Researchers have analyzed more than 25,000 calls to a psychological support hotline for people experiencing difficult effects after using psychedelics and other psychoactive substances.
According to the authors, the resulting database is the largest collection of information on such support requests to date. It could help shed light on the circumstances associated with psychological distress and identify which support strategies are most helpful. The findings were published in the journal Science Advances.
The study included 25,419 calls to the Psychedelic Support Line, operated by the US nonprofit organization Fireside Project, between April 2021 and February 2026. Support was provided by 220 specially trained counselors. The researchers also analyzed 2,777 surveys in which callers evaluated the assistance they had received.
The authors note that most psychedelic experiences take place outside clinical trials — at home, at festivals, during ceremonies and in other public settings. However, there is still a lack of systematic data on the difficulties people encounter in these situations and the type of support they need.
Psilocybin was the most frequently mentioned substance, accounting for 59.9% of calls in which a substance was identified. Cannabis accounted for 12.8% and was associated with the highest overall levels of distress. However, the researchers linked this pattern primarily to the fact that cannabis users were more likely to seek help while still intoxicated. When comparable types of calls were analyzed, no significant differences in distress levels were found between the main substance groups.
The timing of the call proved to be a more important factor than the substance itself: people seeking help during a psychedelic experience were more likely to report severe distress than those calling afterward. According to the authors, this finding could help improve the training of crisis support professionals and harm-reduction strategies.
The database also recorded 43 calls classified as reports of abuse by ceremony facilitators or other organizers. Such reports were disproportionately associated with ceremonial practices and the use of psychoactive plant-based substances. However, Fireside Project did not independently investigate individual reports, meaning they cannot be considered confirmed cases.
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