The Relationships Between Healthcare Access, Gender, and Psychedelics and Their Effects on Distress

Structural inequalities in healthcare access may shape how people experience the psychological effects of psychedelics. Analyzing data from the National Survey on Drug Use and Health (2008–2019; 484,732 participants), private health insurance was associated with lower psychological distress, while public insurance was associated with higher distress. Psychedelic use moderated these associations: it reinforced the protective pattern linked to private insurance and intensified distress among those with public coverage. Among women, psilocybin and LSD use were linked to lower distress for those with private insurance but higher distress for those with public insurance; among men, psychedelic use did not significantly alter the association. Psychedelics do not mitigate structural inequalities and may exacerbate them.

Study at a glance

Abstract

Background: Structural inequalities in healthcare access may influence how individuals experience the psychological effects of psychedelic substances, potentially limiting positive outcomes among vulnerable populations. Objectives: This study uses data from the National Survey on Drug Use and Health (2008–2019; N = 484,732) to examine how public and private health insurance moderate the association between psychedelic use and psychological distress. Methods: Ordinary least squares (OLS) regression models indicate that private health insurance is associated with lower psychological distress, while public insurance is associated with higher distress. Results: Psychedelic use moderates these associations, reinforcing the protective pattern linked to private insurance and intensifying distress among those with public coverage. These patterns vary by gender: among men, psychedelic use does not significantly alter the association between insurance type and distress; among women, however, psilocybin and lysergic acid diethylamide (LSD) use are associated with lower distress among those with private insurance, but with higher distress among those with public insurance. Conclusions: These findings indicate that while psychedelics may interact with existing healthcare conditions, they do not mitigate structural inequalities and may, in some cases, exacerbate them.