Who Keeps Using Lysergic Acid Diethylamide? Correlates of Past-Year Use in People Who Initiated Use at least Five Years Ago

Introduction: Little is known about the correlates of repeated non-medical lysergic acid diethylamide (LSD) use. Therefore, we aimed to determine the prevalence and correlates of past-year LSD use among people aged 18 years and older in the United States who first used LSD at least 5 years ago. Materials and Methods: Using data from the 2015-2019 National Survey on Drug Use and Health, we examined the estimated weighted prevalence of past-year LSD use and explored potential demographic, psychosocial, and drug use correlates using univariable and multivariable modeling. Results: Among US adults who had initiated LSD use at least 5 years ago, 4.2% were estimated to have used LSD in the past year. Estimated past-year LSD use prevalence decreased with time since first use, dropping from 14.4% among those who first used LSD 5 years ago to 0.1% among those who first used LSD 46-50 years ago. On multivariable analysis, past-year LSD use was positively associated with being male, never having been married, living in poverty, having a higher level of education, lifetime stimulant use, being approached by a drug seller in the past 30 days, having ever sold illegal drugs, perceiving LSD as lower risk, perceiving LSD as more available, and having attempted suicide in the past year. Past-year LSD use was negatively associated with having children in the home, living in a small metropolitan area, and years since LSD use initiation. Conclusions: Past-year LSD use is infrequent among lifetime LSD users and appears to decline with time since the initiation of LSD use. Perceived risk (lower) and perceived availability (higher) of LSD were the factors associated with the largest adjusted odds ratios for past-year LSD use. Further research is needed to understand the infrequency of LSD use among lifetime LSD users and its public health implications.