Exploration of Real-World Psychedelic Use Contexts, Risks and Affordances amongst Autistic Adults Engaged in Therapeutic Psychedelic Use

Abstract

This exploratory study seeks to investigate real-world contexts and wellbeing outcomes of psychedelic use amongst Autistic adults engaged in therapeutic psychedelic use, using secondary data from the 2023 Global Psychedelic Survey (GPS). Whilst legal and affordable access to psychedelic-assisted therapies is still a work in progress worldwide, therapeutic intention has been commonly endorsed in real-world psychedelic use contexts (Lake & Lucas, 2024; Mathai et al., 2025). Exploring therapeutic psychedelic use in real-world settings is essential for understanding how benefits, risks, and subjective experiences manifest beyond the controls of clinical trials (Glynos et al., 2023). This is of particular importance for marginalised populations who remain under-represented in psychedelics research. A lack of exploration and understanding of under-represented and marginalised communities contributes to ongoing health disparities and inequities, which the psychedelics field has an opportunity to address prior to widespread mainstream implementation, through more representative research (Jacobs et al., 2024; Viña, 2025). Autistic adults represent one such population warranting further inquiry, particularly in the context of elevated likelihood of therapeutic intention within naturalistic substance use, including psychedelics (Weir et al., 2021). Literature upon the Autistic population remains limited within the psychedelics field, though slowly growing in response to community interest. The Autistic population has the potential to benefit from practices like psychedelic-assisted therapies, due to high co-occurrence of mental health conditions, and preliminary evidence of efficacy in supporting social anxiety as seen in a single randomised controlled trial (Danforth et al., 2018; Lai et al., 2019). Nevertheless, limited psychedelics literature on the Autistic population also highlights potential for greater prevalence of adverse outcomes and requirement of specialised accomodations within psychedelic experiences (Danforth, 2022; Stroud et al., 2025). Research is yet to characterise contexts, risks and affordances of real-world therapeutic psychedelic use amongst Autistic adults despite such use being known to occur. Research is also yet to explore whether there are any unique characteristics of these contexts and wellbeing outcomes that can be associated with identifying as Autistic. This exploratory study hence aims to address these gaps by: a) Characterising real-world psychedelic use with regard to substance, set, setting, and wellbeing outcomes amongst self-identified Autistic adults engaged in therapeutic psychedelic use. b) Exploring and analysing enduring impacts and insights from psychedelic experiences amongst self-identified Autistic adults engaged in therapeutic psychedelic use. Findings from this study will contribute towards formal documentation of the Autistic psychedelic experience within literature, and may provide insight into potential risks and affordances of psychedelic experiences in this population for future research to further investigate.

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