• There is little research on the risks and harms of psychedelics, especially the risk of extended difficulties or unwanted personality changes after psychedelics. 

• We asked whether people ever experienced difficulties lasting longer than a day following the consumption of psychedelic drugs; if so, what sort of difficulties and what if anything helped them cope with these difficulties. 

• We gathered quantitative and qualitative data through a mixed methods survey, analysing the types of difficulties people reported and what they found helpful in coping with them, via thematic analysis of their written responses.  

Main Findings: 

• We received 608 responses from people who reported difficulties lasting longer than a day. 

• A fifth of respondents said their difficulties lasted longer than a year, and a sixth said they lasted longer than three years. 

• The most commonly reported difficulties were anxiety, social disconnection, visual distortions, existential confusion, and derealization / depersonalisation. 

• The most commonly reported coping techniques were asking friends or loved ones for support, meditation and prayer, cognitive techniques like self-talk, and reading / journalling. Some said nothing helped. 

• Conclusion: Psychedelics can cause unexpected and unwanted challenges and personality changes lasting weeks, months, years or decades. More work needs to be done to communicate this to the public and more research needs to be done on what helps people experiencing these difficulties. 

Evans J, Robinson OC, Argyri EK, Suseelan S, Murphy-Beiner A, McAlpine R, et al. (2023) Extended difficulties following the use of psychedelic drugs: A mixed methods study. PLoS ONE 18(10): e0293349. https://doi.org/10.1371/journal.pone.0293349