Most U.S. adults have experienced at least one significant adverse outcome such as chest pain, memory problems, paranoia, or suicidal thoughts after using psychedelic or entactogen drugs—with ibogaine and 5-Me-O-DMT (aka mebufotenin or "toad venom") associated with the most side effects. These survey findings were published yesterday in JAMA Network Open.Why It’s Relevant
Psychedelics and entactogens have shown promise for the treatment of psychiatric disorders in clinical trials, and psilocybin appears to be moving toward Food and Drug Administration approval. Yet the safety findings of those trials, which involve controlled doses of pure medication and exclude people with psychotic disorders, may not translate to the general population.
By the Numbers
- Based on responses from 1,964 U.S. adults, researchers extrapolated that population-wide, 0.2% used ibogaine, 0.3% used 5-Me-O-DMT, 1% used LSD, 1.5% used MDMA (ecstasy), and 3.1% used psilocybin in the past year.
- Most adults who took these drugs reported experiencing at least one of 13 adverse events, ranging from 76% of those taking psilocybin to 95% of those taking 5-Me-O-DMT.
- Each of the 13 side effects were most common following ibogaine or 5-MeO-DMT use. For example, thoughts of death or suicide were endorsed by 59% of ibogaine users and 37% of 5-Me-O-DMT users.
- For psilocybin, LSD, and MDMA, far more respondents reported an improvement in mental health after use versus any worsening. However, for ibogaine and 5-MeO-DMT, about the same proportion reported worsening versus improving mental health.
What’s More
Overall, between 2% and 3% of those who used psilocybin, LSD, or MDMA reported a lifetime schizophrenia diagnosis, compared with 8% who used 5-Me-O-DMT and 10% who used ibogaine.
The Other Side
Preexisting differences across groups, such as psychiatric history, as well as possible substance co-use, may preclude attribution to pharmacology alone. Also, the sample sizes of those taking 5-MeO-DMT and ibogaine were small.
Takeaway Message
“Although these descriptive patterns should be interpreted cautiously, many findings may indicate comparative pharmacological risk, such as the cardiac adverse effects attributed to ibogaine, for instance, which are consistent with its known association with QTc prolongation and arrhythmia,” the researchers wrote. “[T]hese findings support safety surveillance in the general population, targeted harm reduction where warranted, and balanced public health communication.”
Related Information
Source
Otto Simonsson, et al. Adverse health outcomes of psilocybin, LSD, MDMA, ibogaine, and 5-MeO-DMT. JAMA Network Open. Published September 29, 2026. doi:10.1001/jamanetworkopen.2026.36756
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