An estimated 8 million Americans used psilocybin in the past year

Until now, national US drug surveys have only asked about lifetime psilocybin use, or lumped it together with other hallucinogens — making it impossible to say how many Americans are currently using it as psilocybin services expand and clinical interest grows. A study published this week in the American Journal of Psychiatry draws on the first federal survey to ask about psilocybin specifically, using 2024 data [s1].

The data source

Researchers analyzed 58,633 respondents aged 12 and older from the 2024 National Survey on Drug Use and Health (NSDUH), an annual, nationally representative, cross-sectional survey [s1]. The overall response rate was 11.3%, with a 51.5% completion rate among those successfully screened [s1]. Weighted prevalence estimates were calculated for past-year psilocybin use, stratified by demographics and by past-year use of other substances, prescription misuse, alcohol use disorder, and major depressive episode (MDE), each defined per DSM-5 criteria [s1]. A multivariable logistic regression model then estimated adjusted odds ratios for each correlate [s1].

What it found

An estimated 2.8% of individuals aged 12 and older used psilocybin in the past year (95% CI 2.5%–3.1%), corresponding to roughly 8.0 million people [s1].

In the adjusted model, compared with adults aged 35–49, those aged 18–25 had higher odds of past-year use (adjusted odds ratio 1.41, 95% CI 1.14–1.74), while those 50 and older had markedly lower odds (aOR 0.35, 95% CI 0.22–0.56) [s1]. Women had lower odds of use than men (aOR 0.60, 95% CI 0.48–0.76), as did Black adults (aOR 0.40, 95% CI 0.28–0.58) and Hispanic adults (aOR 0.69, 95% CI 0.51–0.93), both compared with white adults [s1]. Higher education was associated with higher odds: some college carried an aOR of 2.35 (95% CI 1.31–4.22) and a college degree an aOR of 2.63 (95% CI 1.36–5.10), both relative to less than a high school education [s1].

The strongest associations by far were with use of other substances in the past year: cannabis (aOR 13.62, 95% CI 9.37–19.79), LSD (aOR 7.87, 95% CI 4.31–14.39), ketamine (aOR 6.03, 95% CI 3.18–11.43), and MDMA (aOR 3.52, 95% CI 2.33–5.31) [s1]. Prescription stimulant misuse (aOR 1.95), cocaine use (aOR 1.90), and alcohol use disorder (aOR 1.32) were also associated with higher odds of psilocybin use [s1]. Past-year major depressive episode was independently associated with higher odds of psilocybin use: aOR 1.37 (95% CI 1.08–1.73) [s1].

The depression finding, and why it cuts against some earlier research

The association between depression and psilocybin use is the finding the paper's authors highlight as most clinically notable, given psilocybin's FDA breakthrough therapy designations for depression and treatment-resistant depression [s1]. It also runs counter to earlier research using older NSDUH data on lifetime (rather than past-year) psilocybin use, which found lifetime use associated with lower odds of a subsequent depressive episode [s1]. The study's authors propose the difference may come down to timeframe: lifetime-use measures can capture people who tried psilocybin decades ago, unconnected to their current mental state, while past-year use captures people using it in closer proximity to their current symptoms [s1]. They offer several possible, untested explanations for the positive association: people with depression may be self-medicating or seeking psilocybin as an alternative treatment outside clinical settings, some may be experiencing adverse psychological effects from unsupervised use, or the association could reflect some shared underlying risk factor rather than either direction of causation [s1].

What this doesn't establish

This is a cross-sectional survey, meaning it cannot determine whether depression leads people toward psilocybin use, psilocybin use contributes to depressive symptoms in some users, or both stem from a separate common cause [s1]. The 11.3% overall response rate is low even by the standards of household surveys, and the authors note that estimates for lower-prevalence substances like psilocybin are particularly susceptible to nonresponse bias [s1]. Homeless individuals and those in institutional settings were not represented, and the survey lacked data on frequency, dosage, or context of use — meaning it can't distinguish between a legally supervised psilocybin-service session, a therapeutic-intent home use, and purely recreational use [s1]. The estimate is also somewhat higher than a separate, methodologically different survey (the National Survey Investigating Hallucinogenic Trends) which estimated 2.1% past-year use among adults using an online-only design that oversampled people who use psychedelics [s1].

What the authors recommend

The study's authors suggest clinicians consider screening for psilocybin use, particularly among patients who use other psychedelics or cannabis or who have depression, and ask about motivations, perceived benefits, and harms [s1] — framed as a call for clinical awareness rather than a specific treatment recommendation, since naturalistic psilocybin use falls outside supervised clinical settings.

What to watch

Whether future NSDUH waves, now that psilocybin-specific questions are included, can establish trends over time, and whether longitudinal research can clarify the direction of the depression association. This article is not medical advice; psilocybin remains a Schedule I controlled substance federally, with regulated legal access limited to specific state programs and clinical trials.

Sources

1. Prevalence and Correlates of Past-Year Psilocybin Use in the US — American Journal of Psychiatry, 22 April 2026