Level of preparedness to use psilocybin among individuals seeking psychedelic risk reduction: a retrospective study of a pilot psychiatric consultation service.

INTRODUCTION

In 2020, Oregon became the first US state to legalize state-regulated psilocybin services. This study aims to examine: (1) the clinical and demographic characteristics, (2) psilocybin use motivations, and (3) differences in preparedness among patients seeking care in an Oregon-based pilot consult service specializing in psilocybin risk reduction.

METHODS

This exploratory retrospective chart review abstracted sociodemographics, trauma history, and medical and psychiatric risks of patients (November 2023-September 2025). The Psychedelic Preparedness Scale (PPS), a validated self-report questionnaire, measured preparedness. Two sample t-tests examined associations of PPS scores by insurance, consult motivations, and prior psychedelic use.

RESULTS

Patients (N = 29) had a mean age of 47.14 years (SD = 15.9), were majority female (55.2%); White (82.8%); and privately insured (62.1%). Patients mostly sought psilocybin to address only a psychiatric concern (75.9%); 27.6% anticipated naturalistic (non-state regulated) use. Most patients were deemed low risk for adverse events. Prevalence of prior challenging psychedelic experiences (CPE) was 17.2%; 58.6% reported lifetime psilocybin use. 86.2% endorsed ≥1 form of lifetime trauma. Of PPS completers (N = 23, 79%), mean score was 91.3 (SD = 23.99). Scores did not significantly differ by insurance; consultation motivation; CPE; prior psilocybin or psychedelic use.

CONCLUSION

Patients utilizing a novel consultation service demonstrate a high prevalence of trauma, prior psilocybin use, and baseline preparedness. While preliminary, this study is among the first describing patients seeking medical and psychiatric consultation when considering psilocybin and highlights potential roles of healthcare systems in providing evidence-based patient education and risk reduction as interest in psychedelics grows.