Research | Fireside Project

Because of the tens of thousands of conversations we’ve had on our Psychedelic Support Line, we are uniquely positioned to learn how psychedelics are actually being used - from recreational to religious, from underground to regulated access, from clinical to non-clinical.

We speak with people in the midst of psychedelic experiences, and with those integrating journeys weeks or years later. Our callers seek support with a broad spectrum of substances - psilocybin, MDMA, LSD, 5-MeO-DMT, ibogaine - and arrive from every background, every age, every lived experience. We also speak regularly with active service members, military veterans, and first responders.

Each conversation produces a triple-bundled record:

The call log - structured notes from the volunteer who took the call.

The post-call survey - sent the day after, capturing how the caller felt before, during, and after.

The anonymized conversation - de-identified transcripts of what was actually said.

We believe this is by far the largest and richest dataset in history of psychedelic conversations - and it expands every day. This unprecedented repository facilitates deeper understanding of every dimension of the psychedelic experience, all of which we endeavor to leverage in service of the field.

A glimpse of our data.

Seven charts from our recently published Five-Year Impact Report, a preliminary look at what conversations have begun to reveal.

Caller demographics.

We support callers from every background, age, and lived experience. The diversity of our dataset is part of what makes it so unique and impactful to the field.

Race & ethnicity

Caller composition.

White 35.7%

Asian 14.9%

Latinx 13.6%

Multi-racial 10.5%

Black 8.3%

Other 17.0%

What callers are taking.

Psilocybin accounts for the majority of calls, a reflection of its growing use across recreational, ceremonial, and therapeutic contexts. Distress rates, however, tell a more complicated story.

Substances people are calling about.

Psilocybin57.5%

LSD13.8%

Cannabis9.5%

Ketamine6.9%

Other5.1%

MDMA3.3%

Ayahuasca2.9%

5-MeO-DMT1.0%

Co-use patterns

How substances combine.

When callers report using more than one substance, psilocybin and cannabis is by far the most common pairing - followed by combinations of psilocybin or LSD with other substances. Pairing data offers a window into real-world use that few clinical studies can capture.

Most common pairings.

Psilocybin + Cannabis25.4%

Psilocybin + Other16.2%

LSD + Psilocybin15.8%

LSD + Other15.6%

LSD + Cannabis11.3%

Psilocybin + MDMA9.8%

Caller-reported distress

Caller distress by substance.

Cannabis has the highest distress rate among callers. This may be a function of the large number of cannabis users in conjunction with a rise in the potency of cannabis products.

Distress rate

% of callers reporting distress.

Cannabis47.2%

Psilocybin42.2%

LSD41.8%

Ketamine40.9%

MDMA40.7%

Emergency escalation

Escalation is rare.

Across every substance, fewer than 1 in 100 calls escalate to emergency services. Even cannabis - the substance with the highest rate - sits at under one percent. Peer support keeps people grounded at home, out of ambulances and ERs.

Escalation rate

% of calls escalating to 911 or ER.

Cannabis0.65% n=13/2,004

MDMA0.44% n=3/682

LSD0.36% n=8/2,247

Psilocybin0.28% n=26/9,348

Ketamine0.08% n=1/1,194

Presenting concerns

What comes up on the line.

Anxiety and overwhelm dominate, together accounting for over 8,000 interactions. But beneath the immediate surface, callers bring relationships, identity, fear, and unprocessed trauma - the deeper material a psychedelic experience tends to surface.

Trip content themes

Mentions across 40,000 calls.

Anxiety4,566

Overwhelm3,562

Relationship2,805

Fear2,780

Identity2,349

Confusion1,826

Loneliness1,724

Spiritual1,666

Somatic1,664

Processing trauma1,645

Mental health context

Diagnoses behind the calls.

Many callers reach out while navigating PTSD, major depression, and generalized anxiety - using psychedelics, at least in part, to address what conventional treatment hasn’t resolved. This trend will likely accelerate as psychedelics continue to mainstream and the cost of clinical care will put it out of reach for many Americans.

Diagnoses mentioned by callers.

PTSD1,449

Major Depression1,308

GAD692

OCD386

BPD200

Schizophrenia185

ADHD120

Social Anxiety113

Visit our five-year impact report, Five Years of Light

The Study

Does a peer-support helpline reduce the harms of nonclinical psychedelic use?

That’s the question we set out to answer. Over 17 months - from our launch in April 2021 through September 2022 - we surveyed callers 24 hours after every conversation and analyzed call logs from every shift.

In partnership with

848

Post-call surveys

4,047

Call logs

Months of data collection

21%

Survey response rate

The Findings

The data answered with a clear yes.

… been physically or emotionally harmed

29.3% 249 callers

… called 9‑1‑1

12.5% 106 callers

… gone to the emergency room

10.8% 92 callers

65.9%

of callers were de‑escalated from psychological distress.

Of 848 callers who responded to our post-call survey, nearly two-thirds said their conversation with a peer supporter moved them out of distress - emotional, mental, or physical - that they were experiencing on the line.

Who Was Calling

Our call logs also revealed the depth of need our callers brought to the line.

27.4%

mentioned an underlying psychiatric condition

39.9%

used psychedelics alone, without anyone present

Study 02 · Accepted for Publication by Science Advances

The Fireside Database: the first systematic dataset on real-world psychedelic support.

The Fireside Database comprises 40,000 peer-support interactions conducted by 700 trained volunteers between 2021 and 2026 - integrated with volunteer-coded metadata and 3,000 post-call survey responses.

Why it matters: This resource will enable groundbreaking research into psychedelic epidemiology, evidence-based training, and what actually makes psychedelic psychological support effective.

Authored by Fireside Project Research Team

40,000

Peer-support interactions

700

Trained volunteers

3,000

Caller satisfaction surveys

2021–26

Five years, every day

Study 03 · Submitted for Publication

Patient interest in psychedelic coaching during ketamine treatment.

We surveyed patients receiving ketamine treatment for depression at MGH’s Ketamine Clinic. We asked them whether they felt like they needed more support with their ketamine experiences and, if so, whether they were open to receiving psychedelic coaching, including as an adjunct to psychotherapy.

Why it matters: this study establishes not only that ketamine patients, even those with therapists, are often getting insufficient support, but that they are open to receiving a non-clinical form of support in a clinical context.

In partnership with

MGH

Ketamine Clinic setting

TRD

Treatment-resistant depression

50+

Patients surveyed

Institutional partners

Study 04 · Coaching has begun

Is psychedelic coaching effective in a clinical context to help ketamine patients suffering from depression?

A pilot study testing whether 12 weeks of coaching from Fireside-Certified psychedelic coaches can prolong and enhance the antidepressant effects of ketamine in patients with treatment-resistant depression at MGH’s Ketamine Clinic.

Why it matters: this pilot study could help show that psychedelic coaching is an effective, accessible, and high-impact modality that can be a critical part of a clinical care team.

In partnership with

Patient cohort

Weeks of coaching

TRD

Treatment-resistant depression

Coaching has begun

Study status

Where Research
Meets Real Life

Where the rubber meets the road.