Psychedelics for Addiction
Have you ever been formally diagnosed with a substance use disorder?
Yes
No
Is your addiction affecting you currently or in the past?
Current
Past
Do you believe your addiction to be rooted in trauma?
Yes
No
Unsure
Which substance(s) have you struggled with? (Select all that apply)
Alcohol
Opioids
Stimulants: cocaine, meth, speed, etc.
Prescription medication
Marijuana
Tobacco
Non-substance related addictions (i.e. gambling, gaming, porn, food, etc.)
Other
What types of treatment have you tried? (Select all that apply)
Group meetings such as AA
Residential treatment
Psychotherapy
Pharmacological such as naltrexone or methadone
Other
Do you use or intend to use psychedelics as the main method to treat your addiction?
Yes
No
Which psychedelics have you used to help with your problematic substance use?
Psilocybin
LSD
DMT Free base or Changa (short acting)
DMT Ayahuasca (long acting)
5-MeO-DMT (Bufo)
Ibogaine
Mescaline (San Pedro / Peyote)
Ketamine
MDMA
Other
Have you ever found yourself becoming dependent on psychedelics?
Yes
No
Unsure
What has been the most beneficial thing for your healing journey if you had to pick one? (It does not have to be a plant medicine; can be meditation, therapy, etc. too)
Feel free to share anything else you think is useful or relevant, or leave blank
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