dissociation or depersonalisation (11.9%), hallucinations or psychosis (3.9%), depression (3.6%), and withdrawal symptoms (3.2%). The findings indicate HHC poses public health concerns and requires monitoring.
The International journal on drug policy
November 1, 2025
Dara Ruane
Punitive policing at music festivals incentivizes people who use drugs to adopt behaviors that lower legal risk but increase health risk, even when they value responsible drug use and harm reduction. An ethnographic study across three policy regimes involving 52 days of observation, 23 practitioner interviews, and 54 festivalgoer surveys found that heavy enforcement made pre-measured, tested stashes useless due to gate confiscation, discouraged information-rich transactions with accountable dealers, and made informal drug checking legally dangerous. Vigilance for police undermined efforts to create a safe set and setting, and both uniformed and undercover policing blocked access to crisis support. The findings illustrate how tough policing creates perverse incentives that increase harm.
The International journal on drug policy
July 1, 2024
Masoomeh Maarefvand, Maziyar Ghiabi
The essay argues that the concept of 'addiction' must be rethought by taking seriously the diverse cultural scripts that shape its meaning and experience. Rather than a fixed, universal category, addiction is a fluid and pluralistic notion, increasingly applied to behaviors like eating, sex, gambling, and substance use, making many people 'addicts in practice.' The politics of addiction remains tied to controlled substances such as opioids, cocaine, cannabis, and psychedelics, yet the line between licit and illicit drugs is blurring. Culture is often overlooked or reduced to Anglo-American perspectives, but exploring non-Western epistemologies and practices of well-being can shift the discussion toward new historical trajectories and policy considerations.
The International journal on drug policy
April 1, 2022
Antonia Bendau, Leonard Viohl, Moritz Bruno Petzold et al.
During the early COVID-19 pandemic, use of party drugs (stimulants, dissociatives, GHB/GBL) shifted substantially. Among 1,231 users surveyed, 48.0–64.8% ceased or decreased use, 11.9–25.5% maintained, and 23.6–29.1% increased consumption. MDMA/ecstasy showed the strongest decrease; GHB/GBL and dissociatives the highest increase. Price, quality, and supply remained mostly unaffected. Mood-related motivations (e.g., feeling exhilarated or high) were common before and during the pandemic, but social and mood-related reasons declined while coping with boredom rose. 16.4–35.6% found drug use helpful for pandemic-related stressors, which was linked to increased consumption. The findings suggest that users who increased use as a coping strategy may need targeted preventive measures.
The International journal on drug policy
December 1, 2021
David B Yaden, Andrea P Berghella, Paul S Regier et al.
Classic psychedelics like psilocybin show promise for treating substance use disorders, and if larger trials confirm efficacy, psychedelic-assisted psychotherapy might be integrated into existing treatments such as cognitive behavioral therapy and twelve-step facilitation programs like Alcoholics Anonymous. Although AA has historically rejected medication-assisted treatments, the authors argue that classic psychedelics and their subjective experiences may be more compatible than conventional medications. They describe Bill Wilson's, the founder of AA, little-known experiences with psychedelics, suggesting aspects of psychedelic treatments could complement AA. A review of clinical trials evaluating psychedelics for substance use disorders is provided, along with discussion of potential large-scale impact if integrated into AA.