Abstract
This study draws attention to, and provides a description of, a previously unmapped and emerging self-medication phenomenon occurring in Aotearoa New Zealand where psychedelic substances are being used in the absence of clinical supervision to address a wide range of health and wellbeing issues, partly in response to unmet mental health needs. We interviewed 34 individuals who had self-administered psychedelics with the intention of improving their health or wellbeing and used thematic analysis to generate themes from the interview data that capture the salient characteristics of this practice. We found that psychedelic substances are being used in Aotearoa New Zealand to address a variety of health and wellbeing concerns, often after other treatment options have been exhausted. Those we spoke to described personalised strategies of using psychedelics which were intended to enhance efficacy and reduce the likelihood of adverse outcomes. Positive results, including symptom remission across a range of clinical disorders and general improvements to psychological wellbeing, were alleged. We highlight concerns this phenomenon raises for clinical practice, offer suggestions for reducing potential harms associated with it, and draw attention to aspects of naturalistic use that future clinical trials might consider exploring more systematically.