The Relationships Between Healthcare Access, Gender, and Psychedelics and Their Effects on Distress.

Background: Structural inequalities in healthcare access may influence how individuals experience the psychological effects of psychedelic substances, potentially limiting positive outcomes among vulnerable populations. Objectives: This study uses data from the National Survey on Drug Use and Health (2008-2019; N = 484,732) to examine how public and private health insurance moderate the association between psychedelic use and psychological distress. Methods: Ordinary least squares (OLS) regression models indicate that private health insurance is associated with lower psychological distress, while public insurance is associated with higher distress. Results: Psychedelic use moderates these associations, reinforcing the protective pattern linked to private insurance and intensifying distress among those with public coverage. These patterns vary by gender: among men, psychedelic use does not significantly alter the association between insurance type and distress; among women, however, psilocybin and lysergic acid diethylamide (LSD) use are associated with lower distress among those with private insurance, but with higher distress among those with public insurance. Conclusions: These findings indicate that while psychedelics may interact with existing healthcare conditions, they do not mitigate structural inequalities and may, in some cases, exacerbate them.