Psychedelics & Autism Spectrum Disorder (ASD): What to Know

Social Communication & Repetitive Patterns

ASD is typically diagnosed during childhood, and the American Psychiatric Association’s diagnostic criteria include atypical characteristics in social communication and interaction, as well as repetitive patterns of behavior and restricted interests, and is often accompanied by co-occurring diagnoses of depression and anxiety (Rai et al., 2018; Hollocks et al., 2019).

Much of the diagnostic criteria is related to socializing, and a lack of social interest. In the past, therapeutic modalities sought to make ASD folk more sociable because someone determined that more sociability was better. 

Now, we see that increased sociability isn’t objectively better. Oftentimes, ASD is accompanied by loneliness, and while some folks want to become more social, they just might not have the tools, support, or even neurological ability necessary to help enact these changes.

Since the official diagnostic criteria (the DSM-5) group together people with many different genetic and biological backgrounds under one “spectrum,” there is no single “autistic brain” type. 

This variety makes it a massive challenge to predict how any one person with ASD might react to psychedelic therapy, as their individual neurobiology can be vastly different from the next person’s.  

Imagination

One commonality we do tend to see being reported in the community, absent from the diagnosis criteria and historically ignored due to improper testing, is the increased imaginary or inner world that many with ASD experience.

In the past, “imagination” has been tested in limited ways and failed to capture the vivid inner world that many autistic folks turn to in challenging or overwhelming situations, or just when they want to have fun.

As we read on, you’ll see how an inclination towards a unique and vivid imagination can come into play during psychedelic experiences. 

Loneliness

As we mentioned, given the atypical social communication that is characteristic of ASD and the tendency towards asocial behavior, it’s no surprise that loneliness is commonly reported by autistic people. 

In a systematic review, Umagami et al. (2022) explored past research on loneliness in autistic adults and found that the factors associated with increased loneliness in autistic adults include: 

• Autistic characteristics 
• Anxiety 
• Depression 
• Suicidal ideation
• Negative experiences 
• Learned helplessness
• A lack of understanding and acceptance of autism
• Sensory avoidance
• Camouflaging 
• Unemployment

Only one study included a measure of loneliness developed for and validated in autistic adults.

Interestingly, the review noted a lack of research on the collective dimension of loneliness (i.e., belonging in society) compared to other loneliness factors such as intimate (i.e., romantic relationships) or relational (i.e., friend/family relationships) dimensions of loneliness.

They also found that factors associated with decreased loneliness in autistic adults include:

• Having relationships 
• Participation in social skill interventions and/or experiencing fewer difficulties with social skills
• Positive views and acceptance of oneself
• Time spent engaging in activities

As we read on, you’ll see why these facets of autism matter when exploring the intersection of ASD and psychedelics. 

Why Does it Matter for Psychedelics?

There’s been plenty of research on the efficacy of psychedelics in treating disorders that are often comorbid with ASD, such as depression, anxiety, and antisocial behavior; however, there is still a lack of systematic, double-blind, placebo-controlled clinical trials assessing the specific therapeutic and adverse effects of psychedelics in neurotypical individuals and in those with ASD.

As we explore the wide range of characteristics that can come with ASD, we see that there are some aspects that may benefit from psychedelic use, such as a decrease in social anxiety, but there are also some aspects of ASD that need to be kept in mind, like hypersensitivity to stimulation or being thrown off rigid thought patterns, leading to possible dysregulation. 

Knowing that psychedelics have the potential to increase sensitivity to stimuli, as well as disrupt rigid thought patterns, one can plan for them accordingly. 

Many autistic folks find careful consideration of the set and setting a great way to mitigate the risk of overwhelming stimuli or disruptive surprises.  

Anecdotal Reports 

We gleaned a lot of anecdotal evidence from online forums, but there are a few autistic people who decided to share their psychedelic stories with the world in hopes that their stories may help others on their own healing journeys, whatever that may look like for them.

First, we want to highlight a podcast episode, Can Psychedelics Cure Autism? LSD & MDMA Therapy, on The Modern Stoic podcast, where hosts Jon and Andrea discuss how LSD and MDMA affected Andrea,

“For me, Autism was being a featureless white room, without windows or doors. MDMA opened a door in that room. Suddenly I could see outside to where ‘real people’ lived. LSD allowed me to leave that room.”

Next, highlighting a book that came out in 2020, Autism on Acid: How LSD Helped Me Understand, Navigate, Alter & Appreciate My Autistic Perceptions by Aaron Paul Orsini, who details his experiences on LSD. His website has recently begun undergoing some changes, but hopefully, the Autistic Psychedelic Community will come back stronger than ever. 

A review of the book reveals an excerpt from the moment he started feeling the LSD, alone in the forest, and it shows just how much neurotypical folk may take for granted in social situations. 

What many people may not realize is that this is a monumental breakthrough for someone with ASD, 

“‘Connection, such connection,’ he writes. ‘[A]s the LSD began to take effect, I felt more and more connected… with the trees and breeze and sunlight around me. I experienced a deep moment of engagement. Yes. A moment of connection, with nature, with thoughts of my parents, my family, friends, and the whole of the human family and the broader web of life… I was awash in a sense of deep, deep love for so many aspects of life.’ A few hours into the trip, he encountered a stranger in the forest and, even though their conversation consisted of small talk, Orsini writes that he ‘felt fully connected to the person opposite me.’ Imagine having this experience of basic connection for the first time at age 27.”

After this initial experience, Orsini goes on to try LSD many times, at varying dosages and in dynamic settings. 

The same review goes on to say that,

“Orsini is still autistic. He always will be. But for him, autism is no longer a burden, and he is able to experience social life fully. He gives an example of his thinking before LSD, contrasted with his thinking after LSD. Before LSD, he might think, “[t]hat woman’s smile indicates she is happy.” After LSD, he would think, “I feel happiness in the presence of this smiling woman.” He moved from analysis of what he saw to intuitive connection with others.”

Orsini himself says, in a podcast episode, that it’s not the volume of the sensory information that becomes overwhelming, it’s the inability to tune it out of your perception, calling it “auditory water torture”.

He even created a soundtrack for psychedelic use while under the influence of LSD that he describes as “auditory ear muffs”, having a slow beat at 60 BPMwhich he states induces a breathing pattern that would be good for meditation. 

Now let’s take to Reddit and Erowid to hear how autistic folks feel about ketamine, LSD, MDMA, DMT, and psilocybin-containing mushrooms or “shrooms”. Note that these were the most popular substances being mentioned and that its possible negative experiences weren’t reported as much, and while the biggest negative side effect reported was overstimulation.

Cannabis can have psychedelic properties, especially when ingested instead of inhaled; however, there were mixed and highly individualized anecdotal reports. We won’t include anecdotal reports on cannabis, but we will default to the available research on cannabis and ASD for this article, which is sparse.

Ketamine

“I have a formal diagnosis. I am now around 40, got my diagnosis at around 30. Struggled my whole life and still do. Started at home troches due to some terribly traumatic events that trauma then intensive therapies helped a little but I could never ever calm my body down.

TK (troches) has changed my life. I notice in the days of the month that I medicate, it’s easier to go with the flow and not get hyper fixated on structure. I feel more creative when other times my creativity is a burden and only part of my work. I DO get overstimulated easier when it starts to leave my system, almost irritable but not PTSD irritable definitely just sensory related- but that can be prepared for. 

Today I went to a movie and that was a bad call. Keep things low stim and see how it goes! As far as thought patterns. Ketamine gave focus to my erratic multi directional creative stream of consciousness. It’s shown me the right questions to ask myself and my work simply by calming down my body and opening my mind.” — Reddit user

“I am also autistic, was diagnosed as a child, and this analysis (above) has also been my experience. It is easier for me to not be so rigid and I also get less overwhelmed by external stimulus on medication days or shortly after.” — Reddit user

“It’s helped me immensely. I was formally diagnosed prior to starting KAP (Ketamine + EMDR + etc). Ketamine creates a peace for my mind unlike anything else. Perhaps the only thing close has been scuba diving. Safe, cool (temp), blues and silvers, calm even in chaos. Serene like the violence of the ocean. It also resets my nervous system. IDGAF what others say, it helps me avoid autistic burnout. I can feel when my system is starting to run a little hot. Ketamine is a hard reset. It has also helped me incorporate sessions from other medicines I’ve explored in my therapeutic journey.” — Reddit user

“I’m autistic and been going for 4 years♡ I believe most of what inhibits me the most in my life are the comorbid diagnosis and symptoms of my CPTSD, OCD, anxiety and depression… ketamine has changed my life. I’m not “cured” of these things but slows me down enough that I can use and practice the skills I’ve been taught. Ive been in therapy since I was 8 and on multiple different meds due to my diagnoses (and misdiagnoses) … nothing really helped.

The ketamine just helps me process and calm so I can use the skills I need to. I feel more grateful and appreciative… still struggle but am fortunate though to have help. My clinic gives me an IM(shot) every 2 weeks for 150$. She offers it cuz she knows I’m low income and struggling.. I do notice a drop in mood a week and a half/ 2 weeks in and she said that’s normal. I’ll notice my disassociation, ocd and depression symptoms will start cycling more when it’s near the end of the 2 weeks. Also, it’s not legal in my state but she did say psilocybin helps the ketamine last much longer and lots of people don’t need ketamine as often. I know some places you can order spores.

Idk how to explain how it made me more like “me” but it did: When someone would flip me off in traffic, I would follow them laying on my horn. Especially if it was a man. Now… I just kinda feel bad I upset them and that’s about it. No yelling. It just .. is? My meltdowns are sooooo much less. My emotional tolerance is higher. I struggle with agoraphobia and it gives me the drive to accomplish things and leave the house. Things suck in life. The ketamine doesn’t stop the bad, it just helps you handle it and be more yourself. 

Some sessions are great and some have been bad but the medicine is always working and doing what it needs to do either way by rebuilding the brain. Part of the healing is rebuilding the synapses, pathways and neurons. They break when there is stress or trauma. Autistic brains have more of these pathways. I am starting a new med called Auvelity and it runs off the same receptors as ketamine. You can look into it from ur psych :)” — Reddit user

“I have diagnosed autism and I feel like my symptoms get way worse on ketamine. My social awkwardness turns up to 110% the whole trip is centered around my interests.” — Reddit user

“Daily nasal spray helped for about 6 months and then sort of turned on me and started to create some unpleasant thought patterns. It still helps tons with my Nerve Pain (Surgical Trauma) and does relieve my depression as long as I don’t overdo it.” — Reddit user

LSD

“It helps my depression a lot as well as I find a great amount of value from the self reflection aspect. It may not directly help my ASD, but it helps my self awareness and indirectly helps me with some of my ASD related struggles.” — Reddit user

“Over time…it just reminded me of how bored and alone I was where I was living, and how difficult it was to get anyone to hang out. That wrapped it up for me. Though I think it really helped with a lot of the social barriers I had before then. I used to have these very two-dimensional ideas of what people were, and it really helped break out for me how complex everyone is on one level or another, whether we’re aware of it or not.” — Reddit user

“My senses don’t get overloaded anymore. I used to feel pain by touching rough surfaces. Now it feels a little uncomfortable, but not to the point where it physically hurts due to the stimulation. While I was tripping, sandpaper actually felt good. Social skills seem improved, as well as reduction of social anxiety. While I was on acid I noticed I had a much harder time expressing myself with language than I do normally. However, I didn’t experience any frustration when I had a hard time expressing myself, I felt pleasure instead.” — Reddit user

One Reddit user diagnosed with Aspergers, prior to the merge in 2013, reported using LSD 3-4 times a year, and while they can’t attribute positive benefits to their LSD sessions specifically, they believe it’s at least partly responsible for their increased ability to deal with chaotic situations, such as multiple people talking at once.

“I find that when I smoke weed or do mushrooms/acid, I have this empathy I’ve heard so much about and I realise that the empathy I thought I had is just an imitation.” — Reddit user

A commonality amongst Redditors with LSD was the ability to put themselves “in others heads”, or in others shoes.

“I’ve only done LSD once and it didn’t really help with my social deficits exactly but definitely was a positive experience that helped understand some things.” — Reddit user

Some note their preference for longer journeys with LSD versus shorter ones with DMT, and it seems like it greatly depends on personal preference. 

“I’ve been caught up in some delusional thinking on LSD and thought loops, something DMT has never done to me.” — Reddit user

“I generally prefer LSD (over DMT) for the length of the experience. But I do find DMT to be a very interesting and thought provoking experience as well. Regardless of which substance, I find that psychedelics in general have helped me a lot with understanding and accepting myself for who I am – the positives and negatives. ‘Accepting’ of course doesn’t mean I won’t try to improve the negatives, just that I don’t get nearly as anxious and hung-up about them as I did before psychedelics.” — Reddit user

Reports on LSD & MDMA (Not Necessarily Together)

“LSD and MDMA helped me pick up on body language I didn’t notice before and makes it really easy to hold a conversation. Doing these drugs were one of the first times I’ve ever just felt normal and gave me an ideal of myself to aspire to. They opened the flood gates of emotion in me and helped me start working to fix my anxiety and depression.” — Reddit user

“I’ve taken LSD and MDMA a few times. I don’t think it really helps, but instead just trips you out. When I took LSD for example, all I did was stare in the mirror and watch my face melt. I looked around at the things around me, and it made me feel really small. Then really big. Then I felt like I was meshing into everything around me. At one point I’m sure I imagined my face was covered in eyeballs. I then closed my eyes and noises made rainbows. I didn’t feel any change in my personality, I was just on some drug. MDMA did nothing but make me feel funny. None of it helped. When it was all over, I was still autistic.” — Reddit user

“Being on the spectrum for me wasn’t as much a lack of empathy as an overabundance of it, and an inability to process it. I guess you could say I got sensory overload from social situations. 

I tried self-therapy with LSD where I took a large dose once a week for a month. I didn’t take the advice to sit in a dark room for the first three, until on the final trip I felt a horrible pain like I had to go lay down in bed. — Reddit user

That last trip was a lot like how dre described his first one, except the opposite. I felt every emotion with great intensity and began to understand them. That night the old me died, or at least it felt like it. It seems to me like psychedelics de-activate the part of the brain where sensory overload originates, and allows the brain to forge new neural pathways that can handle the sensory inputs that once paralyzed it.” — Youtube comment on The Modern Stoic podcast episode

MDMA

“The first time doing MDMA I felt like I could fly. I became extremely emotional towards my friends and wanted to dance and run and jump. I was in a club and had entire conversations with strangers. I’ve done it at home also with friends just hanging out. I like this a lot more. It made me feel so much love towards my friends and we could laugh and talk for hours.

I think I overdid it a bit though. Because I like the feeling of actually ‘feeling’ empathy and love so much I started doing this regularly. Now when I do it I barely feel any emotions extra. Just a big body rush and an energy boost. I recommend to leave a gap of 3 months between using this if you think of doing it again.” — Reddit user

“For social anxiety one of the biggest mindset shifts is that the only person who really cares enough to worry about how you appear and present is yourself.” — Reddit user

DMT

Folks have reported positive experiences with DMT, and appreciate the immersive aspects of it, especially for those who particularly enjoy consciousness or consciousness exploration.

“This is probably one of the most amazing drugs/feelings/experiences I have ever had. There is a feeling of pure serenity, hope, love that hits you when you smoke this. It’s like being embraced by an old, really good friend. But one that knows exactly who you are and will put you in front of a mirror if you try to hide from yourself.” — Reddit user

“I tried some DMT and it changed my mind. I am amazed. I saw that I lived in a very closed down mental space, and the possibilities of human connection seemed endlessly variable.” — Reddit user

“I’ve done DMT 5 or 6 times, it’s my favorite drug. I’m not very good at describing my experiences in depth but to sum it up DMT has no peer in terms of intensity. A breakthrough dosage will shatter your immediate presence on the physical plane sending you on a journey through the deepest reaches of your own mind. This can lead one to deep introspection on the nature of reality, especially upon contact with “the entities”. 

I’m not religious but like to see it as a wild adventure at the intersection of biochemistry and neuroscience. I wouldn’t recommend it to anyone who hasn’t done their research and knows what they’re getting into. Many people would be freaked out by how powerful it is” — Reddit user

Some autistic people find that more immersive psychedelics like DMT are “easier” for them because they live in their head a lot, but also note the extreme intensity that all-encompassing visual hallucinations can have. 

Psilocybin

One Redditor took a “high” dose of psilocybin mushrooms and reported having a lot of self-reflection, even though it was scary and confronting. After their experience they were depressed for a few weeks afterwards before feeling better than they did before the mushroom experience. 

“I’ve only had good experiences on mushrooms but I do A LOT of research and testing first. They’re not all the same and a dosage for one strain won’t always work for another. Some strains amplify emotions while others cause synesthesia. I can understand how this can negatively affect some of us with autism as there is A LOT of sensory overload. Like a lot. 

For example, walking near or turning lights on and off made me noticeably colder or hotter. I also went through heat flashes and chills, noises would be too loud/too quiet, hallucinations, etc. If Psychedelics are something you want to explore, stay natural, stay safe, and make sure you educate yourself on what you could experience. Have a trip sitter who you feel safe with and items that make you comfortable.” — Reddit user

“I’m autistic, and I love shrooms! Since I have synesthesia, being on shrooms just feels like a natural extension of that experience. Be careful if you have sensory issues though. Try to put yourself in an environment that feels safe and comfortable for you when tripping. And always keep a sober person with you! You may need them to take care of your sensory needs, and other things you might want while tripping.” — Reddit user

“I’ve done mushrooms a good number of times. Low to mid level doses are quite pleasant. I had a very hard hitting dose last summer, ego death, fractals, melting into the floor and all that. It was quite intense and might not be for everyone. I also make some microdose mushroom tea once in a while. It adds a little “sparkle” to the day.” — Reddit user

“I’ve had shrooms. They’re free, can’t OD, nonaddictive, can help depression. I’ve had a bad trip once and got really jumpy and anxious so you’ve gotta be careful to go into it relaxed.” — Reddit user

“I did it with a professional and it was the worst time of my life. I got so paranoid and anxious that the poor oke had to open all his doors and windows. I refused to go back inside until my partner arrived to take me home. I’ve been back in therapy ever since. However, I did manage to quit smoking and drinking six months after my bad trip. I never had the courage beforehand. I am not sure how much the shrooms had to do with it but I would like to say there was something positive resulting out of the whole experience.” — Reddit user

“I came to the realization that I am not separate from the universe, but the universe itself, observing itself. Everyone is the universe, and therefore we are all one. This gave me comfort and validated my sense of empathy. But, it also makes it so much harder to understand bad actors in our world. It makes me want to somehow share with them my point of view, even though it isn’t going to be accepted. It also helped me let go a bit as well. I was able to hold on to the fact that everything I’ll experience is just a tiny blip in the grand scheme of it all. Relax and enjoy the ride.” — Reddit user

“I’m on the spectrum myself and I can confidently say after a couple LSD/magic mushrooms experiences, I’ve learned to disregard my fears and I finally found happiness/peace in my life. Psychedelics aren’t for everyone but I believe in the potential of its psychological benefits in the field of mental health treatment.” — Reddit user

From these anecdotal reports we can find similarities in some ASD psychedelic reports in relation to neurotypical reports of psychedelic use. We see examples of mystical experiences, increased empathy or emotional understanding, sociability, and decreases in depression and anxiety. 

The results vary widely anecdotally, but it’s a good start. From here, we can begin to create a picture of what it may be like for neurodiverse folks, and see that benefits are still possible in these populations, giving an even stronger argument for research to be done to specifically determine the relationship between psychedelics and ASD.

Psychedelic Passage Survey Responses on Using Psychedelics to Modulate Autism-Related Traits.

“At some point while I was regularly using psychedelics, I looked back at my life and couldn’t understand how I’d been so ignorant of myself in so many ways… It’s like at some point I snapped out of a certain spell and that was the end of many of the impinging traits of autism.

Social anxiety, blindness to self, I always felt like there was something that others “got” and I was in the dark about it, and as a result couldn’t relate to people. I was very arrogant and incredibly miserable. When psychedelics gave me a good look at myself, I cringed so hard and felt so much shame for my blindness… I don’t think they’re an easy fix for everyone… 

I think one thing that’s key is to take grounding and integration seriously. I always made sure to eat and sleep well and spent a lot of time in nature which gave me plenty of opportunity to integrate my experiences. 

Looking back, my autistic traits seem like some kind of pattern that my brain waves had become entrained to (think binaural beats) and that psychedelics helped reset some of those patterns that seem to maybe be rooted in childhood trauma for me. There’s still bits of my past that affect me today, but there’s also so much I feel I’ve fully let go of.

Obviously, this is all just my personal experience and I don’t necessarily want to encourage anyone but if someone does feel encouraged… I recommend looking at it as a long journey. Baby steps as opposed to great leaps. Deal with the surface baggage before you dive in deep.” — Anonymous survey respondent

“Hi, I microdose mushrooms and use ketamine quarterly. My life has been changed in so many ways and I tell everyone if they can in their state, to find facilitators. It helps me communicate my feelings, turns the noise down, stops pain, helps with nausea and textural issues. Some people are completely against it but once you know, you can’t go back. I had open prescriptions for a terrible amount of highly addictive medications and I have been free of them for over 2 years now. 

I cannot express enough how desperately needed research is in this area. My life’s goal is to change life in the way that mine has been changed. It is truly remarkable.” — Anonymous survey respondent

“I have level 1 (autism) and I’ve tried them. Micro dosing wasn’t for me, it gave me anxiety when I wasn’t in a controlled environment. A full dose was like a brain reset and I felt generally happy for a few days following that. I’m going to go do that again today actually.” — Anonymous survey respondent

“I try to overcome my rigidity caused by autism by microdosing 1P-LSD and truffles. I suffer also from dysthymia, I feel like shrooms are better for this. 

I drink less alcohol since I did psychedelics. Never had a hangover since I started with psychedelics in late 2020 and drink less frequently. It’s been a month now since my last alcoholic beverage.” — Anonymous survey respondent

“I wouldn’t really consider myself autistic at this point in life, I’m still eccentric, I’m sure, but the struggles and suffering I used to experience are largely gone. I did all sorts (of psychedelics), but I feel I owe most of my change to DMT, ayahuasca, and LSD.

They all were useful in different ways. I’ve experimented with low doses, but not doses low enough to be considered microdosing… I think one of the biggest insights leading to change was the realization that my mind is not reality and living within it inevitably leads to suffering and that I can instead look beyond it to live in the here and now. 

Sounds simple but I grew up fully living there (not in the here and now) and I thought that was the place to be and that it’d lead to intelligence, but ultimately lead to being completely blinded to the bigger picture. I honestly do think everyone would benefit from the psychedelic experience so long as it’s done right.” — Anonymous survey respondent

In Summary

While experiences range from “life-changing” to “overwhelming”, reports generally highlight shifts in sensory perception, social processing, and self-reflection.

Many users reported the suspension of social barriers, even if only temporary, including gaining a deeper understanding of empathy or how to express empathy, improved ability to put themselves in “others’ shoes”, and improvement in picking up on body language.

Some users (particularly with mushrooms) did report intense sensory overload, while other users reported the opposite effect, finding previously uncomfortable tactile sensations to be quite pleasurable. 

Many reported significant relief from depression and chronic anxiety, though one user noted a temporary depressive dip immediately following a high dose of psilocybin.

Users also reported that psychedelics allowed them to confront their own behaviors and place in the universe, which in turn helped them reflect on their everyday lives. 

A few folks have communed with psychedelic medicine on and off throughout their lives, but have a hard time determining if their changes were due to psychedelics or just getting older.

We can see that these substances aren’t a “cure-all” and have a wide variety of effects, and many users highlight the importance of set and setting, mentioning how these factors affected their experiences. 

It’s also important to note that addiction is a common comorbidity with ASD, and many online users mention the need to monitor their use and intentions to determine whether these substances are being used for healing, or as a coping mechanism or crutch (Butwicka et al., 2017).

In some instances, people with autism have reported that they feel “normal” while under the influence of substances, and it can lead to disparaging feelings towards being sober.

More research is needed to determine whether it is possible to translate these feelings of normalcy into everyday life, such as through the addition of psychotherapy, as seen in Danforth et al., 2018.

Some folks might just really enjoy consciousness exploration, which is a great hobby and doesn’t need to be accomplished with psychedelics, but if they are being used to achieve that, then an honest exploration into your psychedelic use and intentions is warranted. 

Recommended Reading: 8 Ways to Enter the Psychedelic Realm Without Drugs

Current Research on Psychedelics and ASD

A study done by Mason et al. (2019) shows the subacute effects of a single administration of psilocybin in a social setting on empathy, creative thinking, and subjective well-being, and found that,

“Results indicated that psilocybin enhanced divergent thinking and emotional empathy the morning after use. Enhancements in convergent thinking, valence-specific emotional empathy, and well-being persisted seven days after use. Sub-acute changes in empathy correlated with changes in well-being.”

To respect the double empathy problem, in this case, empathy simply means being able to understand another person on a nuanced level, similar to being able to “put yourself in another’s shoes”, which some autistic people have reported not being able to do until they took a psychedelic. 

This study wasn’t conducted on an autistic population; however, the results are strikingly similar to what has been reported anecdotally. Based on anecdotal reports, it’s not crazy to theorize that, even though it wasn’t tested on an ASD population, there’s no reason to think these benefits couldn’t extend to the ASD population. We look forward to seeing research with autistic populations in the future. 

Social Anxiety

Atypical social communication is one of the two areas that determine an ASD diagnosis, and while many prefer their alone time, others feel as though they’re missing out on key aspects of socialization and have a desire to improve their social skills.  

This is where we have the opportunity to explore if psychedelics could benefit those looking to improve their relationship with socialization.

In one of the first studies to examine psychedelics and autism since the 1970s, researchers looked at how MDMA in combination with psychotherapy affected social anxiety in autistic adults. 

In a randomized, double-blind, placebo-controlled pilot study, they found a reduction in social anxiety after MDMA-assisted psychotherapy (Danforth et al., 2018).

“Autistic adults with marked to very severe social anxiety were randomized to receive MDMA (75 to 125 mg, n = 8) or inactive placebo (0 mg, n = 4) during two 8-h psychotherapy sessions (experimental sessions) in a controlled clinical setting. Double-blinded experimental sessions were spaced approximately 1 month apart with 3 60- to 90-min non-drug preparatory psychotherapy sessions, 2 8-hour MDMA sessions and 3 non-drug psychotherapy sessions following each.”

A dose-finding study design was selected in response to anecdotal data, suggesting that hyper-reactivity to sensory stimulation and emotion regulation challenges associated with autism might indicate the need for a lower, yet therapeutically active, MDMA dose range. 

The psychotherapy was “mindfulness-based therapy adapted from dialectical behavioral therapy (DBT) (with neuroaffirmitive modifications which has helped to manage intense emotion and dysregulation)”.

Not only were the changes apparent during the testing phase, but the results were sustained 6 months after the clinical trial. 

“Social anxiety remained the same or continued to improve slightly for most participants in the MDMA group after completing the active treatment phase.”

A study done by Luoma & Lear. (2021) reviewed past data to determine if MDMA-assisted therapy (MDMA-AT) could be a viable treatment for social anxiety disorder. 

By reviewing research in neurological, perceptual, receptive, and expressive systems regulating social behavior in Social Anxiety Disorder (SAD), they found four domains where MDMA-AT showed lasting effects: 

• social anhedonia and decreased social reward
• heightened social threat perception
• increased shame and self-criticism
• dysfunctional interpersonal behavior

It’s important to note that these results were found largely from basic scientific research using non-human animals and studies assessing humans who ingested MDMA outside the context of psychotherapy.

These four domains can all be affected in ASD as well, with Danforth et al. (2018) actually predating this research. They saw a research avenue that needed to be further explored, which is why it’s relevant to this article, as we saw anecdotally that psychedelics have benefitted autistic people in these areas. 

Cannabis

As promised, we’ll be going over the available research on the therapeutic use of cannabis for people with autism. 

One Redditor,using cannabis for their anxiety, found that in many friends, themself included, “the skills they’ve built over the years tend to disappear when they get high”.

We don’t have an entire library of data to go off of, but we do have a longitudinal analysis done by Karhson, LaFrance & Cuttler, 2025 that collected data from 111 self-identified autistic adults on pre-and post-cannabis use and found that,

“Overall, symptom severity ratings were reduced by 73.09% from before to after cannabis use. More severe symptoms were associated with greater reductions in severity ratings after use. Higher doses predicted greater reductions in severity of Repetitive Behaviors, Mental Control, and Negative Affect but dose of cannabis used to manage all symptoms remained static across time.

This is a small sample, and it relied on a subset of tracked information that reflected changes in core and co-occurring symptoms associated with ASD.

Much of the available research on cannabis and ASD deals with CBD for children or young adults. CBD is a non-psychoactive cannabinoid, with completely different effects than THC, the more psychedelic cannabinoid. 

Because of this, we really don’t have any concrete, scientific answers regarding how cannabis affects autistic people. We do know that some find it helpful, others may find it overwhelming, and the same person may find it both helpful and overwhelming in different scenarios, highlighting the ever-important aspects of set and setting.

Survey Studies

In an online survey study done by Stroud et al. (2024), 233 autistic participants completed the survey that examined participants’ experiences with psychedelics and the extent to which they attributed positive changes in mental health and social engagement to their most “impactful” psychedelic experiences.

The results are as follows: 

“The majority of participants attributed reductions in psychological distress (82%) and social anxiety (78%) and increases in social engagement (70%) to their most ‘impactful’ psychedelic experience. A substantial minority (20%) also reported undesirable effects such as increases in anxiety with some describing their psychedelic experience as among the most negatively impactful experiences of their lives. The only substantial predictor of reductions in psychological distress was increased psychological flexibility.”

Another survey done in 2025 sought to explore the knowledge, perceptions, and experiences of autistic adults regarding psychedelics. 261 participants completed the survey. 

“Participants generally viewed psychedelics positively, with 77.8% expressing a willingness to try them, and 69.7% reported past use—most commonly psilocybin mushrooms. Higher doses and highly meaningful experiences correlated with longer-lasting mental health improvements. Barriers included legal concerns, health risks, and logistical challenges. Participants with prior experience reported greater perceived knowledge and lower perceived risks. Autistic adults in this self-selecting sample demonstrated strong interest in psychedelics as potential treatments for mental health, despite significant barriers to access and research participation” (Afsharnia et al., 2025).

Parallel Research & Theories

While not exclusive to autism, this study is frequently cited in autism research because it used neuroimaging to show how LSD increases global brain connectivity and reduces communication between areas involved in “rigid” planning, which is a key area of interest for autism’s repetitive behaviors (Preller et al., 2018).

Adeyika et al. (2025) notes psilocybin’s potential for treating autism by promoting neuroplasticity and synaptic density.

It’s also theorized that suicide among autistic populations is due to serotonin and glutamate dyshomeostasis, which may be remedied by certain psychedelics (Chen et al., 2024). Suicide and depression aren’t inherent to autism; however, they are not exempt from it either, and in fact, it may very well be even more prevalent in these populations.

Current research is heavily dependent on those who can self-report in surveys, meaning a large part of the population still isn’t properly represented, especially those who are nonverbal or with higher support needs.

On a more positive note, every single one of these papers calls for more research; someone just needs to step up to the plate and tackle these questions in a clinical setting.

Check for Medication Contradictions

There’s a high percentage of autistic individuals who take medication for various co-occurring symptoms such as anxiety, sleep issues, or ADHD. Because of this, we need to be extra careful when seeking out other substances for therapeutic use. 

If you’re on medication like an SSRI or even something like Ozempic, it’s important to check with your doctor for any possible interactions.

Recommended Reading: Interaction & Taper Guide: Psilocybin Mushrooms, SSRIs, and Antidepressants

The Spirit Pharmacist is our go-to resource for professional guidance on psychedelic pharmacology, and we interviewed him here: Psychedelics, Antidepressants, & Tapering – Spirit Pharmacist, Dr. Ben Malcolm

Future Research Directions & Final Thoughts

Currently, we’re seeing a major push for non-psychedelic compounds derived from psychedelics that still promote structural and functional changes in the brain. 

This research is important because it could help autistic people who could benefit from these structural and functional changes in the brain, but may not benefit from the hallucinogenic psychedelic effects like heavy visuals or sensory distortion.

We also see a push for more research in the social aspect of autism and MDMA, with a recent clinical trial being completed in August, 2025 (as of April 2026, no results have been published). 

There’s also a study (ClinicalTrials.gov ID NCT06731621) that’s actively recruiting autistic adults with treatment-resistant depression to receive 20 hours of manualized psychotherapy that has previously been used with psilocybin and also receive psilocybin at 2 different time points, firstly a safety dose of 10mg, followed by a treatment dose of 25mg.

There should be a call for brain-imaging studies that specifically examine the prefrontal cortex (PFC).

Human post-mortem studies have found that the PFC of children with ASD have greater neuronal disorganization and differences in neuronal composition compared to neurotypical children (Stoner et al., 2014).

Due to its high 5-HT2A receptor expression, the PFC is highly modulated by the effects of serotonergic psychedelics (De Gregorio et al., 2021).

In humans, mPFC activation was associated with LSD’s ability to enhance social adaptation to others whose opinions are similar to one’s own, and their research indicated a key role of the 5-HT2A system in social feedback processing. We certainly saw that in anecdotal reports (Duerler et al., 2020). 

So, we know that the ASD prefrontal cortex is different from the neurotypical brain, and we know that it’s through the prefrontal cortex that psychedelics modulate prosocial behavior. We also know that anecdotal reports show LSD to increase prosocial behavior. All we need is more research.

As we look toward the horizon of psychedelic medicine, the goal for the autistic community is shifting from “fixing” a perceived deficit to enhancing quality of life. The focus should remain on the individual’s autonomy and their unique sensory and emotional landscape.

What may be the perfect setting for one could be disastrous for another, which is why, with such a varied diagnosis, it’s best for facilitators to consider what changes would enable their autistic clients to have a conducive psychedelic experience, such as careful attention paid to set and setting, or paying close attention to dosage.

Whether you are a facilitator, a researcher, or an autistic individual curious about these medicines, the directive is the same: Proceed with intention, prioritize safety, and honor the unique architecture of the mind.