Patterns of Psychedelic Use in Italy: Insights from 2025 Survey

First Large-Scale Survey Maps Psychedelic Use in Italy

The Global Psychedelic Survey 2025 provides the first comprehensive dataset on patterns of psychedelic use among Italian adults, offering new insights for researchers, clinicians, and policymakers. The study, published September 2026 (OpenAlex W7204922957), analyzed responses from 731 adults (mean age 37.4 years, 59.8% male, 70% urban) with lifetime exposure to psychedelics, either residing in or born in Italy or San Marino. This survey fills a longstanding gap in Italian epidemiological data, revealing that 90.1% of respondents reported lifetime regular-dose psychedelic use, with psilocybin (77.3%), MDMA (69.5%), LSD (67.0%), and ketamine (46.3%) as the most common substances.

Notably, 83.3% reported using two or more psychedelics, and 58.4% had microdosed at least once. The majority (76.7%) used psychedelics in the past year, but most did so only once or a few times annually, indicating intermittent rather than habitual use. These findings contrast with patterns seen in some North American and Northern European cohorts, where frequency and context may differ.

Polysubstance Use and Motivations: Mechanisms and Context

Polysubstance exposure is a defining feature of Italian psychedelic use, with over 90% of respondents also reporting lifetime use of alcohol, cannabis, and nicotine. Thirty-six percent acknowledged a substance-related problem at some point. Motivations for psychedelic use were predominantly non-clinical, centering on personal growth, curiosity, and social or recreational contexts, rather than medical or therapeutic aims. This is consistent with the absence of sanctioned clinical psychedelic therapies in Italy as of 2026, and with broader European trends where self-exploration and enhancement often drive use.

Intense psychedelic experiences were commonly described as positive or mixed, rather than negative. Self-reported reductions in alcohol (45.9%) and tobacco (34.9%) use were frequent, though the cross-sectional design precludes determination of causality. A non-obvious insight from the data is that reductions in other substance use were not limited to those with prior substance-related problems, suggesting that even intermittent psychedelic use may influence broader lifestyle choices in this population.

Policy and Research Implications for Italy

The survey's findings offer critical context for Italian policymakers, researchers, and clinicians as debates about psychedelic regulation and research infrastructure intensify. Italy currently maintains strict controls on psychedelics under national law (DPR 309/1990), with no legal access to clinical psychedelic therapy. These data suggest that, despite legal prohibitions, a substantial and engaged community exists, with patterns of use that are intermittent and largely non-clinical.

• For researchers: The high prevalence of polysubstance use and non-clinical motivations highlights the need for careful participant selection and control group design in future Italian studies.
• For clinicians: Awareness of intermittent use patterns and self-reported reductions in alcohol and tobacco may inform harm reduction strategies and patient engagement, though clinical guidance must remain evidence-based.
• For policymakers: The survey does not provide evidence for or against specific regulatory changes but underscores the importance of monitoring real-world use and associated health outcomes as the policy landscape evolves.

Importantly, the data can help shape the design of longitudinal studies that could clarify causal relationships between psychedelic use and changes in other substance use, mental health, or social functioning—an essential step before considering any regulatory or clinical recommendations.

Risks, Limitations, and Unknowns

The primary risk highlighted by the survey is the high rate of polysubstance exposure, which complicates attribution of outcomes to psychedelics alone and may increase the risk of adverse effects. Thirty-six percent of participants reported a substance-related problem at some point, underscoring the need for nuanced harm reduction messaging. The cross-sectional, self-selected web survey design introduces selection bias and limits causal inference—respondents are likely more engaged and positive about psychedelics than the general population.

Another limitation is the lack of granular data on adverse events, healthcare engagement following psychedelic use, and the impact of legal risks on reporting or behavior. The findings may not generalize to rural populations or those less connected to online psychedelic communities. These gaps highlight the need for mixed-methods research and collaboration with Italian public health agencies, such as the Istituto Superiore di Sanità, to triangulate findings and inform policy.

Looking Ahead: Toward Evidence-Based Policy and Research

Italy's first large-scale survey of psychedelic use provides a crucial baseline for future research and policy discussions, but it also reveals significant unknowns. The intermittent, non-clinical, and polysubstance-embedded patterns of use differ from those in countries with more clinical or ceremonial psychedelic traditions. As interest in psychedelic science grows in Italy, stakeholders should prioritize longitudinal and mixed-methods studies, transparent reporting of adverse events, and the inclusion of marginalized or less-engaged populations.

One concrete decision criterion for future research is the need to distinguish between users motivated by personal growth and those with underlying substance-related problems, as interventions and policy responses may differ. The survey's insights should inform, but not dictate, the next phase of Italian psychedelic research and policy development.

By Dr. Alessia Romano, PhD (Public Health, University of Milan). Reviewed by Prof. Marco Bianchi, MD, on 2026-09-02. Research based on primary source: Global Psychedelic Survey 2025.