Psychedelic hospitalizations have become a growing topic of interest as public attitudes and policies around substances like psilocybin and MDMA continue to evolve. With decriminalization efforts expanding and clinical research accelerating, many clinicians and policymakers are asking whether increased psychedelic use is leading to more emergency room visits or hospital admissions. A new national analysis suggests the answer, at least so far, is largely no.
Researchers publishing in JAMA Network Open examined trends in hallucinogen-related emergency department visits and hospitalizations across the United States from 2016 to 2023. Their findings indicate that even as psychedelic use has risen, serious adverse events requiring hospital care have remained relatively rare, especially when compared with substances such as alcohol, opioids, and stimulants.
How Researchers Studied Psychedelic Hospitalizations
To understand real-world safety trends, the research team analyzed large administrative health care databases, including commercial insurance and Medicaid claims. These datasets allowed investigators to track substance-related hospital admissions across millions of individuals aged 16 to 64, the age group most likely to engage in recreational or experimental substance use.
Hallucinogen-related admissions were identified using standardized ICD-10 diagnostic codes. Rather than simply counting raw numbers, the researchers calculated the proportion of all substance-related hospitalizations that involved hallucinogens. This approach helped account for broader changes in health care utilization over time and provided a clearer picture of relative risk.
Advanced statistical modeling was used to detect meaningful shifts in trends across the seven-year study period, including changes associated with the COVID-19 pandemic.
What The Data Revealed
Out of more than 1.3 million substance-related admissions, only about 1.6 percent involved hallucinogens. The typical patient admitted for a hallucinogen-related issue was relatively young, with a median age in the late twenties. Many had preexisting mental health conditions, including mood and anxiety disorders, and a smaller subset had schizophrenia-spectrum diagnoses.
While the share of psychedelic hospitalizations increased modestly from 2016 through early 2020, it peaked at just over one percent of all substance-related admissions. After that point, rates declined and stabilized through 2023. Even at their highest level, hallucinogens accounted for a very small fraction of overall substance-related hospital care.
By comparison, alcohol-related admissions made up nearly half of all substance-related hospitalizations at the start of the study and rose further over time. Opioids and stimulants also accounted for far more admissions than hallucinogens throughout the entire period.
How These Findings Fit With Clinical Research
The low rate of psychedelic hospitalizations aligns with data from controlled clinical trials, where serious adverse events such as persistent psychosis are uncommon when participants are carefully screened and supported. The new findings extend this safety signal into broader real-world settings, suggesting that even outside clinical environments, severe outcomes remain infrequent at the population level.
That said, hospitalization data only capture the most serious reactions. Challenging psychedelic experiences that are managed by peers or nonmedical supports do not appear in these records. As a result, the absence of rising hospitalizations should not be interpreted as proof that unsupervised psychedelic use is risk free.
Implications For Public Health And Clinical Care
For clinicians, these findings provide important context when discussing risk with patients who are curious about psychedelics. For policymakers, the data suggest that the public health burden of hallucinogens is currently small relative to legal substances like alcohol. As psychedelic-assisted therapies move closer to mainstream clinical use, continued monitoring will be essential, especially as access expands beyond tightly controlled research settings.
Understanding psychedelic hospitalizations within the broader landscape of substance-related harm helps ground the conversation in evidence rather than fear. Ongoing research will play a key role in shaping safe, responsible approaches to both recreational policy and therapeutic implementation.
Citations
- Steinle JT, Gong L, Buss JL, et al. Trends in hallucinogen-related emergency department and hospital admissions, 2016 to 2023. JAMA Network Open. 2026;9(1):e245xxxx. https://jamanetwork.com/journals/jamanetworkopen
- Nichols DE. Psychedelics. Pharmacological Reviews. 2016;68(2):264–355. https://pharmrev.aspetjournals.org/content/68/2/264