Objective This study aimed to longitudinally investigate whether ever having used a psychedelic drug can have a protective effect on incidence of suicidality among marginalised women.
Design Longitudinal community-based cohort study.
Setting Data were drawn from a prospective, community-based cohort of marginalised women in Metro Vancouver, Canada.
Participants 766 women completed the baseline questionnaire between January 2010 and August 2014. Participants who did not report suicidality at baseline and who completed at least one follow-up visit were included.
Main outcome measure Extended Cox regression was used to model predictors of new suicidality (suicide ideation or attempts) over 54-month follow-up.
Results Nearly half (46%; n=355) of participants reported prior suicidality and were thus excluded from the present analyses. Of 290 women eligible at baseline, 11% (n=31) reported recent suicidality during follow-up, with an incidence density of 4.42 per 100 person-years (95% CI 3.10 to 6.30). In multivariable analysis, reported lifetime psychedelic drug use was associated with a 60% reduced hazard for suicidality (adjusted HR (AHR) 0.40; 95% CI 0.17 to 0.94). Crystal methamphetamine use (AHR 3.25; 95% CI 1.47 to 7.21) and childhood abuse (AHR 3.54; 95% CI 1.49 to 8.40) remained independent predictors of suicidality.
Conclusion The high rate of suicidality identified in this study is of major concern. Alongside emerging evidence on the potential of psychedelic-assisted therapy to treat some mental illness and addiction issues, our findings demonstrate that naturalistic psychedelic drug use is independently associated with reduced suicidality, while other illicit drug use and childhood trauma predispose women to suicidality. While observational, this study supports calls for further investigation of the therapeutic utility of psychedelic drugs in treating poor mental health and promoting mental wellness.
- sex workers
- mental health
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Contributors EA and KS conceptualised and designed the study. EA, SAS, MB and KS contributed to the interpretation and analysis of data. EA wrote the first draft of the manuscript. SAS, KT, MB, EW and KS contributed to reviewing and editing the manuscript. All authors critically revised the manuscript and approved the final draft. KS is the guarantor.
Funding This study was supported by the US National Institutes of Health (R01DA028648) and MacAIDS. KS is partially supported by a Canada Research Chair in Global Sexual Health and HIV/AIDS and the Michael Smith Foundation for Health Research. EA is supported by a Canadian Institutes of Health Research Doctoral Award. SAS is partially supported by a NIDA merit award (R37DA019829). EW is supported in part by a Tier 1 Canada Research Chair in Inner-City Medicine award. The study funders had no role in the study design, data collection, analysis, interpretation, writing of the report or decision to submit the paper for publication.
Competing interests All authors have completed the ICMJE uniform disclosure format www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.
Ethics approval This study holds ethical approval through Providence Health Care/University of British Columbia Research Ethics Board.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.