Beyond psychedelic exceptionalism: how people combine meditation with psychoactive substances, and how this relates to well-being

Abstract

Abstract Background Combining meditation with psychoactive substances is often assumed to be a niche practice centred on classic psychedelics. We sought to broaden this narrative in two cross-sectional studies. Methods Study 1 used a broad naturalistic sample (N = 1,391) to examine the prevalence of substance use, meditation, and their simultaneous combination, as well as associations with subjective happiness. Study 2 used a stratified subsample (n = 397) focusing on classic psychedelic and cannabis users, the most common psychedelic-type substances combined with meditation, to assess associations with mental well-being, peace of mind, psychological flexibility, depression, and anxiety. Results Contrary to prevailing assumptions, alcohol (29%), cannabis (19%), and nicotine (16%) were far more commonly combined with meditation than classic psychedelics (6%). Classic psychedelic use was also embedded within a pattern of pronounced polysubstance use, suggesting that it may reflect a broader substance-use profile rather than an isolated behavioural practice. Regression analyses found no consistent associations between psychedelic or cannabis use, with or without meditation, and any outcome. However, an unexpected pattern emerged for other drugs and alcohol. Other- drug use without meditation was associated with poorer well-being outcomes relative to no other-drug use, whereas other-drug use combined with meditation was not. Alcohol combined with meditation was associated with better well-being outcomes relative to alcohol use without meditation. Conclusions These findings suggest that combining meditation with substance use is not limited to psychedelics and should be studied within broader patterns of polysubstance use and meditation practice.