Psychedelics as Suicide Prevention

Content warning: Sensitive subject.

We all know we’re going to die, but some choose to by suicide. In Canada, about 4000 people die annually by suicide. It causes one-third of deaths in adults ages 45 to 59 years and is the second leading cause of death among youth and young adults aged 15 to 34 years. Rates are approximately three times higher among men compared to women.

Mental health support and tapping into existing resources are crucial to suicide prevention. Warning signs that might suggest someone is at risk of suicide include thinking or talking about suicide, planning for suicide, or other signs and behaviours:

  • withdrawal from family, friends or activities
  • feeling like one has no purpose in life or reason for living
  • increasing substance use, like drugs, alcohol and inhalants
  • feeling trapped or that there’s no other way out of a situation
  • feeling hopeless about the future or feeling like life will never get better
  • talking about being in unbearable pain or burden to someone
  • anxiety or significant mood changes such as anger, sadness or helplessness

Talking honestly, responsibly and safely about suicide can help you determine if someone you know needs help. If you want to help someone who may be in crisis, try to listen and show concern, talk with them and reassure them ‌they’re not alone, let them know you care, or connect them with counsellor or trusted person such as a neighbour, friend, family member or elder, or a crisis line (see the end of this article).

The role of psychedelics in suicide prevention

In the last decade or so, researchers have been studying the effects of psychedelic use on patients with various mental and emotional illnesses.

The Journal of Psychopharmacology published the results of data from 190,000 American adults from five years of the National Survey on Drug Use and Health (2008 to 2012) to evaluate the relationship between a history of using specific non-addictive psychedelic drugs, and psychological distress and suicidality. 

Researchers found ‌lifetime use of these drugs was associated with a decreased likelihood of past-month psychological distress and past-year suicidal thinking, planning, and attempts. Conversely, lifetime use of other illicit substances was associated with an increase in these harms.

Study author Dr. Matthew W. Johnson said the observational nature of the study cannot show that psychedelics caused these effects because those who used psychedelics may have been psychologically healthier before using the drugs. He said results may reflect a benefit from psychedelics; the study controlled variables and found that other drugs assessed in the study were linked to increased harms. 

Using non-addictive psychedelic drugs may exacerbate schizophrenia or other psychotic disorders and can elicit feelings of anxiety, fear, panic and paranoia, which can lead to dangerous behaviour. But these instances of individual harm may not stand out in the survey data because they occur less often than the positive outcomes some experienced.

“Our general societal impression of these drugs is they make people go crazy or are associated with psychological harm, but our data point to the potential psychological benefits from these drugs,” said Dr. Johnson.

Photo: Brooke Cagle

Another observational study published in 2017 investigated whether using a psychedelic drug had a protective effect on incidence of suicidality among marginalized women in Metro Vancouver, Canada. Findings showed that naturalistic psychedelic drug use (psilocybin, DMT, salvia, and mescaline) was independently associated with reduced suicidality, while illicit drug use and childhood trauma predisposed women to suicidality.

In two prospective studies published in 2020 involving a sample of individuals with plans to use a psychedelic, researchers explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, and relationships between changes in these outcomes. 

In the first study, participants reported planning to use psilocybin mushrooms or truffles, LSD/1P-LSD, Ayahuasca, DMT, 5-MeO-DMT, 4-AcO-DMT, 5-MeO-MiPT, more than one psychedelic, and either psilocybin or LSD. In the second study, individuals attended psychedelic ceremonies involving ‌one or more facilitators. 

In both studies, most participants (72% in Study 1, 82% in Study 2) exhibited subclinical levels of baseline depression severity, indicating that the effects of psychedelics range from mild to severe along the spectrum of depression severity.

In 2021, researchers reviewed the relationship between suicidality and classic psychedelics (psilocybin, Ayahuasca, and LSD) in both non-clinical psychedelic use and psychedelic therapy. Findings on the association between lifetime classic psychedelic use and suicidality were mixed.

A few reports identified suicide and decreased suicidality following non-clinical classic psychedelic use. There were several cases of suicide in early psychedelic therapy, though it was unclear whether this was because of the psychedelic therapy. In recent clinical trials involving psychedelic therapy, researchers found no reports of increased suicidality and preliminary evidence for acute and sustained decreases in suicidality following treatment. Researchers deemed two suicidality-related events were not because of the administration of a psychedelic.

It’s clear that we are still in the early stages of exploring the potential for psychedelics in preventing suicide, but many studies have shown positive effects of psychedelics on mental and emotional illnesses. Recent reviews point to the importance of safety within psychedelic therapy and research as it pertains to those experiencing suicidal thoughts or behaviours.

If you are not feeling yourself, are experiencing a crisis, have emotional pain or know someone who needs help, here are a few resources:

  • Crisis Services Canada and Canada Suicide Prevention Service: 1-833-456-4566 (24/7) or text 45645 (4pm–12am ET)
  • Kids Help Phone: 1-800-668-6868 (toll-free) or text CONNECT to 686868. Available 24 hours a day to Canadians aged 5 to 29 who want confidential and anonymous care from professional counsellors.
  • Hope for Wellness Help Line: 1-855-242-3310 (toll-free) or connect to the online Hope for Wellness chat. Available to all Indigenous peoples across Canada who need immediate crisis intervention. On request, telephone counselling is also available in Cree, Ojibway and Inuktitut. Experienced and culturally sensitive counsellors can help if you want to talk or are distressed. Telephone and online counselling are available in English and French.

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