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

The combination of meditation and substance use extends beyond psychedelics and should be investigated within the broader context of polysubstance use and meditation practices

In this study by Krabbe et al. (2026) researchers investigated how people combine meditation with psychoactive substances and whether these combinations are associated with psychological well-being.

The researchers found that combining meditation with substances was not limited to psychedelics: alcohol was most commonly combined with meditation (29%), followed by cannabis (19%), nicotine (16%) and classic psychedelics (6%). Psychedelic use was also associated with broader patterns of using multiple substances. Importantly, psychedelic or cannabis use, with or without meditation, showed no consistent association with the psychological well-being outcomes measured. However, other drug use without meditation was associated with poorer well-being, while this association was not observed among those who combined other drug use with meditation. People who combined alcohol with meditation also reported better well-being outcomes than those who used alcohol without meditation. These findings do not prove that meditation protects against substance-related harms, because other differences between participants could explain the association

Weekly meditation was associated with greater subjective happiness, while lifetime meditation experience was associated with greater psychological flexibility and peace of mind. The study also found that poorer well-being associated with some forms of substance use was not consistently observed among people who practised meditation. However, these findings were observational and do not establish that meditation causes improvements in well-being or enhances the therapeutic effects of psychedelics.

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.

Krabbe A, Lindström L, Sikka P, Jylkkä J. Beyond psychedelic exceptionalism: how people combine meditation with psychoactive substances, and how this relates to well-being. Psychopharmacology (Berl). 2026 Oct 17. doi: 10.1007/s00213-026-07179-5. Epub ahead of print. PMID: 42891832. Read Paper

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