Contextualizing Violence Risk Associated With Hallucinogens

Psilocybin, LSD, and MDMA have regained attention for their potential psychiatric benefits, but their effects on aggression and violence are not well understood. This review examines the historical, medical, legal, and cultural contexts of these compounds, along with how substance type, dose, set and setting, psychiatric comorbidity, and environmental factors influence violence risk. It discusses prevention and response strategies such as harm reduction, risk assessment, and treatment. The article concludes that individual risk factors mediating violence for users of these substances require further research.

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Abstract

Psilocybin, lysergic acid diethylamide (LSD), and 3,4-methylenedioxymethamphetamine (MDMA) have remerged as agents of psychiatric and cultural relevance. However, public discourse has outpaced empirical understanding of their effects. Although hallucinogens have demonstrated a potential to treat certain mental disorders, their effect on aggression and violence risk remains inconclusive. This article reviews the historical, medical, legal, and cultural contexts of these popular psychedelic and entactogenic compounds. The impact of substance type, dose, set and setting, psychiatric comorbidity, and environmental factors on violence is reviewed. Prevention and response strategies relevant to hallucinogenic compounds are discussed, including harm reduction, risk assessment, and treatment. Individual risk factors that mediate violence risk for people who consume psilocybin, LSD, and MDMA remain an area for further research.