Race and Gender Differences in the Moderating Relationship of Psychedelics on Stigma and Distress

Abstract

Objective: Prior research has found an association between psychedelic use and reduced stigma attached to mental illness. However, whether psychedelics alleviate stigma-related distress remains unclear. Since stigma impacts different groups uniquely, any moderating effect of psychedelics on stigma-related distress is likely to vary across subpopulations. This study addresses two main questions: (1) Do psychedelics moderate the relationship between stigma and distress? and (2) does this relationship vary by gender and race/ethnicity? By exploring these questions, this research seeks to contribute to our understanding of psychedelic use and its impact on mental health across diverse populations.

Methods: Data from the National Survey of Drug Use (2008-2019) were analyzed, with a weighted sample of 458,372. The main analysis used regression models in Stata 18 to examine the associations between lifetime psychedelic use (LPU) (psilocybin, lysergic acid diethylamide [LSD], N,N-dimethyltryptamine, peyote/mescaline, ayahuasca, and 3,4-Methylenedioxymethamphetamine), stigma attached to seeking mental health care, and psychological distress. This analysis examines whether the association between stigma and distress differs by gender, race/ethnicity, and psychedelic use (i.e., White men, White women, Black men, Black women, Asian men, Asian women, Hispanic men, and Hispanic women).

Results: Results indicate that men report lower perceived stigma than women, while women report higher distress. White, Black, and Hispanic women report the highest stigma levels. Regression analysis suggests that among the total population, stigma is statistically associated with higher distress, and interaction terms indicate that MDMA, psilocybin, LSD, and LPU are linked to variations in this relationship. Regression models stratified by gender and race/ethnicity suggest that while LPU, LSD, and DMT were statistically associated with differences in the relationship between stigma and distress for White men, these associations appeared weaker for other groups.

Conclusion: Psychedelic use is associated with lower reported distress from internalized stigma, though the directionality and mechanisms underlying this association remain unclear. Further research should be conducted to investigate how psychedelics can be integrated into comprehensive health treatment programs outside of psychedelics-assisted therapy. However, it is worth noting that individuals from gender and racial/ethnic minority groups may not experience the same level of benefits, suggesting other strategies may be necessary to address the stigma experienced by different groups.

Keywords: distress; ethnicity; mental health; psychedelics; race; stigma.