The “Why“ of Psychedelic Drug Use – A Systematic Review of the Literature Investigating Motives to Use Serotonergic Psychedelics
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Background: The use of psychoactive substances is motivated by a variety of explicit reasons ﴾‘motives’﴿. Motives may vary depending on the subjective effects of a substance and the cultural background of substance use. Serotonergicpsychedelics ﴾SPs﴿ are a group of substances that have been investigated as agents of therapeutic change since the 1950s. As a result, researchers developed an increased interest in motives related to self‐medication and coping with stress and mental burden. This systematic review aims to investigate which motives for SP use have been assessed across different types of SPs and cultural backgrounds, while trying to explore if structured self‐reports limit the type of reported use motives.
Method: We searched the academic databases OVID, EBSCO HOST, and WEB OF SCIENCE with a combination of 38 terms related to either SPs or use motives. Research was included if it was published in a peer‐reviewed journal at any time since the database inception, if written in English, German, Spanish or Dutch, and if use motives of at least one human participant in relation to at least one SP were reported. All reported motives were divided into the categories of conformity, coping, enhancement, expansion, and social. We compare the reported motives from standardized self‐reports to those from unstandardized self‐reports.
Results: Our search in November 2020 resulted in 30.256 articles across all databases after duplicates were removed. 30.130 articles were excluded based on title and abstract screening, leaving 126 full‐text articles assessed for eligibility. Of these, 36 were included in the final analysis and 90 were excluded, mainly for not reporting use motives. Across all studies the most common motive for SP use was related to the expansion domain ﴾78% of included studies﴿, followed by coping ﴾67%﴿, and enhancement﴾56%﴿. In studies with unstructured assessments, there is a higher rate of self‐reported coping motives ﴾75% compared to 56%﴿.
Discussion: Across various use contexts, the most consistent motive was related to expansion, including such topics as increase of ﴾self﴿‐knowledge, spiritual development, or curiosity. This result may be interpreted as a sign of the consistency of the psychoactive effects of SPs across different use contexts. Future research should take care to include measures of the expansion domain to provide a comprehensive picture of motives related to SP use.
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