Scoping Review Protocol: Naturalistic Psychedelic Use for Trauma in Military Populations

New Scoping Review Targets Psychedelic Use for Trauma in Military Settings

A protocol published on November 6, 2026 (OpenAlex W7225429729) outlines a planned scoping review to systematically map existing evidence on the use of naturally occurring psychedelics—such as dimethyltryptamine (DMT), ayahuasca, psilocybin, mescaline, and ibogaine—by military veterans and active-duty personnel in real-world, non-clinical settings. This review will focus on trauma-related mental and behavioral health outcomes, including posttraumatic stress disorder (PTSD), depression, substance use, suicidality, and moral injury. The protocol specifically addresses the gap in literature regarding the use of these substances outside regulated clinical trials, such as in retreats, ceremonies, and community or religious contexts.

Mechanisms and Context: What the Review Will Map

The review will use the Participants, Concept, and Context (PCC) framework and follow the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines to ensure comprehensive and transparent reporting. Eligible studies must report empirical data on adults with military service histories who have used naturally occurring psychedelics outside formal research environments. The review will include studies from nine databases and supplementary sources, with no restrictions on publication date, aiming to capture the full scope of available evidence.

Unlike previous reviews that focus on single compounds or diagnoses within controlled trials, this protocol addresses the diversity of substances, settings, and outcomes relevant to military populations. This approach reflects the reality that many veterans and active-duty personnel are seeking psychedelic experiences in naturalistic or community settings, often due to dissatisfaction with conventional treatments or barriers to accessing regulated clinical care. Notably, the review will also describe the cultural and contextual factors—such as the role of peer support, ceremony, or spiritual frameworks—that may influence outcomes and risks.

Policy and Research Implications: Informing Future Directions

The planned review is not a regulatory or legal intervention, but its findings could have significant downstream effects on research priorities, clinical guidance, and policy debates. By systematically mapping what is known—and unknown—about the use of natural psychedelics for trauma in military populations, the review may highlight critical gaps in safety data, efficacy signals, and contextual factors that influence outcomes. This evidence synthesis could inform the design of future clinical trials, the development of harm reduction strategies, and the allocation of research funding.

One underappreciated implication is that the review may reveal patterns of self-medication or community-based innovation that are not captured in formal research. For example, if certain retreat models or peer-led support structures are associated with better or worse outcomes, this could help guide both regulatory oversight and the development of best practices, even in the absence of randomized controlled trial (RCT) data.

Risks, Unknowns, and Methodological Challenges

There are substantial risks and unknowns associated with naturalistic psychedelic use among military populations, particularly in unregulated settings. Adverse events—including psychological distress, re-traumatization, or unsafe physical environments—may be underreported or poorly characterized in the literature. The review protocol acknowledges these limitations and will tabulate safety and tolerability data where available. However, the heterogeneity of settings, substances, and participant backgrounds poses significant methodological challenges for synthesis and interpretation.

Another real-world failure mode is the potential for selection bias: veterans and personnel who seek out psychedelic experiences outside clinical trials may differ systematically from those who do not, in ways that affect both risks and benefits. Furthermore, the lack of standardized outcome measures and follow-up periods in naturalistic studies complicates efforts to draw firm conclusions about efficacy or safety. These limitations underscore the need for cautious interpretation and the importance of triangulating findings with data from clinical research and surveillance systems.

Looking Forward: Bridging Evidence Gaps and Supporting Informed Policy

The forthcoming scoping review represents a critical step in understanding the landscape of naturally occurring psychedelic use for trauma among military populations. Its comprehensive mapping of existing evidence will help identify where robust data exist, where significant gaps remain, and what contextual factors may shape outcomes. As policymakers, clinicians, and community leaders grapple with rising interest in psychedelic-assisted therapies—and the reality of unsupervised use—this review may provide a foundation for more nuanced guidance, targeted research, and harm reduction efforts.

Ultimately, the review's findings could catalyze a more evidence-informed dialogue about the role of psychedelics in addressing trauma among veterans and active-duty personnel, balancing hope for novel interventions with a clear-eyed assessment of risks and unknowns. The protocol's rigorous approach and focus on real-world contexts offer a model for future research in other vulnerable or underserved populations.

Byline: Dr. Jamie R. McConnell, PhD (Clinical Psychology, University of Washington). How we research: This article was reviewed by Dr. McConnell on 2026-11-08 and is based on direct analysis of the OpenAlex protocol and related primary sources.