Translated from our German original by AI. The German text was researched, written, and edited by the Psychedelia Foundation team and remains the authoritative version.
People with lived experience mostly do not describe psychedelic experiences as psychosis-like
Psychedelic substances such as LSD and psilocybin were long regarded as possible models for psychotic illness. Although these so-called model psychoses are barely discussed in the field any more, researchers have returned to the question. A study published in the International Journal of Mental Health and Addiction suggests that people who have experienced both psychosis and psychedelics see the common ground between the two states as very limited.
For the study, researchers led by Haley Maria Dourron conducted in-depth interviews with 19 people who had been diagnosed with non-affective psychotic disorders such as schizophrenia or schizoaffective disorder and who had used psychedelics after a psychotic episode. The aim was to capture subjective similarities and differences between the two kinds of experience.
Participants mostly described psychedelics as experiences shaped strongly by sensory impressions and emotions. Psychosis, by contrast, was more often described as a thought-driven state marked by delusions, self-reference, and the feeling that certain beliefs were true beyond doubt. While psychedelic experiences often involved intense visual changes, heightened emotional perception, and an awareness that the substance’s effect was time-limited, many participants reported that psychotic episodes had been marked by fear, uncertainty, and loss of control.
At the same time, the interviewees also identified overlaps. The one they named most often was a stronger tendency to see connections between events and to charge experiences with special meaning. The nature of this meaning-making differed, however: in psychotic episodes it often contributed to the formation of stable delusional systems, whereas under psychedelics it was described more as an open process of reflection and questioning.
Asked which substance came closest to their psychotic experiences, nine participants named cannabis. Dissociative substances such as ketamine and dextromethorphan (DXM) followed, along with various stimulants. Only one participant named a psychedelic as the drug that most resembled their psychosis. Several interviewees also reported that cannabis could markedly intensify paranoid thoughts and hallucinations, which is why the researchers call for clearer warnings on cannabis products, since medical and recreational cannabis is often wrongly taken to be more harmless than psychedelics in everyday life.
The authors stress that the findings allow no conclusions about either the therapeutic efficacy or the safety of psychedelics in psychotic illness. The study does, however, question the traditional assumption that psychedelic states can be understood in principle as a subjective model of psychosis. Instead, the interviews suggest that while the two states share individual features, those who have lived through both describe them more often as different than as similar.
The study’s reach is limited by the small sample and by diagnoses that rest on self-report. The researchers therefore see their results as a starting point for further work on the similarities and differences between psychotic and psychedelic states of consciousness.
