Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey

Background Observational data and preliminary studies suggest serotonin 2A agonist psychedelics may hold potential in treating a variety of substance use disorders (SUDs), including opioid use disorder (OUD). Aims The study aim was to describe and analyze self-reported cases in which naturalistic psychedelic use was followed by cessation or reduction in other substance use. Methods An anonymous online survey of individuals reporting cessation or reduction in cannabis, opioid, or stimulant use following psychedelic use in non-clinical settings. Results Four hundred forty-four respondents, mostly in the USA (67%) completed the survey. Participants reported 4.5 years of problematic substance use on average before the psychedelic experience to which they attributed a reduction in drug consumption, with 79% meeting retrospective criteria for severe SUD. Most reported taking a moderate or high dose of LSD (43%) or psilocybin-containing mushrooms (29%), followed by significant reduction in drug consumption. Before the psychedelic experience 96% met SUD criteria, whereas only 27% met SUD criteria afterward. Participants rated their psychedelic experience as highly meaningful and insightful, with 28% endorsing psychedelic-associated changes in life priorities or values as facilitating reduced substance misuse. Greater psychedelic dose, insight, mystical-type effects, and personal meaning of experiences were associated with greater reduction in drug consumption. Conclusions While these cross-sectional and self-report methods cannot determine whether psychedelics caused changes in drug use, results suggest the potential that psychedelics cause reductions in problematic substance use, and support additional clinical research on psychedelic-assisted treatment for SUD.

Thank you for your interest in this questionnaire study on the potential relationship between psychedelic experiences and reduction or cessation of addictive behaviors. This research is being conducted by scientists at Johns Hopkins University School of Medicine and has been approved by the Johns Hopkins University Institutional Review Board (IRB).

Our Previous Research
Our research team has conducted surveys characterizing positive and challenging experiences after taking psychedelics in nonlaboratory settings, as well as instances in which taking a psychedelic was associated with a cessation or reduction in cigarette smoking. We've also studied both positive and psychologically difficult experiences, as well as headaches, after giving psilocybin to volunteers in our laboratory.

Purpose of This Study
The goal of this survey is to learn more about whether use of psychedelic drugs may be associated with reduction or cessation of addictive behaviors. We want to characterize people's experiences in nonlaboratory settings in which taking a psychedelic may have led to reducing or quitting alcohol or another drug. For the purposes of this survey, we will be asking specifically about individuals who have quit or reduced using alcohol, opioids (heroin, morphine, hydrocodone, oxycodone, codeine, Oxycontin, Vicodin, Percocet, etc.), stimulants (cocaine, methamphetamine, amphetamine, methylphenidate, Adderall, Ritalin, Dexedrine, etc.), or cannabis after a psychedelic experience. For example, if you had an alcohol abuse problem that improved after a psychedelic experience, you would be a good candidate for this study. For the purposes of this survey, a psychedelic experience can refer to an experience with psilocybin (magic) mushrooms, LSD, morning glory seeds, mescaline, peyote cactus, San Pedro cactus, DMT, Ayahuasca, or MDMA (ecstasy).

Inclusion Criteria
You are invited to participate in this survey if you fulfill all of the four criteria listed below. 1) You are at least 18 years old.
2) You read and write English fluently.
3) You have taken a psychedelic drug outside of an official university or hospital study, and 4) You experienced a reduction in addictive behavior (alcohol or other drug use) after taking a psychedelic.

What the Study Entails
Participation in this study involves filling out an online survey that will take approximately 35 minutes. You will be required to complete the survey in one sitting. At the conclusion of the main survey you will be invited to participate in an optional extension of the survey that will ask some more detailed questions and take about 10 minutes to complete in addition to the main survey. These additional questions are completely optional, and you are free to accept or decline to respond to these as you choose.

Why should I participate?
We believe that this study is scientifically important. We would like you to participate because we need to collect responses from many different people. You may find this survey interesting. There is also a chance that you will be bored. Although there is no monetary compensation for participation, you will be making a unique and important contribution to science.
other Is my participation confidential?
Yes. We do not collect identifying information such as your name, email address, or IP address. Your anonymous responses will be seen and analyzed by Johns Hopkins staff or representatives. To further protect the confidentiality of participants, the results of most questions will be presented in aggregate. We may quote from your textual responses.
However, if you provide specific identifying information, we will edit your responses to protect your confidentiality.
What kind of information will I be providing?
At the beginning of the survey, you will be asked questions about your background, alcohol and drug use history.
Psychological questionnaires are also included to assess relationships between constructs of interest like personality, and their relevance to addiction and/or drug use. Finally, we will be collecting detailed information about your alcohol or other drug use patterns before and after the psychedelic experience, as well as information on the nature of your psychedelic experience, and why it may have led to a change in your alcohol or other drug use.
What will become of the results from this study?
The researchers intend to publish the results from this study in the scientific literature and to present results at scientific meetings. We will also make the results publicly available by posting a notice of any scholarly publications on the website of the Council on Spiritual Practices (www.csp.org).
Your responses will not be used in this study if you do not complete the survey.
Your participation in this study is voluntary. Your completing the survey will serve as your consent to be in the study.
Even after you begin the survey, you may stop answering the questions at any time. If you stop early, none of your responses will be used. At the end of the main survey, you will have a final opportunity to consent, or not, to all of your responses being submitted. At that time you will be invited to continue on to some additional questions that will assess your decision making process. These extra questions are optional. If you begin them then decide to quit before finishing, your responses to the earlier parts of the survey will already be recorded, and will still be used for the research study.

How do I start?
You can begin the survey by clicking 'Begin survey' at the bottom of this page. This survey will take approximately 35 minutes, with the option to respond to some additional questions at the end. You will be required to complete the survey in one sitting.
It is important that you complete the survey only once, and that you answer each question honestly and seriously. If you are not ready to complete the survey now, please return to this page at a time that is convenient for you.
You can exit the survey at any time by clicking the link in the upper right corner of your screen. If you exit the survey early, your responses will not be used.
During the survey, please do not hit the "back" button on your internet browser as it may erase your answers or prematurely terminate your session.
By clicking 'Begin survey' below, you affirm that: l you have read the information above, l you voluntarily agree to participate, l you are at least 18 years old, l you read and write English fluently, l you have taken a psychedelic substance outside of an official university or hospital study, and l you experienced a reduction in addictive behavior (alcohol or other drug use) after taking a psychedelic.   86. On approximately how many separate occasions have you taken each of these substances during your lifetime?
87. How old were you when you first took a psychedelic substance? For the purposes of this survey, please count only the following substances: psilocybin (magic) mushrooms, LSD, morning glory seeds, mescaline, peyote cactus, San Pedro cactus, DMT, Ayahuasca, or MDMA (ecstasy, Molly).
88. When did you last use a psychedelic substance? For the purposes of this survey, please count only the following substances: psilocybin (magic) mushrooms, LSD, morning glory seeds, mescaline, peyote cactus, San Pedro cactus, DMT, Ayahuasca, or MDMA (ecstasy, Molly). In the past 10 years n m l k j More than 10 years ago n m l k j 89. How much distress or dysfunction have you experienced during your lifetime as a result of your use of the following drugs? By distress or dysfunction, we mean any significant problems in your personal relationships, work, or home life that may have been caused by use of these substances.
For the next portion of the survey, we will be asking you to focus on a specific substance you deemed to be most problematic in your life (either alcohol, opioids, stimulants, or cannabis), and a particular psychedelic experience that seemed to help you stop or reduce your use of that substance.
If your psychedelic experience helped you to cut down or quit using several substances, you will be able to comment on that in later sections. However, for now we would like you to focus on just one of these substances that you were able to reduce or stop using after a psychedelic experience: alcohol, opioids, stimulants, or cannabis. 90. Which of these substances did you reduce or stop using after a psychedelic experience?
For this section we would like you to focus on just one psychedelic experience that you deemed to be most important in affecting a decrease in your alcohol use. If you reduced your alcohol use after multiple psychedelic experiences, you will be able to provide more information on the substances, doses, and sequence of events in later sections. 91. How long ago did the psychedelic experience that led to your quitting or reducing alcohol occur? 92. Please characterize your alcohol consumption after this psychedelic experience.   Stopped drinking completely for a period of time, then returned to drinking the same amount as before. n m l k j Reduced drinking for a period of time, then returned to drinking the same amount as before.   Recreational (e.g., to enjoy the experience, which may or may not involve a social recreational event such as a concert).
g f e d c A serious intention for psychological selfexploration (e.g., resolve a personal issue or to increase self understanding).
g f e d c A serious intention to explore spirituality or the sacred (e.g., to contemplate God, as you understand that word, or the nature of ultimate reality, and so on).
124. You are convinced now, as you look back on your experience, that in it you encountered ultimate reality (i.e., that you "knew" and "saw" what was really real).
128. Sense of awe or awesomeness.
129. Experience of unity with ultimate reality.
130. Feeling that it would be difficult to communicate your own experience to others who have not had similar experiences.

Feelings of joy.
The purpose of the following questions is to obtain your retrospective assessment of the psychedelic experience that led to your alcohol use reduction, and your contemplation of that experience. For all questions on this page, please choose the highest rating that applies. 132. How personally meaningful were the psychedelic experience that led to your alcohol use reduction, and your contemplation of that experience?
133. Indicate the degree to which the psychedelic experience that led to your alcohol use reduction, and your contemplation of that experience, were spiritually significant to you.
134. How psychologically challenging was the most psychologically challenging portion of the psychedelic experience that led to your alcohol use reduction?
No more than routine, everyday experiences n m l k j Similar to meaningful experiences that occur on average once or more a week n m l k j Similar to meaningful experiences that occur on average once a month n m l k j Similar to meaningful experiences that occur on average once a year n m l k j Similar to meaningful experiences that occur on average once every 5 years 135. How psychologically insightful to you were the psychedelic experience that led to your alcohol use reduction, and your contemplation of that experience?
136. Do you believe that the psychedelic experience that led to your alcohol use reduction, and your contemplation of that experience, have led to change in your current sense of personal wellbeing or life satisfaction?
No more than routine, everyday psychologically insightful experiences n m l k j Similar to psychologically insightful experiences that occur on average once or more a week n m l k j Similar to psychologically insightful experiences that occur on average once a month n m l k j Similar to psychologically insightful experiences that occur on average once a year n m l k j Similar to psychologically insightful experiences that occur on average once every 5 years 137. Please rank items in order of their importance to your psychedelicassociated alcohol abstinence or reduction.
138. Please describe any additional reasons (not listed above) that your psychedelic experience may have contributed to your quitting or reducing alcohol. 6 Strengthening your belief in your own ability to quit. Increasing space between the experience of craving and taking action. 139. Did you experience any other behavioral changes after this psychedelic session? Check all that apply, and please provide any relevant details in the Comments box below.
140. Did you experience any persisting negative effects from this psychedelic experience? By persisting, we mean negative effects that lasted beyond the acute period of drug effects. 142. Overall, how would you rate the severity of these negative effects?
The following questions pertain to your alcohol use in the year prior to your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question.
143. In the year prior to your psychedelicassociated alcohol use reduction, approximately how many alcoholic drinks did you consume per week?
144. In the year prior to your psychedelicassociated alcohol use reduction, how often did you have a drink containing alcohol? In the year prior to your psychedelicassociated alcohol use reduction, how many drinks containing alcohol did you have on a typical day when you were drinking?
146. During the year prior to your psychedelicassociated alcohol use reduction...

147.
During the year prior to your psychedelicassociated alcohol use reduction, were you or someone else injured because of your drinking?
148. During the year prior to your psychedelicassociated alcohol use reduction, was a relative, friend, doctor, or other health worker concerned about your drinking, or suggest that you should cut down?

Frequency
How often during the year prior to your psychedelicassociated alcohol use reduction did you have six or more drinks on one occasion? 6 How often during the year prior to your psychedelicassociated alcohol use reduction did you find that you were not able to stop drinking once you had started? In the year prior to your psychedelicassociated alcohol use reduction, please indicate whether each of the following was true or false regarding your alcohol use.

True False
In the year prior to my psychedelic experience, I often consumed alcohol in larger amounts or over a longer period than intended.
n m l k j n m l k j In the year prior to my psychedelic experience, I had a persistent desire or unsuccessful efforts to cut down or control alcohol use.
n m l k j n m l k j In the year prior to my psychedelic experience, I spent a great deal of time in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
n m l k j n m l k j In the year prior to my psychedelic experience, I experienced craving, or a strong desire or urge to use alcohol. In the year prior to my psychedelic experience, I continued using alcohol despite knowledge of having a persistent or recurrent physical or psychological problem that was likely to have been caused or exacerbated by alcohol. 150. Listed below are questions that ask about your feelings about drinking in the year prior to your psychedelicassociated alcohol use reduction. The words "drinking" and "have a drink" refer to having a drink containing alcohol such as beer, wine, or liquor. Please indicate how much you would have agreed or disagreed with each of the following statements in the year before your psychedelic experience by selecting one response for each question between STRONGLY DISAGREE and STRONGLY AGREE. Please complete every item. We are interested in how you were thinking or feeling generally during the year prior to your psychedelicassociated alcohol use reduction.
The following questions pertain to your alcohol use in the time since your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question.
151. In the period of time since your psychedelicassociated alcohol use reduction, approximately how many alcoholic drinks have you consumed per week?
152. In the period of time since your psychedelicassociated alcohol use reduction, how often did you have a drink containing alcohol?

Response
All I would have wanted to do was have a drink.

6
I would not have needed to have a drink. 6 It would have been difficult to turn down a drink.

6
Having a drink would have made things seem perfect.

6
I would have wanted a drink so bad, I could almost taste it.

6
Nothing would have tasted better than a drink.

6
If I had the chance to have a drink, I don't think I would have drank it.

6
I would have craved a drink.  How often in the period of time since your psychedelic experience did you need a first drink in the morning to get yourself going after a heavy drinking session or to steady your nerves? 157. In the time since your psychedelicassociated alcohol cessation or reduction, please indicate whether each of the following was true or false regarding your alcohol use.

True False
In the time since my psychedelic experience, I often consumed alcohol in larger amounts or over a longer period than intended. 158. Listed below are questions that ask about your feelings about drinking right now. The words "drinking" and "have a drink" refer to having a drink containing alcohol such as beer, wine, or liquor. Please indicate how much you agree or disagree with each of the following statements by selecting one response for each question between STRONGLY DISAGREE and STRONGLY AGREE. Please complete every item. We are interested in how you are thinking or feeling right now.
159. Have you had any alcoholic beverages...
160. How old were you when you first started drinking alcohol?
161. How many years do you think you had a "drinking problem" before quitting or reducing your alcohol use?

Response
All I want to do now is have a drink.

6
I do not need to have a drink right now.

6
It would be difficult to turn down a drink this minute.

6
Having a drink right now would make things seem perfect.

6
I want a drink so bad I can almost taste it.

6
Nothing would be better than a drink right now.

6
If I had the chance to have a drink, I don't think I would drink it.

6
I crave a drink right now. Other (please specify)

Other
Other 162. Prior to your psychedelic experience, which of the following did you use in your efforts to quit or reduce drinking? (Check all that apply): 163. Prior to your psychedelicassociated alcohol use reduction, how many times in your life had you made a serious attempt to quit drinking (i.e., attempts lasting at least 1 day)?
164. Other than your psychedelicassociated alcohol use reduction, what was the longest period of time that you were able to refrain from drinking alcohol? 165. Some people report withdrawal symptoms (like the ones listed below) immediately upon stopping or reducing their regular alcohol use. After your psychedelicassociated alcohol use reduction, how serious were each of the following problems in comparison to your previous quit attempts? 166. Would you say your quitting or reducing alcohol was the result of a single or multiple psychedelic sessions?

Not Applicable
167. If your alcohol cessation or reduction was the result of multiple psychedelic sessions, please briefly describe the process, including substances ingested, number of sessions, and length of time between sessions.
For this section we would like you to focus on just one psychedelic experience that you deemed to be most important in affecting a decrease in your opioid use. If you reduced your opioid use after multiple psychedelic experiences, you will be able to provide more information on the substances, doses, and sequence of events in later sections. Greatly reduced using opioids since the experience.
n m l k j Reduced using opioids somewhat since the experience.
n m l k j Stopped using opioids completely for a period of time, then returned to using the same amount as before.
n m l k j Reduced using opioids for a period of time, then returned to using the same amount as before. Recreational (e.g., to enjoy the experience, which may or may not involve a social recreational event such as a concert).
g f e d c A serious intention for psychological selfexploration (e.g., resolve a personal issue or to increase self understanding).
g f e d c A serious intention to explore spirituality or the sacred (e.g., to contemplate God, as you understand that word, or the nature of ultimate reality, and so on).
g f e d c A premeditated intention to quit or reduce your opioid use. 178. Please provide a brief description of the psychedelic experience that led to your quitting or reducing your opioid use.
Looking back on the entirety of the psychedelic session that occurred prior to your opioid reduction or cessation, please rate the degree to which at any time during that session you experienced the following phenomena. Answer each question according to your feelings, thoughts, and experiences at the time of the psychedelic session.
179. Loss of your usual sense of time.
187. Certainty of encounter with ultimate reality (in the sense of being able to "know" and "see" what is really real at some point during your experience).
188. Feeling that you could not do justice to your experience by describing it in words. 207. Feeling that it would be difficult to communicate your own experience to others who have not had similar experiences.
The purpose of the following questions is to obtain your retrospective assessment of the psychedelic experience that led to your opioid use reduction, and your contemplation of that experience. For all questions on this page, please choose the highest rating that applies. 209. How personally meaningful were the psychedelic experience that led to your opioid use reduction, and your contemplation of that experience?
210. Indicate the degree to which the psychedelic experience that led to your opioid use reduction, and your contemplation of that experience, were spiritually significant to you.
211. How psychologically challenging was the most psychologically challenging portion of the psychedelic experience that led to your opioid use reduction?
No more than routine, everyday experiences n m l k j Similar to meaningful experiences that occur on average once or more a week 212. How psychologically insightful to you were the psychedelic experience that led to your opioid use reduction, and your contemplation of that experience?
213. Do you believe that the psychedelic experience that led to your opioid use reduction, and your contemplation of that experience, have led to change in your current sense of personal wellbeing or life satisfaction?
No more than routine, everyday psychologically insightful experiences n m l k j Similar to psychologically insightful experiences that occur on average once or more a week n m l k j Similar to psychologically insightful experiences that occur on average once a month 214. Please rank items in order of their importance to your psychedelicassociated opioid abstinence or reduction.
215. Please describe any additional reasons (not listed above) that your psychedelic experience may have contributed to your quitting or reducing your opioid use.

6
Strengthening your belief in your own ability to quit. Increasing space between the experience of craving and taking action. 216. Did you experience any other behavioral changes after this psychedelic session? Check all that apply, and please provide any relevant details in the Comments box below.
217. Did you experience any persisting negative effects from this psychedelic experience? By persisting, we mean negative effects that lasted beyond the acute period of drug effects. 219. Overall, how would you rate the severity of these negative effects?
The following questions pertain to your opioid use in the year prior to your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question.
220. What was your opioid of choice and preferred route of administration? Other (please specify)

221.
In the year prior to your psychedelicassociated opioid use reduction, how often did you use opioids? 222.
In the year prior to your psychedelicassociated opioid use reduction, how many times would you take opioids on a typical day when you were using?
223. During the year prior to your psychedelicassociated opioid use reduction...

224.
During the year prior to your psychedelicassociated opioid use reduction, were you or someone else injured because of your opioid use?

Frequency
How often in the year prior to your psychedelic experience did you use a noticeable psychoactive dose of opioids?

6
How often in the year prior to your psychedelic experience did you find that you used more opioids than you thought you would? During the year prior to your psychedelicassociated opioid use reduction, was a relative, friend, doctor, or other health worker concerned about your opioid use, or suggest that you should cut down? 226.
In the year prior to your psychedelicassociated opioid use reduction, please indicate whether each of the following was true or false regarding your opioid use.

True False
In the year prior to my psychedelic experience, I often used larger amounts of opioids or used over a longer period than intended.
n m l k j n m l k j In the year prior to my psychedelic experience, I had a persistent desire or unsuccessful efforts to cut down or control opioid use. 227. Listed below are questions that ask about your feelings about using opioids in the year prior to your psychedelicassociated opioid use reduction. The word "using" refers to taking opioids in order to get high or to "stay regular." Please indicate how much you would have agreed or disagreed with each of the following statements in the year before your psychedelic experience by selecting one response for each question between STRONGLY DISAGREE and STRONGLY AGREE. Please complete every item. We are interested in how you were thinking or feeling generally during the year prior to your psychedelic associated opioid use reduction.
The following questions pertain to your opioid use in the time since your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question.
228. In the period of time since your psychedelicassociated opioid use reduction, how often did you use opioids?
229. In the period of time since your psychedelicassociated opioid use reduction, how many times did you take opioids on a typical day when you were using?

Response
All I would have wanted to do was to use opioids.

6
I would not have needed to use opioids. 6 It would have been difficult to turn down opioids.

6
Using opioids would have made things seem perfect.

6
I would have wanted to use opioids so bad, I could almost taste it.

6
Nothing would have felt better than using opioids.

6
If I had the chance to use opioids, I don't think I would have. 233. In the time since your psychedelicassociated opioid cessation or reduction, please indicate whether each of the following was true or false regarding your opioid use.

True False
In the time since my psychedelic experience, I often took opioids in larger amounts or over a longer period than was intended. 234. Listed below are questions that ask about your feelings about using opioids right now. The word "using" refers to taking an opioid to get high or "stay regular." Please indicate how much you agree or disagree with each of the following statements by selecting one response for each question between STRONGLY DISAGREE and STRONGLY AGREE. Please complete every item. We are interested in how you are thinking or feeling right now.
236. How old were you when you first started using opioids?
237. How many years do you think you had an "opioid problem" before quitting or reducing your opioid use?

Response
All I want to do now is use opioids.

6
I do not need to use opioids right now.
6 It would be difficult to turn down opioids this minute.

6
Using opioids right now would make things seem perfect.
6 I want to use opioids so bad I can almost taste it.

6
Nothing would be better than using opioids right now.

6
If I had the chance to use opioids now, I don't think I would.
6 I crave opioids right now. Other (please specify) Other 238. Prior to your psychedelic experience, which of the following did you use in your efforts to quit or reduce opioid use? (Check all that apply): 239. Prior to your psychedelicassociated opioid use reduction, how many times in your life had you made a serious attempt to quit using (i.e., attempts lasting at least 1 day)?
240. Other than your psychedelicassociated opioid use reduction, what was the longest period of time that you were able to refrain from using opioids?  For this section we would like you to focus on just one psychedelic experience that you deemed to be most important in affecting a decrease in your stimulant use. If you reduced your stimulant use after multiple psychedelic experiences, you will be able to provide more information on the substances, doses, and sequence of events in later sections.
244. What was your stimulant of choice and preferred route of administration? Greatly reduced using stimulants since the experience.
n m l k j Reduced using stimulants somewhat since the experience.
n m l k j Stopped using stimulants completely for a period of time, then returned to using the same amount as before.
n m l k j Reduced using stimulants for a period of time, then returned to using the same amount as before. Recreational (e.g., to enjoy the experience, which may or may not involve a social recreational event such as a concert).
g f e d c A serious intention for psychological selfexploration (e.g., resolve a personal issue or to increase self understanding).
g f e d c A serious intention to explore spirituality or the sacred (e.g., to contemplate God, as you understand that word, or the nature of ultimate reality, and so on).
g f e d c A premeditated intention to quit or reduce your stimulant use. 254. After your psychedelic experience, did you use any other methods to help maintain stimulant abstinence or reduction? (Check all that apply): 255. Please provide a brief description of the psychedelic experience that led to your quitting or reducing your stimulant use. Looking back on the entirety of the psychedelic session that occurred prior to your stimulant reduction or cessation, please rate the degree to which at any time during that session you experienced the following phenomena. Answer each question according to your feelings, thoughts, and experiences at the time of the psychedelic session.
256. Loss of your usual sense of time.
258. Sense that the experience cannot be described adequately in words. 278. You are convinced now, as you look back on your experience, that in it you encountered ultimate reality (i.e., that you "knew" and "saw" what was really real).

Gain of insightful knowledge experienced at an intuitive level.
279. Feeling that you experienced something profoundly sacred and holy. 287. Indicate the degree to which the psychedelic experience that led to your stimulant use reduction, and your contemplation of that experience, were spiritually significant to you.
288. How psychologically challenging was the most psychologically challenging portion of the psychedelic experience that led to your stimulant use reduction?
289. How psychologically insightful to you were the psychedelic experience that led to your stimulant use reduction, and your contemplation of that experience?  Increasing space between the experience of craving and taking action. 293. Did you experience any other behavioral changes after this psychedelic session? Check all that apply, and please provide any relevant details in the Comments box below. 294. Did you experience any persisting negative effects from this psychedelic experience? By persisting, we mean negative effects that lasted beyond the acute period of drug effects.
295. Please describe any negative or potentially negative persisting effects you may have experienced as a result of this psychedelic session.
296. Overall, how would you rate the severity of these negative effects?
The following questions pertain to your stimulant use in the year prior to your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question. In the year prior to your psychedelicassociated stimulant use reduction, how often did you use stimulants? 298.
In the year prior to your psychedelicassociated stimulant use reduction, how many times would you take stimulants on a typical day when you were using?
299. During the year prior to your psychedelicassociated stimulant use reduction...

300.
During the year prior to your psychedelicassociated stimulant use reduction, were you or someone else injured as a result of your stimulant use?

Frequency
How often during the year prior to your psychedelic experience did you use a noticeable psychoactive dose of a stimulant drug?

6
How often during the year prior to your psychedelic experience did you find that you used more stimulants than you thought you would? During the year prior to your psychedelicassociated stimulant use reduction, was a relative, friend, doctor, or other health worker concerned about your stimulant use, or suggest that you should cut down?
302. In the year prior to your psychedelicassociated stimulant cessation or reduction, please indicate whether each of the following was true or false regarding your stimulant use.

True False
In the year prior to my psychedelic experience, I often used larger amounts of stimulants or used over a longer period than intended. 303. Listed below are questions that ask about your feelings about using stimulants in the year prior to your psychedelicassociated stimulant use reduction. The word "using" refers to taking stimulants in order to get high or to "stay regular." Please indicate how much you would have agreed or disagreed with each of the following statements in the year before your psychedelic experience by selecting one response for each question between STRONGLY DISAGREE and STRONGLY AGREE. Please complete every item. We are interested in how you were thinking or feeling generally during the year prior to your psychedelic associated stimulant use reduction.
The following questions pertain to your stimulant use in the time since your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question.
304. In the period of time since your psychedelicassociated stimulant use reduction, how often did you use stimulants?
305. In the period of time since your psychedelicassociated stimulant use reduction, how many times did you take stimulants on a typical day when you were using?
306. In the period of time since your psychedelicassociated stimulant use reduction...

307.
In the period of time since your psychedelicassociated stimulant use reduction, were you or someone else injured because of your stimulant use?
308. In the period of time since your psychedelicassociated stimulant use reduction, has a relative, friend, doctor, or other health worker been concerned about your stimulant use, or suggest that you should cut down?

Frequency
How often in the period of time since your psychedelic experience did you take a noticeable psychoactive dose of a stimulant drug? 6 How often in the period of time since your psychedelic experience did you take more stimulants than you thought you would? 310. Listed below are questions that ask about your feelings about using stimulants right now. The word "using" refers to taking a stimulant to get high or "stay regular." Please indicate how much you agree or disagree with each of the following statements by selecting one response for each question between STRONGLY DISAGREE and STRONGLY AGREE. Please complete every item. We are interested in how you are thinking or feeling right now.

312.
How old were you when you first started using stimulants?
313. How many years do you think you had a "stimulant problem" before quitting or reducing your stimulant use?

Response
All I want to do now is use stimulants.

6
I do not need to use stimulants right now.
6 It would be difficult to turn down stimulants this minute.

6
Using stimulants right now would make things seem perfect.
6 I want to use stimulants so bad I can almost taste it.

6
Nothing would be better than using stimulants right now.

6
If I had the chance to use stimulants now, I don't think I would.
6 I crave stimulants right now. Other (please specify) Other Other / 314. Prior to your psychedelic experience, which of the following did you use in your efforts to quit or reduce your stimulant use? (Check all that apply): 315. Prior to your psychedelicassociated stimulant use reduction, how many times in your life had you made a serious attempt to quit taking stimulants (i.e., attempts lasting at least 1 day)?
316. Other than your psychedelicassociated stimulant use reduction, what was the longest period of time that you were able to refrain from taking stimulants? For this section we would like you to focus on just one psychedelic experience that you deemed to be most important in affecting a decrease in your cannabis use. If you reduced your cannabis use after multiple psychedelic experiences, you will be able to provide more information on the substances, doses, and sequence of events in later sections. Recreational (e.g., to enjoy the experience, which may or may not involve a social recreational event such as a concert).
g f e d c A serious intention for psychological selfexploration (e.g., resolve a personal issue or to increase self understanding).
g f e d c A serious intention to explore spirituality or the sacred (e.g., to contemplate God, as you understand that word, or the nature of ultimate reality, and so on).
g f e d c A premeditated intention to quit or reduce your cannabis use. 329. After your psychedelic experience, did you use any other methods to help maintain cannabis abstinence or reduction? (Check all that apply): 330. Please provide a brief description of the psychedelic experience that led to your quitting or reducing cannabis. 359. Feeling that it would be difficult to communicate your own experience to others who have not had similar experiences.
The purpose of the following questions is to obtain your retrospective assessment of the psychedelic experience that led to your cannabis use reduction, and your contemplation of that experience. For all questions on this page, please choose the highest rating that applies.
361. How personally meaningful were the psychedelic experience that led to your cannabis use reduction, and your contemplation of that experience? 362. Indicate the degree to which the psychedelic experience that led to your cannabis use reduction, and your contemplation of that experience, were spiritually significant to you.
363. How psychologically challenging was the most psychologically challenging portion of the psychedelic experience that led to your cannabis use reduction?
364. How psychologically insightful to you were the psychedelic experience that led to your cannabis use reduction, and your contemplation of that experience?  Increasing space between the experience of craving and taking action. 369. Did you experience any persisting negative effects from this psychedelic experience? By persisting, we mean negative effects that lasted beyond the acute period of drug effects.
370. Please describe any negative or potentially negative persisting effects you may have experienced as a result of this psychedelic session.
371. Overall, how would you rate the severity of these negative effects?
The following questions pertain to your cannabis use in the year prior to your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question. During the year prior to your psychedelicassociated cannabis use reduction, was a relative, friend, doctor, or other health worker concerned about your cannabis use, or suggest that you should cut down?
377. In the year prior to your psychedelicassociated cannabis use reduction, please indicate whether each of the following was true or false regarding your cannabis use.

True False
In the year prior to my psychedelic experience, I often smoked/consumed cannabis in larger amounts or over a longer period than intended.
n m l k j n m l k j In the year prior to my psychedelic experience, I had a persistent desire or unsuccessful efforts to cut down or control my cannabis use.
n m l k j n m l k j In the year prior to my psychedelic experience, I spent a great deal of time in activities necessary to obtain cannabis, use cannabis, or recover from its effects.
n m l k j n m l k j In the year prior to my psychedelic experience, I experienced craving, or a strong desire or urge to use cannabis. In the year prior to my psychedelic experience, I continued using cannabis despite knowledge of having a persistent or recurrent physical or psychological problem that was likely to have been caused or exacerbated by cannabis.   378. Listed below are questions that ask about your feelings about using cannabis in the year prior to your psychedelicassociated cannabis use reduction. The word "using" refers to smoking cannabis or eating anything containing cannabis in order to get high or to "stay regular." Please indicate how much you would have agreed or disagreed with each of the following statements in the year before your psychedelic experience by selecting one response for each question between STRONGLY DISAGREE and STRONGLY AGREE. Please complete every item. We are interested in how you were thinking or feeling generally during the year prior to your psychedelicassociated cannabis use reduction.
The following questions pertain to your cannabis use in the time since your psychedelic experience. Your answers will remain confidential so please be honest. Select the options that best describe your answer to each question.
379. In the period of time since your psychedelicassociated cannabis use reduction, how often did you smoke/consume cannabis?
380. In the period of time since your psychedelicassociated cannabis use reduction, how many times did you smoke/consume cannabis on a typical day when you were using?

Response
All I would have wanted to do was to use cannabis.
384. In the time since your psychedelicassociated cannabis use reduction, please indicate whether each of the following was true or false regarding your cannabis use.

True False
In the time since my psychedelic experience, I often smoked/consumed cannabis in larger amounts or over a longer period than intended.   Great! You've completed the majority of the main survey. Just a few more pages to go. These next two sections will assess some personality and dispositional tendencies that may be associated with drug use and altered states of consciousness.
Select whether each item is true or false for you regarding your general experiences in day to day life.
395. Sometimes I feel and experience things as I did when I was a child.
396. I can be greatly moved by eloquent or poetic language.   412. I am able to wander off into my thoughts while doing a routine task and actually forget that I am doing the task, and then find a few minutes later that I have completed it.
413. I can sometimes recollect certain past experiences in my life with such clarity and vividness that it is like living them again or almost so.
414. Things that might seem meaningless to others often make sense to me. 415. While acting in a play I think I could really feel the emotions of the character and "become" her/him for the time being, forgetting both myself and the audience.
416. My thoughts often don't occur as words but as visual images.
417. I often take delight in small things (like the fivepointed star shape that appears when you cut an apple across the core or the colors in soap bubbles).
418. When listening to organ music or other powerful music I sometimes feel as if I am being lifted into the air.
419. Sometimes I can change noise into music by the way that I listen to it.   433. I prefer to analyze problems rather than just describe them.
434. When I am upset, I don't know if I am sad, frightened, or angry.
435. I am often puzzled by sensations in my body. 451. Do you have anything to add about psychedelics or your experiences using them that you think would be valuable to know?
452. Thank you very much for your time and participation! You have completed the initial part of the survey, providing us with critical information about the experience of quitting or reducing alcohol or other drug use after a psychedelic experience. At this point you are invited to continue to answer some additional questions that could further help us to characterize this phenomenon. These questions will ask you to make some decisions regarding money and health. If you are interested in continuing with this optional part of the survey, which should take about 10 more minutes to complete, please choose Yes. If not, please choose No to submit your previous responses, and officially exit and complete the survey. If you begin the next part of the survey and then decide to quit before completing it, your previous answers will still be used for our research. Thank you! For each of the next 9 choices, please choose which reward you would prefer: the smaller reward today, or the larger reward in the specified number of days. Please take the choices seriously. Although the choices are pretend and you won't receive the money, please make each decision as if it were really for money. For each of the next 9 choices, please choose which reward you would prefer: the smaller reward today, or the larger reward in the specified number of days. Please take the choices seriously. Although the choices are pretend and you won't receive the consequences, please make each decision as if it were for real consequences.
For these questions you will be asked about your preference for durations of improved health. By improved health, we mean that you are less likely to catch a cold or other infection, you get better quality sleep, you feel more well rested and energetic, you have less of a cough, and you feel more fit overall.