Microdosing substances
Respondents reported the substance they used to microdose and were removed if they indicated using substances other than LSD or psilocybin. This sample includes 278 respondents in three categories: LSD-only (N = 195), psilocybin-only (N = 50), and respondents that have microdosed with LSD and psilocybin (N = 33).
Empirical codebook: benefits of microdosing
Grounded theory analyses resulted in a total of 807.5 coded benefits of microdosing. Taxonomy-building resulted in 46 codes organized into 21 sub-categories and 11 categories. The most frequently reported codes were improved mood (12.8%), improved focus (10.0%), creativity (9.4%), and improved energy (7.6%).
Categories of benefit
This summary provides descriptions of the 11 categories of benefits that were distiled from participant reports (Fig. 1). As per grounded theory, the naming conventions for codes reflect the language used by respondents, but more flexibility was introduced as needed at higher orders of abstraction. Full descriptions of every code are available in the full codebook (see Additional file 1).
Improved mood (26.6%, 215 reports): This most frequently reported benefit-category captures all codes related to mood improvements: happiness, well-being, peace, calm, and reductions in depressive symptoms. Also included are reports of improved outlook, appreciation of life, optimism, spiritual and emotional insights, and being more in touch with emotions.
Improved focus (14.8%, 119.5 reports): This benefit-category references codes concerning focus and concentration, conscious awareness, mindfulness, and increased engagement and attentiveness.
Creativity (12.9%, 104 reports): This category includes creativity per se, as well as meta-creative processes, e.g. shifting perspectives, divergent thinking, curiosity, and openness.
Self-efficacy (11.3%, 91.5 reports): This category references improvements in self-efficacy (motivation/ambition, productivity, confidence, sense of agency) and self-care (introspection, meditation, and other behaviours facilitating mental health).
Improved energy (10.5%, 84.5 reports): This category includes codes referencing “improved energy” per se, as well as alertness, wakefulness, and stimulation.
Social benefits (7.6%, 61 reports): This category references various socially facilitating benefits such as extraversion, empathy, sense of connection, and verbal fluency.
Cognitive benefits (5.8%, 47 reports): This category concerns cognitive enhancement (understanding, problem-solving), clarity of thought (clear headedness, lucidity), and memory.
Reduced anxiety (4.2%, 34 reports): References to anxiety reduction and social-anxiety reduction fit in this category.
Physiological enhancement (3.0%, 24 reports): This category concerns biological processes including enhanced senses (especially visual), cardiovascular endurance, sleep quality, and reduced migraines and/or headaches.
Other perceived benefits (2.2%, 18 reports): This category was a catch-all for otherwise uncategorized codes. These include the novelty of the experience itself, the ability to control the dose, the lack of side-effects, and other miscellany. This category also includes 1 report that there were no beneficial effects.
Reduced symptoms (other) (1.1%, 9 reports): References to stress reduction, reduced sensitivity to trauma, and references to reduced substance dependence (e.g. quitting smoking) are included.
Empirical codebook: challenges of microdosing
Grounded theory coding resulted in a total of 603.5 coded challenges of microdosing. Taxonomy-building resulted in 44 codes organized into 23 sub-categories and 11 categories. The most frequently reported low-level codes were illegality (10.8%), dose accuracy (9.1%), poor focus (8.8%), and anxiety (5.3%).
Categories of challenges
As above, this summary provides extended descriptions of the 11 categories of challenge (Fig. 1).
Illegality (29.5%, 178 reports): This category captures codes concerning the illegality of psychedelic microdosing substances per se, as well as codes concerning the consequences thereof. These include dosing challenges associated with unregulated substances (e.g. taking too much or too little), the availability of the substance (i.e. dealing with the black market), and cost of the substance. Also included is the social stigma surrounding the use of these substances and feeling the need to hide one’s activity from others.
Physiological discomfort (18.0%, 108.5 reports): This category concerns physically detrimental challenges including disrupted senses (visual), temperature dysregulation, numbing/tingling, insomnia, gastrointestinal distress, reduced appetite, and increased migraines and/or headaches.
Impaired focus (8.8%, 53 reports): This challenge category references codes concerning poor focus, distractibility, and absent-mindedness.
Increased anxiety (6.7%, 40.5 reports): References to increased anxiety (general, social, existential) fit in this category.
Impaired energy (7.2%, 43.5 reports): This category includes codes referencing both excessive energy (restlessness, jitters) and inadequate energy (fatigue, drowsiness, brain fog).
Impaired mood (6.9%, 41.5 reports): This category includes codes related to mood deterioration (sadness, discontent, irritability), emotional difficulties (over-emotionality, mood swings), and impaired outlook (fear, feeling unusual).
Social interference (2.6%, 15.5 reports): This category references various socially impairing challenges such as awkwardness, oversharing, and difficulties with sentence-production in social settings.
Cognitive interference (2.3%, 14 reports): This category concerns confusion, disorientation, racing thoughts, and poor memory.
Self-interference (1.2%, 7.5 reports): This category references codes concerning self-processing concerns (dissociation, depersonalization) and self-sabotaging (rumination, over-analysis).
Other perceived challenges (10.6%, 64 reports): This category was a catch-all for otherwise uncategorized codes. These include the unknown risk-effect profile of microdosing itself, the need to prepare and remember to dose, references specifically citing that there were no challenges (1.5%), and other miscellany. This category also includes reports that there were no beneficial effects (0.6%). Furthermore, this category includes substance-related concerns regarding taste, pupil dilation, and duration of effects, and also concerns about negative drug interactions.
Increased symptoms (other) (6.2%, 37.5 reports): References to after effects (psychological dependence and concerns about potential addiction, substance tolerance, comedown or hangover) and also more concerning, but rare, adverse psychological events (0.7%).
Benefits and challenges by microdosing substance
Subjective importance ratings were non-normally distributed thus Wilcoxon signed rank tests were used to compare between substances. There was a significant difference between the subjective rated importance of benefits based on substance (W = 3658, p < 0.01, N1 = 195, N2 = 50, d = 0.353) with psilocybin-only microdosers (median = 87.83, SD = 15.76) rating benefits as significantly more important than LSD-only microdosers (median = 76.67, SD = 14.59); there were no differences found relative to respondents using both LSD and psilocybin (median = 82.33, SD = 14.28, ps > 0.14). The substance-related difference between subjective importance of challenges was non-significant (W = 3841.5, p = 0.56, N1 = 177, N2 = 46, d = 0.079) with psilocybin-only microdosers (median = 47.67, SD = 24.98) rating challenges equivalently to LSD-only microdosers (median = 47.5, SD = 24.65); there were no differences found relative to respondents using both LSD and psilocybin (median = 51.67, SD = 23.79, ps > 0.66). Rates at which specific MDBC categories were reported did not differ between LSD-only, psilocybin-only, and LSD and psilocybin respondents (benefits χ2(20) = 17.26, p = 0.636; challenges χ2(20) = 7.73, p = 0.994).
Improvements and reductions
After reporting open-ended outcomes, participants answered targeted questions concerning behavioural improvements and substance-use reductions (Fig. 2). Respondents reported improved mood (92.9%), anxiety (59.2%), meditative practice (49.1%), exercise (49.1%), eating habits (36.0%), and sleep (28.8%). They also indicated reduced use of caffeine (44.2%), alcohol (42.3%), cannabis (30.3%), tobacco (21.0%), psychiatric prescription medications (16.9%), and illicit substances (16.1%).