Psychedelics are associated with changes in spiritual beliefs and orientations in US veterans

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Brown, Kenneth Shinozuka, Irakli Kaloiani, Lena Kozyr, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8960226/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The acute effects of psychedelic medicines include shifts in perception and awareness that can often include mystical or spiritual elements. Research suggests that these experiences can also extend into more persisting changes in spirituality, yet this area is underexplored. This study examined the effects of psychedelic experiences on spiritual beliefs using a survey of N = 151 people who had received funding to attend a psychedelic-based treatment. Participants were primarily United States (US) veterans who retrospectively completed an online survey assessing the impact of their most memorable psychedelic experience on thoughts, emotions, and behavior. When comparing beliefs reported after one’s most memorable psychedelic experience with those reported before, the proportion of participants who endorsed an active belief in God or a higher power was significantly higher, and the proportion who denied a belief in God or a higher power was significantly lower. We did not observe significant changes in affiliation with spiritual or religious groups after the psychedelic experience, but qualitative analysis suggested that the nature of the participants’ relationship with spirituality exhibited some shifts. These findings suggest that psychedelic experiences can act as a catalyst for increased spiritual connection and reorientation, particularly among individuals who previously identified as doubting or nonbelieving. Psychology psychedelics spiritual beliefs religious affiliation ibogaine veterans Figures Figure 1 Figure 2 Introduction In recent years, there has been a resurgence in psychedelic research, driven by the urgent need for novel treatments for mental health conditions (Hadar et al., 2023; Perkins et al., 2021; Vargas et al., 2021). This need is particularly strong among US military veterans, who experience high rates of treatment-resistant post-traumatic stress disorder (PTSD) and depression (Liu et al., 2019; Wisco et al., 2022). Emerging evidence suggests that psychedelic-assisted therapies may offer meaningful therapeutic benefit for PTSD, depression, and related disorders (Mitchell et al., 2023; Yao et al., 2024). However, despite growing interest and promising outcomes, many effects of these substances remain incompletely characterized. One underexplored domain concerns the impact of psychedelic experiences on spiritual and religious beliefs. Many psychedelic substances have long histories of use within indigenous religions and spiritual traditions (Fotiou, 2019); however, the spiritual and religious impacts of these substances in Western medicalized contexts remain understudied. Thus far, one finding with consistent appearance across observational and experimental studies is a greater sense of spirituality following psychedelic use (Davis et al., 2020; Gezon & Bartlett, 2025; Griffiths et al., 2019; Kavenská & Simonová, 2015; Nayak et al., 2023; for review see Schutt et al., 2024). An important mechanism underlying this observed effect may be acute experiences of changes in consciousness during the psychedelic treatment. Phenomenological syntheses of subjective psychedelic experiences describe a broad range of features commonly reported by users, including altered sensory perception (visual and somatic), symbolic imagery, ego-dissolution, and emergent meaning (Costines & Schmidt, 2024). Particularly with classic psychedelics (e.g., lysergic acid diethylamide [LSD], psilocybin, N,N-dimethyltryptamine [DMT]), these experiences frequently include elements described as spiritually significant. Such experiences, defined in the psychedelic literature as “mystical experiences”, are characterized by a sense of unity, sacredness, ego dissolution, ineffability, profound peace, and the impression of encountering an ultimate reality or objective truth (Griffiths et al., 2006; Søgaard Juul et al., 2023). It is important to note that spiritual beliefs can be expressed by both religious and non-religious individuals and provide the context and foundation for interpretation of mystical experiences (Hood & Chen, 2005). Several studies have found a positive correlation between mystical experiences and ratings of spiritual connection or growth following psychedelic use (Nayak et al., 2023; Schutt et al., 2025). The association between spirituality and psychedelics is important to understand, given the strong influence of spirituality on health and well-being. Several large-scale population studies have found endorsement of spirituality or religiosity to be predictive of better physical or mental health (Koenig, 2012; Oman & Thoresen, 2005; Zimmer et al., 2019). Additional studies focused on populations with mental health conditions have found higher levels of spirituality or religiousness to be associated with lower rates of depression, suicidality, and substance use disorders (Head, 2025; Lucchetti et al., 2021). As described above, US veterans have been identified as a population for which hopes for advances in mental health care via psychedelic medicine are high. Sharma et al. (2017) replicated this pattern in a sample of more than 3,000 US veterans, finding an inverse relationship between spirituality/religiosity and depression, suicidality, and alcohol use disorder. Elucidating the relationship between psychedelics and spirituality is also of interest for sociological reasons. At the macro-level, public opinion and special interest groups have impacted psychedelic medicine in the past and are certain to influence the future of psychedelic research and accessibility of these substances (Andrews & Wright, 2022; Koning et al., 2024). Given the intense and often profound nature of psychedelic experiences, there is both concern and optimism about how these experiences may impact beliefs and community cohesiveness (Dupuis, 2021; Johnson & Yaden, 2020). Additionally, perceptions held by one’s community can have a strong impact on the individual experience with psychedelics. For example, among participants who used a psychedelic, greater approval of psychedelics by one’s spiritual/religious community was associated with a higher likelihood of a positive experience of resolving a spiritual struggle (Schutt et al., 2025). Furthermore, psychedelics can increase sensitivity to expectations and social influences, making surrounding context and community beliefs (i.e., “set and setting”) highly impactful (Hartogsohn, 2016). One unresolved question is whether psychedelics impact religious affiliation (Carroll, 2025; Johnson & Yaden, 2020). There is some evidence suggesting a trend toward decreased affiliation with organized religion following psychedelic experiences (Cherniak & Granqvist, 2025; Griffiths et al., 2019). Additionally, a positive association has been found between psychedelic use and the personality trait of openness (Erritzoe et al., 2019; MacLean et al., 2011; Raison et al., 2022), which, in turn, is associated with decreased religious fundamentalism (Ashton & Lee, 2021; Saroglou, 2002). While these findings raise the possibility of decreased affiliation with organized religion following psychedelic experiences, the existing evidence is limited and indirect. The current study is also uniquely positioned to provide information on ibogaine. Most prior psychedelic research has focused on classic psychedelics, with more limited data on ibogaine. Ibogaine is not considered to be a classic psychedelic and is sometimes defined as an oneirogen due to its production of an extended dream-like state (Alper, 2001; Mash et al., 2018). Prior research saw beneficial effects of ibogaine on substance use disorders (Brown & Alper, 2018; Mash et al., 2018; Noller et al., 2018), yet enthusiasm for research and clinical use of ibogaine is tempered by recognition of rare yet potentially lethal cardiometabolic effects (Alper, 2001; Köck et al., 2022; Ona et al., 2022). Recently, the Stanford Brain Stimulation Lab studied co-administration of ibogaine and magnesium protocol (“MISTIC”), designed to minimize the potential cardiometabolic risk (Cherian et al., 2024). This observational study of US Special Operations Forces Veterans with a history of traumatic brain injury (TBI) and trauma who independently elected to undergo ibogaine treatment found significant reductions in TBI-related disability, posttraumatic stress, depression, and anxiety symptom severity. Additionally, qualitative analysis of data from this study found that experiences with ibogaine often included heavily symbolic and spiritual imagery (Olash et al., 2026). Therefore, ibogaine also appears to frequently evoke mystical experiences. Study Aims and Hypotheses The current study aims to determine whether psychedelics are associated with altered spiritual beliefs and religious affiliations in veterans, based on retrospective responses to a survey about their most memorable psychedelic experiences. Our study is also uniquely positioned to provide information on ibogaine, given that most participants reported on an experience with ibogaine. Our primary hypotheses were: 1) The proportion of participants who endorsed active belief in and pursuit of a relationship with God or a higher power will be higher after the most memorable psychedelic experience, and 2) The proportion of participants who denied belief in God or a higher power will be lower after the most memorable psychedelic experience. We also proposed secondary hypotheses that the proportion of participants endorsing affiliation with 1) organized religion, and 2) Christian religion, will be lower after the most memorable psychedelic experience (Christianity is the organized religion with highest representation in the current sample). Methods Veterans Exploring Treatment Solutions VETS: Veterans Exploring Treatment Solutions, Inc. (VETS) is a 501(c)(3) non-profit organization that provides grant funding for Special Operations Forces (SOF) veterans seeking psychedelic-assisted therapy. VETS is not a psychedelic treatment provider, and grants are primarily awarded to SOF veterans (e.g., Navy SEALs, Army Green Berets, Marine RECON) and their spouses. Occasionally, special circumstance grants are awarded on a case-by-case basis to veterans who may not meet SOF distinction but are in immediate need of assistance. Grant recipients are awarded grant funding to attend psychedelic programs in countries where these treatments are legal or unregulated. Psychedelic programs vary in length, clinical approach, and psychedelic substance offered, among other considerations. Grant recipients self-select the psychedelic program they wish to attend. Despite the availability of disparate psychedelic programs, most VETS grant recipients pursue ibogaine-assisted therapy in conjunction with 5-MeO-DMT. Participant Recruitment All VETS grant recipients who had completed a psychedelic program were eligible to participate in the survey. Beginning in November 2023 and continuing through February 2025, five email campaigns invited 659 total grant recipients to participate. Email communications described the survey as an effort to better understand the religious and faith experience of grant recipients in order to inform organizational programming and policy development. No compensation was provided, but participants were invited to enter a raffle for VETS merchandise. The survey was anonymous, unless respondents provided an email to be entered into the raffle. The link to the survey was also posted on the VETS community platform, a private webspace available to grant recipients to access programming, network, and communicate with peers and organizational staff. VETS staff members also encouraged survey participation by word of mouth during programming. Consent for anonymized release of survey responses and testimonial data was collected prior to survey participation when participants were awarded their grants through VETS. Survey Administration The survey was designed and housed on Jotform, an online survey and workforce platform. Participants accessed the survey using a weblink. The survey took approximately 20 to 40 minutes to complete, depending on responses to free-form questions. Survey Description Demographics Participants were asked six items gauging demographic information, including age, VETS grant classification, marital status, race/ethnicity, and sexual orientation. Religious/Spiritual Patronage Participants were asked about religious affiliation and participation in faith-based groups before their most memorable psychedelic experience and at the time of the survey completion. Responses included Lutheran, Methodist, Reformist, Buddhist, Spiritual, Jewish, Baptist, Anglican, Non-denominational Christianity, Hindu, Atheist, Agnostic, Presbyterian, Pentecostal, Catholic, New Age, Muslim, Mormon, Other (open field), None of the above. Respondents could select multiple options. Relationship with God or Higher Power Using a five-item scale (below), participants were asked to describe their belief in God or a higher power before their most memorable psychedelic experience and at survey completion. The scale is not a validated measure. Five-Item Scale: 1) Do not believe in God or a higher power , 2) Doubting in God or a higher power , 3) Searching for God or a higher power , 4) Passively believe in God or a higher power , and 5) Actively believe in and pursue a relationship with God or a higher power . Participants were also asked if their most memorable psychedelic experience brought them closer to God or a higher power, with “yes” or “no” as the response options. Psychedelic Use History Respondents were asked when their most memorable psychedelic experience was, which psychedelic substances were consumed in that experience, and psychedelic use outside of the most memorable experience. Changes in Emotions, Beliefs, and Behaviors A five-item Likert scale (below) was used to assess changes in religious or spiritual emotions, beliefs, and behaviors. A list of the 33 emotions, beliefs, and behaviors can be found in Supplementary Figures 2 and 3. Response options for the Likert Scale were: 1) Significantly Decreased , 2) Decreased , 3) No Change , 4) Increased , and 5) Significantly Increased. Testimony Respondents were invited to share testimony relating to how their experience has affected their faith or spiritual beliefs. Please see Supplementary Material for a description of additional survey items not included in the analysis. These items were excluded in order to focus on the main outcomes of interest for this manuscript, as outlined in the registration of hypotheses (doi:10.17605/osf.io/6CGZU). Additionally, several items had insufficient endorsement to yield meaningful results (e.g., changes in addiction behaviors were excluded from analyses due to low response). Data management Screening for duplicate entries Given the nature of data collection, steps were taken to screen the data for duplicate entries (i.e., multiple completions of the survey by the same participant). Screening for duplicates was undertaken using a sliding window (review of data from participants from current age +/- 1 year). Data entries were compared across the following categories: age (at survey submission), veteran status (veteran, spouse of a veteran, or other), gender, race, sexual orientation, date of most memorable psychedelic experience, estimate of lifetime use of psychedelic substances (+/- 5), marital status, spiritual/religious affiliation before most memorable psychedelic experience, alcohol or drug use dependencies/behavioral addictions before one’s most memorable psychedelic experience. This screening process identified six instances of potential duplicate entries (there were no instances of exact matches across any two survey responses, but these cases shared enough information to flag). Sensitivity analyses were conducted excluding the second response from each potential-duplicate pair of items. Spiritual/Religious affiliation categorization Responses to the survey items indexing affiliation with spiritual or religious traditions were available for all N = 151 respondents. To facilitate data visualization, we combined related sub-categories into broader categories. Specifically, the 19 original categories were consolidated into a smaller set of 7, as follows: 1) Buddhist, 2) Non-denominational Christian, 3) Christian (Lutheran, Methodist, Reformist, Baptist, Anglican, Presbyterian, Pentecostal, or Catholic) 4) Spiritual, 5) Agnostic-Atheist (Atheist, Agnostic, write-in response of “questioning”), 6) Other (none of the above, other/write-in response, Muslim, Jewish, Mormon, Hindu, New Age), 7) Multiple. Given that the term “spiritual” is often used to describe engagement in any spiritual or religious practice, in cases where both “spiritual” and another option (e.g., “Buddhist”, “Christian”) was selected, the more specific affiliation was assigned for the analysis. The affiliations of Muslim, Jewish, Mormon, Hindu, and New Age were included in the “other” category due to low numbers precluding meaningful analysis. For participants who selected multiple Christian affiliations, if non-denomination Christian was among the affiliations selected, they were included in the “non-denominational” category (Figure 2). After the aforementioned processes were carried out, the “Multiple” label was assigned if a participant reported affiliations encompassing at least two different categories (e.g., a participant who selected both “Reformist” and “Non-denominational Christian” would be included in the “Non-denominational Christian category; a participant who selected both “Buddhist” and “Non-denominational Christian” would be included in the “Multiple” category). Given the subjective nature of the categorization decisions described above, we conducted a sensitivity analysis of our outcomes in which we excluded participants who were assigned the “Multiple” label ( n = 28) Statistical analyses De-identified data was shared by VETS with Stanford Brain Stimulation Lab for analysis. Our primary and secondary hypotheses were assessed using McNemar’s test (chi-square test for paired samples). Additionally, to further explore changes in proportions from before to after the most memorable psychedelic experience, we used Generalized Estimating Equation (GEE) models to conduct binary logistic regression. GEEs were conducted in R using the geepack library (Højsgaard et al., 2025) and used a logit link function, First-Order Autoregressive correlation structure (AR-1), and robust variance estimation. To explore the impact of psychedelic experiences associated with ibogaine, we reanalyzed our primary and secondary outcomes with the sample restricted to those participants who reported completing the survey questions based on ibogaine use. We also conducted a sensitivity analysis to explore the robustness of our outcomes regarding religious/spiritual affiliation. Specifically, we reanalyzed the data after excluding responses of participants who selected multiple affiliations (e.g., Christian and Buddhist; New Age and Muslim). Finally, we conducted exploratory analyses (estimation of mean and spread) of participants’ ratings on a 5-item Likert scale indexing changes for 33 emotions, beliefs, and behaviors. Results and discussion from these findings are available in the Supplementary information. Analyses and data visualization were conducted using R and SPSS (IBM Corp., 2024; Posit Software, PBC, 2025). Packages in R included geepack (Højsgaard et al., 2025), broom (Robinson et al., 2025), dplyr (Wickham et al., 2023), ggplot2 (Wickham, Chang, et al., 2025), tidyr (Wickham, Vaughan, et al., 2025), and reshape2 (Wickham, 2025). Qualitative Analysis Respondents were invited to share testimony relating to how their experience has affected their faith or spiritual beliefs using the following free-form question: “Please share any testimony relating to how your most personally meaningful psychedelic experience has affected your faith or spiritual beliefs.” We performed thematic analysis on responses to this question, following previously established methods (Ahmed et al., 2025). Codes describing meaningful features of the data were generated using ( ATLAS.Ti Scientific Software Development GmbH , 2023), which were automatically grouped into five categories. Two researchers (K.S. and I.K.) independently searched for themes in the codes and then, through discussion, converged on a final set of themes. Results Descriptives Participants included N = 151 individuals, consisting of 133 U.S. veterans and 18 spouses or other individuals relevant to the group, who attended psychedelic programs with grant support from VETS. The mean age of participants was 47.2 years (SD = 7.2). The sample was predominantly male ( n = 129, 85.4%) and largely identified as Caucasian/White ( n = 127, 84.1%), with smaller proportions identifying as Hispanic/Latino ( n = 20, 13.2%), American Indian/Alaska Native ( n = 6, 4.0%), Asian/Filipino ( n = 5, 3.3%), Black/African American ( n = 2, 1.3%), Native Hawaiian/Pacific Islander ( n = 2, 1.3%), and Other ( n = 7, 4.6%; Table 1). Table 1. Demographic Characteristics of Participants Variable n (%) Veteran status Veteran 133 (88.1%) Spouse / Other 18 (11.9%) Gender Male 129 (85.4%) Female 22 (14.6%) Race / Ethnicity* Caucasian / White 127 (84.1%) Hispanic / Latino 20 (13.2%) American Indian / Alaska Native 6 (4.0%) Asian / Filipino 5 (3.3%) Black / African American 2 (1.3%) Native Hawaiian / Pacific Islander 2 (1.3%) Other / Prefer not to say 7 (4.6%) Note. N = 151 and participants were on average 47.2 years of age (SD = 7.2). *Participants could select more than one race/ethnicity; percentages may exceed 100%. Belief in a higher power before and after the most memorable psychedelic experience Responses to the survey item indexing belief in God or a higher power before and after one’s most memorable psychedelic experience were available for all N = 151 respondents. To investigate Hypothesis 1, we dichotomized survey responses into “active belief and pursuit of a relationship with a higher power” (hereby referred to as “active belief”) versus selection of any other response option (i.e., “passive belief”, “doubting in”, “searching for”, or “do not believe” in God or a higher power). McNemar’s test indicated a significant change in proportions for endorsement of active belief with the proportion of participants who endorsed belief in a higher power increasing at the after time point ( (1) = 79.012, p < .001). Specifically, n = 27 participants reported active belief at both the before and after time points; n = 0 before but not after; n = 81 after but not before; and n = 43 participants neither before nor after. A GEE model estimated the odds of endorsing active belief after versus before the most memorable psychedelic experience was 11.5 (95% CI: 6.7, 19.9). McNemar’s test also indicated a significant change in the proportion of participants who endorsed “do not believe” (hereby referred to as “no belief”) in God or a higher power from before to after their most memorable psychedelic experience; a binomial test on discordant pairs was used due to a small number of counts across some discordant cells rendering the chi-square test unreliable ( p < .001, two-sided statistical test at α = .05). Specifically, n = 2 participants reported no belief before and after; n = 19 before but not after; n = 0 after but not before; and n = 130 neither before nor after. A GEE model estimated the odds of endorsing no belief after versus before the most memorable psychedelic experience at .08 (95% CI: .02, 36; i.e., the odds of endorsing “no belief” were 12.5 times lower at the after time point). Sensitivity analyses found consistent outcomes for the two analyses described above (i.e., change in active belief and change in no belief) when responses identified as potential duplicates were excluded. The McNemar’s tests for changes in proportion of participants endorsing belief in God or a higher power were rerun in a sample restricted to participants who had taken ibogaine (or ibogaine + 5-MeO-DMT) during their most memorable psychedelic experience ( n = 104 participants). Outcomes remained the same in this subsample. Specifically, McNemar’s test indicated a significantly higher proportion of participants endorsing active belief after compared to before their most memorable psychedelic experience ( (1) = 52.019, p < .001). McNemar’s test (using binomial test on discordant pairs) also indicated a significantly lower proportion of participants who endorsed no belief after compared to before their most memorable psychedelic experience ( p < .001, two-sided statistical test at α = .05); specifically, from before to after the most memorable psychedelic experience, 14 participants shifted from endorsement of “no belief” to another selection, and no participant shifted from another selection to “no belief”. See Supplemental Figure 1 for counts of participants selecting each pair of responses at the before and after time points. Although responses were binarized for the use of McNemar’s statistical test, the full range of responses endorsed before and after one’s most memorable psychedelic experience are presented in Figure 1. The most notable pattern appears to be a transition from less to greater belief, as evidenced by darker color in the left-sided columns of Figure 1. For example, across participants who selected one of the four options other than “active belief” the percentage of participants who transitioned to selecting active belief after their most memorable psychedelic experience ranged from 43% (for those who selected “no belief” before) to 88% (for those who selected “searching for” before). Spiritual/Religious affiliation before and after most memorable psychedelic experience To examine our hypothesis that affiliation with organized religion would be lower after one’s most memorable psychedelic experience, we conducted McNemar’s test on affiliation with organized religion across the before and after time points. Affiliation with organized religion encompassed participants who were included in categories 1-3 (Buddhist, non-denominational Christian, Christian) as well as the few participants from category 6 (other) who selected Muslim, Jewish, Mormon, or Hindu (this applied for n = 2 participants at the before time point and n = 1 at the after time point). Lack of affiliation with organized religion was assigned for all participants who did not meet the aforementioned criteria. Outcomes from McNemar’s test did not support our hypothesis. McNemar’s test (using binomial test on discordant pairs) indicated that there was no significant change in the proportion of participants endorsing affiliation with an organized religious group from before to after their most memorable psychedelic experience ( p = .664, two-sided statistical test at α = .05). N = 70 participants endorsed affiliation with organized religion both before and after the most memorable psychedelic experience; n = 12 before but not after; n = 9 after but not before; and n = 60 neither before nor after. When this test was repeated in a sample that excluded n = 28 participants who had made multiple affiliation selections, outcomes remained the same ( p = 1). Specifically, the proportion of participants who endorsed affiliation with organized religion was 46% at both the before and after timepoints. To examine our hypothesis that endorsement of affiliation with a Christian religion would be lower after one’s most memorable psychedelic experience, we conducted McNemar’s test. Affiliation with Christian religion encompassed participants who were included in categories 2 or 3 (non-denominational Christian or Christian). McNemar’s test (using binomial test on discordant pairs) indicated that there was no significant change in the proportion of participants endorsing affiliation with Christianity ( p = .189, two-sided statistical test at α = .05). N = 66 participants endorsed affiliation with Christianity both before and after the most memorable psychedelic experience; n = 14 before but not after; n = 7 after but not before; and n = 64 neither before nor after. When this test was repeated in the sample excluding n = 28 participants who had made multiple affiliation selections (i.e., selected multiple affiliations at either the before or after time point), outcomes remained approximately the same ( p = .424); specifically, the proportion of participants endorsing affiliation with Christianity was 57% at the before time point and 54% at the after time point. Similarly, when these analyses of the proportion of participants who affiliated with organized religion and Christianity were repeated in the subsample that endorsed use of ibogaine associated with their most memorable experience, outcomes were consistent. McNemar’s test did not indicate a statistically significant shift in proportion of participants endorsing these affiliations ( p > .05). Figure 2 shows the number of participants endorsing each affiliation before and after their most memorable psychedelic experience. This supports more nuanced review of changes in affiliation. As can be observed from the intensity of color along the upwards diagonal, the majority of participants seemed to retain the same affiliation. The Spiritual category exhibited the greatest increase in affiliation after psychedelics. Similarly, the selection “Agnostic-atheist” exhibited a relatively large decrease in selection. While no participants affiliated with Buddhism before their most memorable psychedelic experience, several participants selected this affiliation after (Please note that there may be additional participants who selected a Buddhist affiliation, but who also made other selections and were therefore included in the “multiple” category). Qualitative analysis of self-reported changes in spiritual beliefs 102 participants provided a response available for qualitative analysis. Our qualitative analysis identified four themes: 1) Shifts from belief-based to experience-based knowledge of God, 2) Reinterpretation of established religious concepts, 3), Perennialism and love, and 4) The continuity of consciousness after death. Shifts from belief-based to experience-based knowledge of God Participants consistently reported that ibogaine led them to directly experience God, rather than merely believing in God. One participant stated, “I no longer have any need for faith. I now have the knowledge that God is very, very real,” while another described becoming “certain there’s a creator, a single source that connects us all” following a 5-MeO-DMT experience. This “noetic” quality of their religious experience, felt immediately, authoritatively, and beyond doubt, was often framed as the most consequential aspect of the experience. Participants repeatedly emphasized that this knowledge was gained not through reasoning, scripture, or instruction, but instead through direct encounter (e.g., “I saw God”; “I stood in the presence of the all knowing”). Such reports suggest that psychedelic experiences can transform abstract theological concepts into experiential certainties. Reinterpretation of established religious concepts While many participants reported strengthening or restoration of their faith, it also distanced them from religious dogma, authority structures, or exclusive truth claims. As one participant stated, “psychedelics released me from the religious dogma that Christianity places on people” while simultaneously confirming “who God truly is.” A few participants described how religious dogma had caused them to lose their connection to God; for example, one participant noted that her strict Catholic upbringing constrained her innate curiosity about spirituality, while another participant reported that the term “God” had begun to carry too much baggage. Both participants reported that their psychedelic experience led them to feel closer to God than ever before, including a sense of God that transcended their preconceived, dogmatic beliefs. According to another participant, “Prior to [my] second [psychedelic] journey, my 'beliefs' were based in religion - which in my opinion is a blueprint for what one ‘should’ believe. During/after this journey, I've realized their [ sic ] is no blueprint and there is no ‘one’ way for faith/spiritual beliefs.” In other words, participants described their psychedelic experiences as fomenting a new form of spirituality that does not conform to a rigid structure or set of rules, but can rather be understood as a personal, experiential, and relational process that unfolds outside the boundaries of institutional authority. Perennialism and love Following their psychedelic experience, many participants reported embracing perennialism, the view that all religions are different expressions of the same, underlying truth. Several respondents articulated an expanded theological framework in which religious traditions were understood as culturally specific expressions of a shared reality rather than competing, incompatible belief systems. Participants experienced the insight that “God is too big for any one faith/religion,” for “whatever is out there is much bigger than we can comprehend”; indeed, “all religions - all Gods - all manifestations” are equally valid. While some respondents had an ineffable experience of God during their psychedelic experience, others did describe God as a “unified field of eternal love,” “perfect love,” or as a being whose “love transcends all things.” In other words, psychedelics revealed to many participants that love was not merely an emotional state but rather the foundation of spirituality, the common substrate beneath diverse religious symbols, narratives, and practices. This love was often characterized as “unconditional,” “non-judgmental,” and miraculous, fueling the profound psychological transformation and healing that participants experienced on psychedelics. The continuity of consciousness after death Finally, many participants reported a newly consolidated belief in reincarnation or the afterlife, often due to vivid encounters with deceased loved ones or spiritual beings. These experiences were frequently described as resolving long-standing grief, survivor guilt, or existential fear. For example, one respondent described seeing deceased family members who “assured me that they were OK,” while another felt a newfound sense of peace following the death of a parent by recalling a vision of “a beautiful, uncapped land where the hand of God was waiting for him.” Such experiences often reinforced the perception that death represents a transition rather than an endpoint of consciousness. Notably, these beliefs were again framed as experiential knowledge rather than speculative belief, contributing to a broader sense of existential reassurance and meaning. Discussion Psychedelic experience was associated with increased belief in a higher power Our outcomes indicated a robust shift toward increased spiritual beliefs, coupled with a decline in explicit nonbelief. The odds of endorsing active belief in a higher power after the experience were more than 11 times greater than before (OR=11.5, 95% CI: 6.7–19.9). Notably, no participants who endorsed active belief prior to their experience shifted away from this position afterward. In contrast, explicit nonbelief declined sharply, with the vast majority of participants who reported “no belief” at the before time point transitioning to another belief category. These findings are consistent with outcomes reported by previous studies assessing belief in God or a higher power across psychedelic use. Specifically, several quantitative and qualitative analyses have shown that classic psychedelic use is associated with increased belief in a higher power (Davis et al., 2020; Gezon & Bartlett, 2025; Griffiths et al., 2019; Kavenská & Simonová, 2015; Nayak et al., 2023; Schutt et al., 2024). A notable exception is Nayak et al. (2025), which prospectively assessed belief before and after psychedelic use and found no change in belief in a higher power. Additional prospective studies are needed to determine whether this result reflects a true null effect or reduced retrospective bias. Several contemporary studies have confirmed that psychedelics frequently evoke mystical experiences (Holze et al., 2020, 2021; Ley et al., 2023). Qualitative analysis of participant's free responses in the current study indicated mystical experiences were well-represented. For example, participants’ descriptions of profound encounters with God or other spiritual beings as well as experiences with a “noetic” quality of connecting with a universal truth are all encompassed under current conceptualization of the “mystical experience” (Barrett et al., 2015; James, 2003; Stace, 1960). It appears likely that these mystical experiences directly contributed to increased endorsement of belief in God or a higher power following the psychedelic experience. However, the occurrence of mystical experiences and their relationship with spiritual beliefs was not quantified in this sample. Aspects of the psychedelic protocols undertaken by many of the participants represented in this survey may have predisposed them towards experiences with spiritual content. The VETS organization supports access for grant recipients to therapists with experience in spiritual integration. Therefore, given that psychedelics appear to amplify the effect of therapeutic context on participant’s psyche, these preparatory therapy sessions may have predisposed participants to have spiritual experiences (Dupuis, 2021; Hartogsohn, 2016). Psychedelic experience and stability of religious affiliation Despite a clear increase in belief in a higher power, affiliation with organized religion remained largely stable. Neither overall religious affiliation nor Christian identification demonstrated statistically significant shifts. Most participants retained their original affiliation, as reflected by the strong diagonal patterns in the affiliation heatmap (see Figure 2). Outcomes from previous studies regarding changes in spiritual or religious affiliation following psychedelic use have been mixed. For example, Cherniak and Granqvist (2025) presented results from two large-sample survey studies; the first study found evidence of an association between psychedelic use and a greater likelihood of transitioning away from religious affiliation, but the second study did not replicate this finding. A qualitative study by Gezon and Bartlett (2025) found evidence for two paths of deepening spiritual connection: 1) increased closeness to one’s faith tradition of origin, or 2) increased spiritual connection accompanied by distancing from organized religion. We did not observe evidence for the latter in our analysis, but it is possible that in larger studies these patterns may be observable in different subsamples of participants. It is also notable that the qualitative analysis of our sample discovered a theme of increased personal connection with God or a higher power that was felt to supersede institutional dogma, which, as noted above, is consistent with classical accounts of mystical experience (James, 2003). Our qualitative outcomes suggest that the increased belief in God or a higher power observed in quantitative analyses was driven by reinforcement of a personal connection with one’s faith, as opposed to by reinforced attachment to religious doctrine. Despite the absence of significant change in spiritual affiliation, several lines of evidence suggest one’s most memorable psychedelic experience may be associated with a more expansive spiritual affiliation. Specifically, the heatmap tracking affiliation before and after one’s most memorable psychedelic experience (Figure 2) shows an increase in the proportion of participants who endorsed “Spiritual” and “Buddhist” from before to after their most memorable psychedelic experience, while explicit Christian affiliation showed only modest net change (Note: we include discussion of Buddhism alongside “Spiritual”, as Buddhism is generally considered to be a non-dogmatic religion; additionally, versions of Buddhism practiced in the US tend to emphasize a spiritual but not religious philosophy and way of life; (Cheah, 2017; The Conversation , 2018). However, we must note that formal statistical testing of this pattern was not conducted. Additional evidence for increased expansiveness of spiritual affiliation following psychedelic experience emerges from the qualitative analysis. This analysis noted a theme of “perennialism”, or belief in a shared universal truth that traverses categories of religious affiliation, in participants’ free-form survey responses. These outcomes are consistent with the notion that salient spiritual experiences can preferentially reshape beliefs about the sacred, without necessarily prompting changes in institutional or identity-based religious affiliation (Park, 2010). Overall, our findings align with the idea that psychedelic experiences facilitate spiritual expansion rather than religious conversion (Griffiths et al., 2006). Specific associations between ibogaine and spiritual beliefs Given that the majority of participants in this study (69% of the sample) based their response on an experience with ibogaine or ibogaine + 5-MeO-DMT, we examined our primary outcomes in this subsample. The main patterns outlined above were also observed in this group, namely 1) increased endorsement of belief in a higher power and decreased endorsement of no belief, and 2) lack of significant change in identification with organized religion or Christianity following one’s most memorable psychedelic experience. The trend of increased belief in a higher power is consistent with findings from a recent qualitative analysis of narrative self-reports from 30 Special Operations Forces veterans who underwent ibogaine treatment (Olash et al., 2026; Note: there may be some overlap in sample participants across Olash et al., 2026 and the current study.). The narratives reviewed in Olash et al. (2026) frequently included elements consistent with mystical experiences, including interactions with a divine presence. The ibogaine experiences appeared to facilitate healing through profound experiences of forgiveness, compassion, and restoration of meaning. Overall, the participant’s experiences during ibogaine were rich in spiritual content and appeared to play a meaningful role in the therapeutic effects that followed. The association between ibogaine treatment and increased spiritual connectedness in this majority-veteran sample suggests exciting potential for the treatment of moral injury (Nichter et al., 2021). Moral injury describes a set of effects that can follow perpetrating and/or witnessing actions that violate ones deeply held values; it is associated with increased distress, suicidality, and social withdrawal (Griffin et al., 2019). Recent estimates suggest approximately one third of combat veterans have experienced at least one potentially morally injurious event (Nichter et al., 2021). Moral injury is inextricably linked with spirituality, and spiritual support appears to be an integral part of effective treatment (Brémault-Phillips et al., 2019; Wortmann et al., 2017). In other words, ibogaine appears capable of supporting spiritual healing in combat veterans, a group at high risk for moral injury. This is especially exciting given recent evidence for profound effects of ibogaine treatment on mental health and TBI-related disability of combat veterans (Cherian et al., 2024). Future studies will be needed to validate this putative relationship between experiences under ibogaine and healing of moral injury, as well as to explore how spiritual healing interacts with general clinical improvement. Interpretation and Broader Implications Taken together, our findings support models of psychedelic experiences acting as catalysts for spiritual reorientation, particularly among individuals who previously identified as doubting or nonbelieving (Griffiths et al., 2006). Rather than producing a strong association with organized religion, psychedelic experiences appear to foster a sense of connection, transcendence, and existential meaning that participants interpret within their existing or newly developing spiritual frameworks (Griffiths et al., 2006). Additionally, psychedelic-associated belief change is better conceptualized as a transformation in how spiritual meaning is constructed and experienced, rather than what formal religious identity is endorsed. These findings carry clinical implications as spiritual changes may represent meaningful components of therapeutic response, especially in scenarios marked by hopelessness, existential distress, or moral injury (Griffiths et al., 2016; Kelly & Eddie, 2020). Because psychedelics tended not to change religious affiliation in this survey, our results may alleviate concerns among clinicians, religious communities and the public that psychedelic therapies inherently undermine religious identity, promote ideological conversion, or erode faith. Instead, our data suggests that profound psychedelic experiences tended to support personal spiritual exploration, while largely preserving preexisting religious identities. This distinction may be relevant for the responsible integration of psychedelic-assisted therapies in culturally and religiously diverse populations. Future prospective studies will be critical for clarifying the durability of these changes, their relationship to clinical outcomes, and the ways in which preparation, integration, and cultural context shape the interpretation of spiritual experiences. Limitations Several limitations warrant consideration. First, belief and religious affiliation were assessed retrospectively, raising the possibility of recall bias or post-hoc reinterpretation of pre-experience beliefs. Prospective designs that assess belief and spirituality both before and after psychedelic experiences are needed to avoid retrospective bias. Second, the sample was self-selected, consisting of individuals who voluntarily participated in the program. These individuals may be more predisposed to reporting meaningful or positive psychedelic effects than the general population. We also note that the survey process prioritized anonymity over verified responses; specifically, survey recipients had the option to remain fully anonymous (i.e., not enter email address for raffle participation), which may have facilitated more honest responding, but at the cost of verified responses. In other words, it is possible that recipients entered duplicate responses or even forwarded the survey to non-intended recipients. The observational design of the current study precludes causal inference, and unmeasured contextual factors such as set, setting, cultural background, or integration practices, may have influenced reported changes (Hartogsohn, 2016). Additionally, the categorical nature of belief and affiliation measures may obscure more nuanced shifts in belief intensity or spiritual practice. Regarding the qualitative analysis, while rich and informative, qualitative analyses are inherently interpretive and may be influenced by analytic framing. Although thematic patterns among participants’ narrative responses were consistent and conceptually coherent, these responses may reflect culturally idiosyncratic views on spirituality. Finally, the durability of reported belief and spiritual changes remain uncertain. The present study did not systematically assess long-term stability of belief change, leaving possibility that some shifts may attenuate or evolve over time Future Directions Future research would benefit from prospective, longitudinal designs, inclusion of validated multidimensional spirituality measures, as well as qualitative interview-based studies of experience both before and after psychedelics (Park, 2010). Future studies should also examine how specific features of psychedelic experiences such as mystical-type phenomena, emotional intensity, or perceived insight relate to subsequent spiritual belief change (Griffiths et al., 2008). Longitudinal studies assessing durability of these changes, their relationship to mental health outcomes, and their interaction with cultural or religious context shape the interpretation and integration of psychedelic experiences, as well as the acceptability and ethical implementation of psychedelic-assisted interventions across diverse populations. Such work may help identify contexts in which spiritual change is experienced as supportive rather than disruptive and inform culturally sensitive clinical practices (Griffiths et al., 2016). Clinically, understanding how spiritual transformations intersect with therapeutic benefit may help inform ethical guidelines for psychedelic-assisted interventions (Thal et al., 2024). Declarations Acknowledgements We thank VETS: Veterans Exploring Treatment Solutions, Inc. (VETS), a non-profit organization committed to advancing healthcare options for veterans, for generously sharing their de-identified survey data with us for completion of this project. We also must acknowledge late Dr. Nolan R. Williams, without whose leadership and vision this work would not have been possible. Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Several authors of this manuscript are employed by the WOMEN CoE and/or WRIISC at the VA Palo Alto Healthcare System. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government. Author D.O. was formerly employed by VETS from October 2021 to June 2025; D.O. developed and disseminated the survey analyzed in this manuscript but was not involved in direct data analyses presented in the current manuscript (de-identified data were shared directly with Stanford BSL by VETS). D.O.'s contributions to this manuscript were made as an independent scholar and not as a representative of VETS. Competing Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Author Contributions: CRediT Randi Brown: Conceptualization, Methodology, Formal analysis, Data curation, Visualization, Writing - original draft, Writing - Review & Editing. Kenneth Shinozuka: Conceptualization, Formal analysis, Writing - original draft, Writing - Review & Editing. Irakli Kaloiani: Conceptualization, Validation, Writing - original draft, Writing - Review & Editing. Lena Kozyr: Conceptualization, Data curation, Writing - original draft, Writing - Review & Editing. Dylan Orion: Methodology, Investigation, Writing - original draft, Writing - Review & Editing. Afik Faerman: Conceptualization, Writing - Review & Editing. Maheen Adamson: Supervision, Writing - Review & Editing. Data Availability De-identified survey data were provided by VETS, for the purpose of this project. Any data sharing is accordingly managed by VETS; please contact VETS directly for any data-sharing requests (https://vetsolutions.org/pages/contact/). Ethics Approval The Stanford Institutional Review Board has confirmed that this research does not involve human subjects as defined in 45 CFR 46.102(e) or 21 CFR 50.3(g) and so ethical approval is not required. Consent for anonymized release of survey responses and testimonial data was collected prior to survey participation by VETS when participants were awarded their grants through VETS. Stanford received de-identified data for analysis. References Ahmed, S. K., Mohammed, R. A., Nashwan, A. J., Ibrahim, R. H., Abdalla, A. Q., M. Ameen, B. M., & Khdhir, R. M. (2025). Using thematic analysis in qualitative research. 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Today at Elon. https://www.elon.edu/u/news/2018/01/22/the-conversation- %e2%80%8bwhy-so-many-americans-think-buddhism-is-just-a-philosophy/ Vargas, M. V., Meyer, R., Avanes, A. A., Rus, M., & Olson, D. E. (2021). Psychedelics and Other Psychoplastogens for Treating Mental Illness. Frontiers in Psychiatry , 12 , 727117. https://doi.org/10.3389/fpsyt.2021.727117 Wickham, H. (2025). reshape2: Flexibly Reshape Data: A Reboot of the Reshape Package (Version 1.4.5) [Computer software]. https://cran.r-project.org/web/packages/reshape2/index.html Wickham, H., Chang, W., Henry, L., Pedersen, T. L., Takahashi, K., Wilke, C., Woo, K., Yutani, H., Dunnington, D., Brand, T. van den, Posit, & PBC. (2025). ggplot2: Create Elegant Data Visualisations Using the Grammar of Graphics (Version 4.0.1) [Computer software]. https://cran.r-project.org/web/packages/ggplot2/index.html Wickham, H., François, R., Henry, L., Müller, K., Vaughan, D., Software, P., & PBC. (2023). dplyr: A Grammar of Data Manipulation (Version 1.1.4) [Computer software]. https://cran.r-project.org/web/packages/dplyr/index.html Wickham, H., Vaughan, D., Girlich, M., Ushey, K., Software, P., & PBC. (2025). tidyr: Tidy Messy Data (Version 1.3.2) [Computer software]. https://cran.r-project.org/web/packages/tidyr/index.html Wisco, B. E., Nomamiukor, F. O., Marx, B. P., Krystal, J. H., Southwick, S. M., & Pietrzak, R. H. (2022). Posttraumatic Stress Disorder in US Military Veterans: Results From the 2019–2020 National Health and Resilience in Veterans Study. The Journal of Clinical Psychiatry , 83 (2). https://doi.org/10.4088/JCP.20m14029 Wortmann, J. H., Eisen, E., Hundert, C., Jordan, A. H., Smith, M. W., Nash, W. P., & Litz, B. T. (2017). Spiritual features of war-related moral injury: A primer for clinicians. Spirituality in Clinical Practice , 4 (4), 249–261. https://doi.org/10.1037/scp0000140 Yao, Y., Guo, D., Lu, T.-S., Liu, F.-L., Huang, S.-H., Diao, M.-Q., Li, S.-X., Zhang, X.-J., Kosten, T. R., Shi, J., Bao, Y.-P., Lu, L., & Han, Y. (2024). Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta- analysis. Psychiatry Research , 335 , 115886. https://doi.org/10.1016/j.psychres.2024.115886 Zimmer, Z., Rojo, F., Ofstedal, M. B., Chiu, C.-T., Saito, Y., & Jagger, C. (2019). Religiosity and health: A global comparative study. SSM - Population Health , 7 , 100322. https://doi.org/10.1016/j.ssmph.2018.11.00 Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8960226","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596488400,"identity":"4bf0e69f-ac88-4da0-a6dc-16a6ff55f5d9","order_by":0,"name":"Randi E. Brown","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0klEQVRIiWNgGAWjYJACicQGGzDjAwMDM5BKIEpLGgMPAwPjDOK1MDYcJkGLefvZgzce7jhvb89+9mDDxz3WDPzsOQZ4tcicyUu2SDxzO7GHJy+xccazdAbJnjf4tUgw5JhJJLbdTuBhyDF/zHPgMIPBDQK2SPC/AWk5Z8/D/8awGaTFnqAWCbAtBxh7JHIgWgwkCGp5Ywz0S3Jiz403ho0zDqTzSJx5VkDAYTmGN3/usLNn788xbPhwwFqOvz15A14tGICHNOWjYBSMglEwCrACAElBRoQSEexVAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0002-5708-0078","institution":"Stanford University School of Medicine; Palo Alto VA Health Care Center","correspondingAuthor":true,"prefix":"","firstName":"Randi","middleName":"E.","lastName":"Brown","suffix":""},{"id":596488401,"identity":"2f18aba2-e75b-4202-901d-060ac0410c72","order_by":1,"name":"Kenneth Shinozuka","email":"","orcid":"https://orcid.org/0000-0002-2859-9161","institution":"Stanford University School of Medicine; Palo Alto VA Health Care Center","correspondingAuthor":false,"prefix":"","firstName":"Kenneth","middleName":"","lastName":"Shinozuka","suffix":""},{"id":596488402,"identity":"5799dab6-9337-4b23-9061-585b6e126d7e","order_by":2,"name":"Irakli Kaloiani","email":"","orcid":"https://orcid.org/0009-0002-9198-1336","institution":"Stanford University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Irakli","middleName":"","lastName":"Kaloiani","suffix":""},{"id":596488403,"identity":"36450b9c-887a-4c3a-8f49-a90b7fee901a","order_by":3,"name":"Lena Kozyr","email":"","orcid":"","institution":"Stanford University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Lena","middleName":"","lastName":"Kozyr","suffix":""},{"id":596488404,"identity":"07fe809f-acfb-4c20-a530-daa8c0119fad","order_by":4,"name":"Dylan Orion","email":"","orcid":"","institution":"Independent Scholar","correspondingAuthor":false,"prefix":"","firstName":"Dylan","middleName":"","lastName":"Orion","suffix":""},{"id":596488405,"identity":"9b9ca97f-b73e-473f-bb8f-2df27679e64e","order_by":5,"name":"Afik Faerman","email":"","orcid":"","institution":"Craig Hospital, Englewood","correspondingAuthor":false,"prefix":"","firstName":"Afik","middleName":"","lastName":"Faerman","suffix":""},{"id":596488406,"identity":"cc968815-38c0-4193-97d7-95f0cf9595d9","order_by":6,"name":"Maheen M. Adamson","email":"","orcid":"","institution":"Stanford University School of Medicine; Palo Alto VA Health Care Center","correspondingAuthor":false,"prefix":"","firstName":"Maheen","middleName":"M.","lastName":"Adamson","suffix":""}],"badges":[],"createdAt":"2026-02-24 18:18:28","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8960226/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8960226/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103601771,"identity":"f8bd1adc-27ad-4644-b1ee-7c4054a993aa","added_by":"auto","created_at":"2026-02-27 14:10:53","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":225878,"visible":true,"origin":"","legend":"\u003cp\u003eLevel of belief in God or a higher power reported before and after one’s most memorable psychedelic experience. Numbers in figure reflect the number of participants endorsing each set of Before/After responses (e.g., in the top left corner, 9 participants selected “No belief” at the before time point and “Active belief” at the after time point). The tile colors indicate the percentage of participants from each row (i.e., each “before” response selection) who selected each response at the after time point. (e.g., in the top row, out of 21 participants who selected “No belief” at the before time point, 43% (\u003cem\u003en\u003c/em\u003e = 9) selected “Active belief” at the after time point (medium blue) and no participants selected “Doubting in” at the after time point (white/ no color). Responses options presented in the figure have been abridged as follows: 1) “Active belief” = Actively believe in and pursue a relationship with God or a higher power, 2) “Passive belief” = Passively believe in God or a higher power, 3) “Searching for” = Searching for God or a higher power, 4) “Doubting in” = Doubting in God or a higher power, 5) “No belief” = Do not believe in God or a higher power.\u003c/p\u003e","description":"","filename":"heatmap1.png","url":"https://assets-eu.researchsquare.com/files/rs-8960226/v1/59867e4abce6313c4cf05326.png"},{"id":103601940,"identity":"f50a97e6-1861-4474-a067-90d235740539","added_by":"auto","created_at":"2026-02-27 14:11:11","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":275805,"visible":true,"origin":"","legend":"\u003cp\u003eAffiliations reported before and after one’s most memorable psychedelic experience. Numbers in figure reflect the number of participants endorsing each set of Before/After affiliations (e.g., in the second row and first column, \u003cem\u003en\u003c/em\u003e = 3 participants selected “Non-denominational Christian” at the before time point and made multiple selections [“Multiple”] at the after time point). The tile colors indicate the percentage of participants from each row (i.e., each before affiliation selection) who selected each response at the after time point (e.g., in the second row, out of 47 participants who selected “Non-denominational Christian” at the before time point, 77% (dark blue, \u003cem\u003en\u003c/em\u003e = 36) selected this same affiliation at the after time point, while 9% (pale blue, \u003cem\u003en\u003c/em\u003e = 4) selected “Spiritual” at the after time point ).\u003c/p\u003e","description":"","filename":"heatmap2.png","url":"https://assets-eu.researchsquare.com/files/rs-8960226/v1/078c9297ebbfdd97d3b7e1fa.png"},{"id":103602046,"identity":"9c3152e2-563b-4b6d-a80e-e650e365d8af","added_by":"auto","created_at":"2026-02-27 14:11:53","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1654403,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8960226/v1/03f447ed-868a-440d-bcd8-cb61e930d1bd.pdf"},{"id":103601893,"identity":"85063121-82cc-494c-8ef9-280970905f4c","added_by":"auto","created_at":"2026-02-27 14:11:04","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":4143383,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-8960226/v1/933f057278878182aef33e23.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003ePsychedelics are associated with changes in spiritual beliefs and orientations in US veterans\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, there has been a resurgence in psychedelic research, driven by the urgent need for novel treatments for mental health conditions (Hadar et al., 2023; Perkins et al., 2021; Vargas et al., 2021). This need is particularly strong among US military veterans, who experience high rates of treatment-resistant post-traumatic stress disorder (PTSD) and depression (Liu et al., 2019; Wisco et al., 2022). Emerging evidence suggests that psychedelic-assisted therapies may offer meaningful therapeutic benefit for PTSD, depression, and related disorders (Mitchell et al., 2023; Yao et al., 2024). However, despite growing interest and promising outcomes, many effects of these substances remain incompletely characterized.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOne underexplored domain concerns the impact of psychedelic experiences on spiritual and religious beliefs. Many psychedelic substances have long histories of use within indigenous religions and spiritual traditions (Fotiou, 2019); however, the spiritual and religious impacts of these substances in Western medicalized contexts remain understudied. Thus far, one finding with consistent appearance across observational and experimental studies is a greater sense of spirituality following psychedelic use (Davis et al., 2020; Gezon \u0026amp; Bartlett, 2025; Griffiths et al., 2019; Kavensk\u0026aacute; \u0026amp; Simonov\u0026aacute;, 2015; Nayak et al., 2023; for review see Schutt et al., 2024).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAn important mechanism underlying this observed effect may be acute experiences of changes in consciousness during the psychedelic treatment. Phenomenological syntheses of subjective psychedelic experiences describe a broad range of features commonly reported by users, including altered sensory perception (visual and somatic), symbolic imagery, ego-dissolution, and emergent meaning (Costines \u0026amp; Schmidt, 2024). Particularly with classic psychedelics (e.g., lysergic acid diethylamide [LSD], psilocybin, N,N-dimethyltryptamine [DMT]), these experiences frequently include elements described as spiritually significant. Such experiences, defined in the psychedelic literature as \u0026ldquo;mystical experiences\u0026rdquo;, are characterized by a sense of unity, sacredness, ego dissolution, ineffability, profound peace, and the impression of encountering an ultimate reality or objective truth (Griffiths et al., 2006; S\u0026oslash;gaard Juul et al., 2023). It is important to note that spiritual beliefs can be expressed by both religious and non-religious individuals and provide the context and foundation for interpretation of mystical experiences (Hood \u0026amp; Chen, 2005). Several studies have found a positive correlation between mystical experiences and ratings of spiritual connection or growth following psychedelic use (Nayak et al., 2023; Schutt et al., 2025).\u003c/p\u003e\n\u003cp\u003eThe association between spirituality and psychedelics is important to understand, given the strong influence of spirituality on health and well-being. Several large-scale population studies have found endorsement of spirituality or religiosity to be predictive of better physical or mental health (Koenig, 2012; Oman \u0026amp; Thoresen, 2005; Zimmer et al., 2019). Additional studies focused on populations with mental health conditions have found higher levels of spirituality or religiousness to be associated with lower rates of depression, suicidality, and substance use disorders (Head, 2025; Lucchetti et al., 2021). As described above, US veterans have been identified as a population for which hopes for advances in mental health care via psychedelic medicine are high. Sharma et al. (2017) replicated this pattern in a sample of more than 3,000 US veterans, finding an inverse relationship between spirituality/religiosity and depression, suicidality, and alcohol use disorder.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eElucidating the relationship between psychedelics and spirituality is also of interest for sociological reasons. At the macro-level, public opinion and special interest groups have impacted psychedelic medicine in the past and are certain to influence the future of psychedelic research and accessibility of these substances (Andrews \u0026amp; Wright, 2022; Koning et al., 2024). Given the intense and often profound nature of psychedelic experiences, there is both concern and optimism about how these experiences may impact beliefs and community cohesiveness (Dupuis, 2021; Johnson \u0026amp; Yaden, 2020). Additionally, perceptions held by one\u0026rsquo;s community can have a strong impact on the individual experience with psychedelics. For example, among participants who used a psychedelic, greater approval of psychedelics by one\u0026rsquo;s spiritual/religious community was associated with a higher likelihood of a positive experience of resolving a spiritual struggle (Schutt et al., 2025). Furthermore, psychedelics can increase sensitivity to expectations and social influences, making surrounding context and community beliefs (i.e., \u0026ldquo;set and setting\u0026rdquo;) highly impactful (Hartogsohn, 2016).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOne unresolved question is whether psychedelics impact religious affiliation (Carroll, 2025; Johnson \u0026amp; Yaden, 2020). There is some evidence suggesting a trend toward decreased affiliation with organized religion following psychedelic experiences (Cherniak \u0026amp; Granqvist, 2025; Griffiths et al., 2019). Additionally, a positive association has been found between psychedelic use and the personality trait of openness (Erritzoe et al., 2019; MacLean et al., 2011; Raison et al., 2022), which, in turn, is associated with decreased religious fundamentalism (Ashton \u0026amp; Lee, 2021; Saroglou, 2002). While these findings raise the possibility of decreased affiliation with organized religion following psychedelic experiences, the existing evidence is limited and indirect.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe current study is also uniquely positioned to provide information on ibogaine. Most prior psychedelic research has focused on classic psychedelics, with more limited data on ibogaine. Ibogaine is not considered to be a classic psychedelic and is sometimes defined as an oneirogen due to its production of an extended dream-like state (Alper, 2001; Mash et al., 2018). Prior research saw beneficial effects of ibogaine on substance use disorders (Brown \u0026amp; Alper, 2018; Mash et al., 2018; Noller et al., 2018), yet enthusiasm for research and clinical use of ibogaine is tempered by recognition of rare yet potentially lethal cardiometabolic effects (Alper, 2001; K\u0026ouml;ck et al., 2022; Ona et al., 2022). Recently, the Stanford Brain Stimulation Lab studied co-administration of ibogaine and magnesium protocol (\u0026ldquo;MISTIC\u0026rdquo;), designed to minimize the potential cardiometabolic risk (Cherian et al., 2024). This observational study of US Special Operations Forces Veterans with a history of traumatic brain injury (TBI) and trauma who independently elected to undergo ibogaine treatment found significant reductions in TBI-related disability, posttraumatic stress, depression, and anxiety symptom severity. Additionally, qualitative analysis of data from this study found that experiences with ibogaine often included heavily symbolic and spiritual imagery (Olash et al., 2026). Therefore, ibogaine also appears to frequently evoke mystical experiences.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Aims and Hypotheses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe current study aims to determine whether psychedelics are associated with altered spiritual beliefs and religious affiliations in veterans, based on retrospective responses to a survey about their most memorable psychedelic experiences. Our study is also uniquely positioned to provide information on ibogaine, given that most participants reported on an experience with ibogaine. Our primary hypotheses were: 1) The proportion of participants who endorsed active belief in and pursuit of a relationship with God or a higher power will be higher after the most memorable psychedelic experience, and 2) The proportion of participants who denied belief in God or a higher power will be lower after the most memorable psychedelic experience. We also proposed secondary hypotheses that the proportion of participants endorsing affiliation with 1) organized religion, and 2) Christian religion, will be lower after the most memorable psychedelic experience (Christianity is the organized religion with highest representation in the current sample).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eVeterans Exploring Treatment Solutions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eVETS: Veterans Exploring Treatment Solutions, Inc. (VETS) is a 501(c)(3) non-profit organization that provides grant funding for Special Operations Forces (SOF) veterans seeking psychedelic-assisted therapy. VETS is not a psychedelic treatment provider, and grants are primarily awarded to SOF veterans (e.g., Navy SEALs, Army Green Berets, Marine RECON) and their spouses. Occasionally, special circumstance grants are awarded on a case-by-case basis to veterans who may not meet SOF distinction but are in immediate need of assistance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGrant recipients are awarded grant funding to attend psychedelic programs in countries where these treatments are legal or unregulated. Psychedelic programs vary in length, clinical approach, and psychedelic substance offered, among other considerations. Grant recipients self-select the psychedelic program they wish to attend. Despite the availability of disparate psychedelic programs, most VETS grant recipients pursue ibogaine-assisted therapy in conjunction with 5-MeO-DMT.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipant Recruitment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll VETS grant recipients who had completed a psychedelic program were eligible to participate in the survey. Beginning in November 2023 and continuing through February 2025, five email campaigns invited 659 total grant recipients to participate. Email communications described the survey as an effort to better understand the religious and faith experience of grant recipients in order to inform organizational programming and policy development. No compensation was provided, but participants were invited to enter a raffle for VETS merchandise. The survey was anonymous, unless respondents provided an email to be entered into the raffle. The link to the survey was also posted on the VETS community platform, a private webspace available to grant recipients to access programming, network, and communicate with peers and organizational staff. VETS staff members also encouraged survey participation by word of mouth during programming. Consent for anonymized release of survey responses and testimonial data was collected prior to survey participation when participants were awarded their grants through VETS.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSurvey Administration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe survey was designed and housed on Jotform, an online survey and workforce platform. Participants accessed the survey using a weblink. The survey took approximately 20 to 40 minutes to complete, depending on responses to free-form questions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSurvey Description\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eDemographics\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were asked six items gauging demographic information, including age, VETS grant classification, marital status, race/ethnicity, and sexual orientation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eReligious/Spiritual Patronage\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were asked about religious affiliation and participation in faith-based groups before their most memorable psychedelic experience and at the time of the survey completion. Responses included Lutheran, Methodist, Reformist, Buddhist, Spiritual, Jewish, Baptist, Anglican, Non-denominational Christianity, Hindu, Atheist, Agnostic, Presbyterian, Pentecostal, Catholic, New Age, Muslim, Mormon, Other (open field), None of the above. Respondents could select multiple options.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eRelationship with God or Higher Power\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUsing a five-item scale (below), participants were asked to describe their belief in God or a higher power before their most memorable psychedelic experience and at survey completion. The scale is not a validated measure. Five-Item Scale: 1) \u003cem\u003eDo not believe in God or a higher power\u003c/em\u003e, 2) \u003cem\u003eDoubting in God or a higher power\u003c/em\u003e, 3) \u003cem\u003eSearching for God or a higher power\u003c/em\u003e, 4) \u003cem\u003ePassively believe in God or a higher power\u003c/em\u003e, and 5) \u003cem\u003eActively believe in and pursue a relationship with God or a higher power\u003c/em\u003e. Participants were also asked if their most memorable psychedelic experience brought them closer to God or a higher power, with \u0026ldquo;yes\u0026rdquo; or \u0026ldquo;no\u0026rdquo; as the response options.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePsychedelic Use History\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRespondents were asked when their most memorable psychedelic experience was, which psychedelic substances were consumed in that experience, and psychedelic use outside of the most memorable experience.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eChanges in Emotions, Beliefs, and Behaviors\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA five-item Likert scale (below) was used to assess changes in religious or spiritual emotions, beliefs, and behaviors. A list of the 33 emotions, beliefs, and behaviors can be found in Supplementary Figures 2 and 3. Response options for the Likert Scale were: 1) \u003cem\u003eSignificantly Decreased\u003c/em\u003e, 2) \u003cem\u003eDecreased\u003c/em\u003e, 3) \u003cem\u003eNo Change\u003c/em\u003e, 4) \u003cem\u003eIncreased\u003c/em\u003e, and 5) \u003cem\u003eSignificantly Increased.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTestimony\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRespondents were invited to share testimony relating to how their experience has affected their faith or spiritual beliefs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePlease see Supplementary Material for a description of additional survey items not included in the analysis. These items were excluded in order to focus on the main outcomes of interest for this manuscript, as outlined in the registration of hypotheses (doi:10.17605/osf.io/6CGZU). Additionally, several items had insufficient endorsement to yield meaningful results (e.g., changes in addiction behaviors were excluded from analyses due to low response).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData management\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eScreening for duplicate entries\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGiven the nature of data collection, steps were taken to screen the data for duplicate entries (i.e., multiple completions of the survey by the same participant). Screening for duplicates was undertaken using a sliding window (review of data from participants from current age +/- 1 year). Data entries were compared across the following categories: age (at survey submission), veteran status (veteran, spouse of a veteran, or other), gender, race, sexual orientation, date of most memorable psychedelic experience, estimate of lifetime use of psychedelic substances (+/- 5), marital status, spiritual/religious affiliation before most memorable psychedelic experience, alcohol or drug use dependencies/behavioral addictions before one\u0026rsquo;s most memorable psychedelic experience. This screening process identified six instances of potential duplicate entries (there were no instances of exact matches across any two survey responses, but these cases shared enough information to flag). Sensitivity analyses were conducted excluding the second response from each potential-duplicate pair of items.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSpiritual/Religious affiliation categorization\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResponses to the survey items indexing affiliation with spiritual or religious traditions were available for all \u003cem\u003eN\u003c/em\u003e = 151 respondents. To facilitate data visualization, we combined related sub-categories into broader categories. Specifically, the 19 original categories were consolidated into a smaller set of 7, as follows: 1) Buddhist, 2) Non-denominational Christian, 3) Christian (Lutheran, Methodist, Reformist, Baptist, Anglican, Presbyterian, Pentecostal, or Catholic) 4) Spiritual, 5) Agnostic-Atheist (Atheist, Agnostic, write-in response of \u0026ldquo;questioning\u0026rdquo;), 6) Other (none of the above, other/write-in response, Muslim, Jewish, Mormon, Hindu, New Age), 7) Multiple.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGiven that the term \u0026ldquo;spiritual\u0026rdquo; is often used to describe engagement in any spiritual or religious practice, in cases where both \u0026ldquo;spiritual\u0026rdquo; and another option (e.g., \u0026ldquo;Buddhist\u0026rdquo;, \u0026ldquo;Christian\u0026rdquo;) was selected, the more specific affiliation was assigned for the analysis. The affiliations of Muslim, Jewish, Mormon, Hindu, and New Age were included in the \u0026ldquo;other\u0026rdquo; category due to low numbers precluding meaningful analysis. For participants who selected multiple Christian affiliations, if non-denomination Christian was among the affiliations selected, they were included in the \u0026ldquo;non-denominational\u0026rdquo; category (Figure 2). After the aforementioned processes were carried out, the \u0026ldquo;Multiple\u0026rdquo; label was assigned if a participant reported affiliations encompassing at least two different categories (e.g., a participant who selected both \u0026ldquo;Reformist\u0026rdquo; and \u0026ldquo;Non-denominational Christian\u0026rdquo; would be included in the \u0026ldquo;Non-denominational Christian category; a participant who selected both \u0026ldquo;Buddhist\u0026rdquo; and \u0026ldquo;Non-denominational Christian\u0026rdquo; would be included in the \u0026ldquo;Multiple\u0026rdquo; category). Given the subjective nature of the categorization decisions described above, we conducted a sensitivity analysis of our outcomes in which we excluded participants who were assigned the \u0026ldquo;Multiple\u0026rdquo; label (\u003cem\u003en\u003c/em\u003e = 28)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDe-identified data was shared by VETS with Stanford Brain Stimulation Lab for analysis. Our primary and secondary hypotheses were assessed using McNemar\u0026rsquo;s test (chi-square test for paired samples). Additionally, to further explore changes in proportions from before to after the most memorable psychedelic experience, we used Generalized Estimating Equation (GEE) models to conduct binary logistic regression. GEEs were conducted in R using the geepack library (H\u0026oslash;jsgaard et al., 2025) and used a logit link function, First-Order Autoregressive correlation structure (AR-1), and robust variance estimation.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;To explore the impact of psychedelic experiences associated with ibogaine, we reanalyzed our primary and secondary outcomes with the sample restricted to those participants who reported completing the survey questions based on ibogaine use. We also conducted a sensitivity analysis to explore the robustness of our outcomes regarding religious/spiritual affiliation. Specifically, we reanalyzed the data after excluding responses of participants who selected multiple affiliations (e.g., Christian and Buddhist; New Age and Muslim).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFinally, we conducted exploratory analyses (estimation of mean and spread) of participants\u0026rsquo; ratings on a 5-item Likert scale indexing changes for 33 emotions, beliefs, and behaviors. Results and discussion from these findings are available in the Supplementary information.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAnalyses and data visualization were conducted using R and SPSS (IBM Corp., 2024; Posit Software, PBC, 2025). Packages in R included geepack (H\u0026oslash;jsgaard et al., 2025), broom (Robinson et al., 2025), dplyr (Wickham et al., 2023), ggplot2 (Wickham, Chang, et al., 2025), tidyr (Wickham, Vaughan, et al., 2025), and reshape2 (Wickham, 2025).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQualitative Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRespondents were invited to share testimony relating to how their experience has affected their faith or spiritual beliefs using the following free-form question: \u0026ldquo;Please share any testimony relating to how your most personally meaningful psychedelic experience has affected your faith or spiritual beliefs.\u0026rdquo; We performed thematic analysis on responses to this question, following previously established methods (Ahmed et al., 2025). Codes describing meaningful features of the data were generated using (\u003cem\u003eATLAS.Ti Scientific Software Development GmbH\u003c/em\u003e, 2023), which were automatically grouped into five categories. Two researchers (K.S. and I.K.) independently searched for themes in the codes and then, through discussion, converged on a final set of themes.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eDescriptives\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants included \u003cem\u003eN\u003c/em\u003e = 151 individuals, consisting of 133 U.S. veterans and 18 spouses or other individuals relevant to the group, who attended psychedelic programs with grant support from VETS. The mean age of participants was 47.2 years (SD = 7.2). The sample was predominantly male (\u003cem\u003en\u003c/em\u003e = 129, 85.4%) and largely identified as Caucasian/White (\u003cem\u003en\u003c/em\u003e = 127, 84.1%), with smaller proportions identifying as Hispanic/Latino (\u003cem\u003en\u003c/em\u003e = 20, 13.2%), American Indian/Alaska Native (\u003cem\u003en\u003c/em\u003e = 6, 4.0%), Asian/Filipino (\u003cem\u003en\u003c/em\u003e = 5, 3.3%), Black/African American (\u003cem\u003en\u003c/em\u003e = 2, 1.3%), Native Hawaiian/Pacific Islander (\u003cem\u003en\u003c/em\u003e = 2, 1.3%), and Other (\u003cem\u003en\u003c/em\u003e = 7, 4.6%; Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eDemographic Characteristics of Participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"609\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003eVeteran status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Veteran\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e133 (88.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Spouse / Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e18 (11.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e129 (85.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e22 (14.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003eRace / Ethnicity*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Caucasian / White\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e127 (84.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hispanic / Latino\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e20 (13.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;American Indian / Alaska Native\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e6 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Asian / Filipino\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e5 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Black / African American\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e2 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Native Hawaiian / Pacific Islander\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e2 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 305px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other / Prefer not to say\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 304px;\"\u003e\n \u003cp\u003e7 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e \u003cem\u003eN\u003c/em\u003e = 151 and participants were on average 47.2 years of age (SD = 7.2).\u003c/p\u003e\n\u003cp\u003e*Participants could select more than one race/ethnicity; percentages may exceed 100%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBelief in a higher power before and after the most memorable psychedelic experience\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResponses to the survey item indexing belief in God or a higher power before and after one\u0026rsquo;s most memorable psychedelic experience were available for all \u003cem\u003eN\u003c/em\u003e = 151 respondents. To investigate Hypothesis 1, we dichotomized survey responses into \u0026ldquo;active belief and pursuit of a relationship with a higher power\u0026rdquo; (hereby referred to as \u0026ldquo;active belief\u0026rdquo;) versus selection of any other response option (i.e., \u0026ldquo;passive belief\u0026rdquo;, \u0026ldquo;doubting in\u0026rdquo;, \u0026ldquo;searching for\u0026rdquo;, or \u0026ldquo;do not believe\u0026rdquo; in God or a higher power).\u003c/p\u003e\n\u003cp\u003eMcNemar\u0026rsquo;s test indicated a significant change in proportions for endorsement of active belief with the proportion of participants who endorsed belief in a higher power increasing at the after time point ( \u003cimg width=\"17\" height=\"22\" src=\"https://myfiles.space/user_files/58895_8739fc6c57c1c19a/58895_custom_files/img1772033324.gif\" alt=\"image\"\u003e(1) = 79.012, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001). Specifically, \u003cem\u003en\u003c/em\u003e = 27 participants reported active belief at both the before and after time points; \u003cem\u003en\u003c/em\u003e = 0 before but not after; \u003cem\u003en\u003c/em\u003e = 81 after but not before; and \u003cem\u003en\u003c/em\u003e = 43 participants neither before nor after. A GEE model estimated the odds of endorsing active belief after versus before the most memorable psychedelic experience was 11.5 (95% CI: 6.7, 19.9).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMcNemar\u0026rsquo;s test also indicated a significant change in the proportion of participants who endorsed \u0026ldquo;do not believe\u0026rdquo; (hereby referred to as \u0026ldquo;no belief\u0026rdquo;) in God or a higher power from before to after their most memorable psychedelic experience; a binomial test on discordant pairs was used due to a small number of counts across some discordant cells rendering the chi-square test unreliable (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001, two-sided statistical test at \u0026alpha; = .05). Specifically, \u003cem\u003en\u003c/em\u003e = 2 participants reported no belief before and after; \u003cem\u003en\u003c/em\u003e = 19 before but not after; \u003cem\u003en\u003c/em\u003e = 0 after but not before; and \u003cem\u003en\u003c/em\u003e = 130 neither before nor after. A GEE model estimated the odds of endorsing no belief after versus before the most memorable psychedelic experience at .08 (95% CI: .02, 36; i.e., the odds of endorsing \u0026ldquo;no belief\u0026rdquo; were 12.5 times lower at the after time point). Sensitivity analyses found consistent outcomes for the two analyses described above (i.e., change in active belief and change in no belief) when responses identified as potential duplicates were excluded.\u003c/p\u003e\n\u003cp\u003eThe McNemar\u0026rsquo;s tests for changes in proportion of participants endorsing belief in God or a higher power were rerun in a sample restricted to participants who had taken ibogaine (or ibogaine + 5-MeO-DMT) during their most memorable psychedelic experience (\u003cem\u003en\u003c/em\u003e = 104 participants). Outcomes remained the same in this subsample. Specifically, McNemar\u0026rsquo;s test indicated a significantly higher proportion of participants endorsing active belief after compared to before their most memorable psychedelic experience (\u003cimg width=\"17\" height=\"22\" src=\"https://myfiles.space/user_files/58895_8739fc6c57c1c19a/58895_custom_files/img1772033324.gif\" alt=\"image\"\u003e(1) = 52.019, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001). McNemar\u0026rsquo;s test (using binomial test on discordant pairs) also indicated a significantly lower proportion of participants who endorsed no belief after compared to before their most memorable psychedelic experience (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001, two-sided statistical test at \u0026alpha; = .05); specifically, from before to after the most memorable psychedelic experience, 14 participants shifted from endorsement of \u0026ldquo;no belief\u0026rdquo; to another selection, and no participant shifted from another selection to \u0026ldquo;no belief\u0026rdquo;. See Supplemental Figure 1 for counts of participants selecting each pair of responses at the before and after time points.\u003c/p\u003e\n\u003cp\u003eAlthough responses were binarized for the use of McNemar\u0026rsquo;s statistical test, the full range of responses endorsed before and after one\u0026rsquo;s most memorable psychedelic experience are presented in Figure 1. The most notable pattern appears to be a transition from less to greater belief, as evidenced by darker color in the left-sided columns of Figure 1. For example, across participants who selected one of the four options other than \u0026ldquo;active belief\u0026rdquo; the percentage of participants who transitioned to selecting active belief after their most memorable psychedelic experience ranged from 43% (for those who selected \u0026ldquo;no belief\u0026rdquo; before) to 88% (for those who selected \u0026ldquo;searching for\u0026rdquo; before).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSpiritual/Religious affiliation before and after most memorable psychedelic experience\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo examine our hypothesis that affiliation with organized religion would be lower after one\u0026rsquo;s most memorable psychedelic experience, we conducted McNemar\u0026rsquo;s test on affiliation with organized religion across the before and after time points. Affiliation with organized religion encompassed participants who were included in categories 1-3 (Buddhist, non-denominational Christian, Christian) as well as the few participants from category 6 (other) who selected Muslim, Jewish, Mormon, or Hindu (this applied for \u003cem\u003en\u003c/em\u003e = 2 participants at the before time point and \u003cem\u003en\u003c/em\u003e = 1 at the after time point). Lack of affiliation with organized religion was assigned for all participants who did not meet the aforementioned criteria.\u003c/p\u003e\n\u003cp\u003eOutcomes from McNemar\u0026rsquo;s test did not support our hypothesis. McNemar\u0026rsquo;s test (using binomial test on discordant pairs) indicated that there was no significant change in the proportion of participants endorsing affiliation with an organized religious group from before to after their most memorable psychedelic experience (\u003cem\u003ep\u003c/em\u003e = .664, two-sided statistical test at \u0026alpha; = .05). \u003cem\u003eN\u003c/em\u003e = 70 participants endorsed affiliation with organized religion both before and after the most memorable psychedelic experience; \u003cem\u003en\u003c/em\u003e = 12 before but not after; \u003cem\u003en\u003c/em\u003e = 9 after but not before; and \u003cem\u003en\u003c/em\u003e = 60 neither before nor after. When this test was repeated in a sample that excluded \u003cem\u003en\u003c/em\u003e = 28 participants who had made multiple affiliation selections, outcomes remained the same (\u003cem\u003ep\u003c/em\u003e = 1). Specifically, the proportion of participants who endorsed affiliation with organized religion was 46% at both the before and after timepoints.\u003c/p\u003e\n\u003cp\u003eTo examine our hypothesis that endorsement of affiliation with a Christian religion would be lower after one\u0026rsquo;s most memorable psychedelic experience, we conducted McNemar\u0026rsquo;s test. Affiliation with Christian religion encompassed participants who were included in categories 2 or 3 (non-denominational Christian or Christian). McNemar\u0026rsquo;s test (using binomial test on discordant pairs) indicated that there was no significant change in the proportion of participants endorsing affiliation with Christianity (\u003cem\u003ep\u003c/em\u003e = .189, two-sided statistical test at \u0026alpha; = .05). \u003cem\u003eN\u003c/em\u003e = 66 participants endorsed affiliation with Christianity both before and after the most memorable psychedelic experience; \u003cem\u003en\u003c/em\u003e = 14 before but not after; \u003cem\u003en\u003c/em\u003e = 7 after but not before; and \u003cem\u003en\u003c/em\u003e = 64 neither before nor after. When this test was repeated in the sample excluding \u003cem\u003en\u003c/em\u003e = 28 participants who had made multiple affiliation selections (i.e., selected multiple affiliations at either the before or after time point), outcomes remained approximately the same (\u003cem\u003ep\u003c/em\u003e = .424); specifically, the proportion of participants endorsing affiliation with Christianity was 57% at the before time point and 54% at the after time point.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSimilarly, when these analyses of the proportion of participants who affiliated with organized religion and Christianity were repeated in the subsample that endorsed use of ibogaine associated with their most memorable experience, outcomes were consistent. McNemar\u0026rsquo;s test did not indicate a statistically significant shift in proportion of participants endorsing these affiliations (\u003cem\u003ep\u003c/em\u003e \u0026gt; .05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFigure 2 shows the number of participants endorsing each affiliation before and after their most memorable psychedelic experience. This supports more nuanced review of changes in affiliation. As can be observed from the intensity of color along the upwards diagonal, the majority of participants seemed to retain the same affiliation. The Spiritual category exhibited the greatest increase in affiliation after psychedelics. Similarly, the selection \u0026ldquo;Agnostic-atheist\u0026rdquo; exhibited a relatively large decrease in selection. While no participants affiliated with Buddhism before their most memorable psychedelic experience, several participants selected this affiliation after (Please note that there may be additional participants who selected a Buddhist affiliation, but who also made other selections and were therefore included in the \u0026ldquo;multiple\u0026rdquo; category).\u003c/p\u003e\n\u003ch3\u003eQualitative analysis of self-reported changes in spiritual beliefs\u003c/h3\u003e\n\u003cp\u003e102 participants provided a response available for qualitative analysis. Our qualitative analysis identified four themes: 1) Shifts from belief-based to experience-based knowledge of God, 2) Reinterpretation of established religious concepts, 3), Perennialism and love, and 4) The continuity of consciousness after death.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eShifts from belief-based to experience-based knowledge of God\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants consistently reported that ibogaine led them to directly experience God, rather than merely believing in God. One participant stated, \u0026ldquo;I no longer have any need for faith. I now have the knowledge that God is very, very real,\u0026rdquo; while another described becoming \u0026ldquo;certain there\u0026rsquo;s a creator, a single source that connects us all\u0026rdquo; following a 5-MeO-DMT experience. This \u0026ldquo;noetic\u0026rdquo; quality of their religious experience, felt immediately, authoritatively, and beyond doubt, was often framed as the most consequential aspect of the experience. Participants repeatedly emphasized that this knowledge was gained not through reasoning, scripture, or instruction, but instead through direct encounter (e.g., \u0026ldquo;I saw God\u0026rdquo;; \u0026ldquo;I stood in the presence of the all knowing\u0026rdquo;). Such reports suggest that psychedelic experiences can transform abstract theological concepts into experiential certainties.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eReinterpretation of established religious concepts\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile many participants reported strengthening or restoration of their faith, it also distanced them from religious dogma, authority structures, or exclusive truth claims. As one participant stated, \u0026ldquo;psychedelics released me from the religious dogma that Christianity places on people\u0026rdquo; while simultaneously confirming \u0026ldquo;who God truly is.\u0026rdquo; A few participants described how religious dogma had caused them to lose their connection to God; for example, one participant noted that her strict Catholic upbringing constrained her innate curiosity about spirituality, while another participant reported that the term \u0026ldquo;God\u0026rdquo; had begun to carry too much baggage. Both participants reported that their psychedelic experience led them to feel closer to God than ever before, including a sense of God that transcended their preconceived, dogmatic beliefs. According to another participant, \u0026ldquo;Prior to [my] second [psychedelic] journey, my \u0026apos;beliefs\u0026apos; were based in religion - which in my opinion is a blueprint for what one \u0026lsquo;should\u0026rsquo; believe. During/after this journey, I\u0026apos;ve realized their [\u003cem\u003esic\u003c/em\u003e] is no blueprint and there is no \u0026lsquo;one\u0026rsquo; way for faith/spiritual beliefs.\u0026rdquo; In other words, participants described their psychedelic experiences as fomenting a new form of spirituality that does not conform to a rigid structure or set of rules, but can rather be understood as a personal, experiential, and relational process that unfolds outside the boundaries of institutional authority. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePerennialism and love\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFollowing their psychedelic experience, many participants reported embracing perennialism, the view that all religions are different expressions of the same, underlying truth. Several respondents articulated an expanded theological framework in which religious traditions were understood as culturally specific expressions of a shared reality rather than competing, incompatible belief systems. Participants experienced the insight that \u0026ldquo;God is too big for any one faith/religion,\u0026rdquo; for \u0026ldquo;whatever is out there is much bigger than we can comprehend\u0026rdquo;; indeed, \u0026ldquo;all religions - all Gods - all manifestations\u0026rdquo; are equally valid.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhile some respondents had an ineffable experience of God during their psychedelic experience, others did describe God as a \u0026ldquo;unified field of eternal love,\u0026rdquo; \u0026ldquo;perfect love,\u0026rdquo; or as a being whose \u0026ldquo;love transcends all things.\u0026rdquo; In other words, psychedelics revealed to many participants that love was not merely an emotional state but rather the foundation of spirituality, the common substrate beneath diverse religious symbols, narratives, and practices. This love was often characterized as \u0026ldquo;unconditional,\u0026rdquo; \u0026ldquo;non-judgmental,\u0026rdquo; and miraculous, fueling the profound psychological transformation and healing that participants experienced on psychedelics.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe continuity of consciousness after death\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFinally, many participants reported a newly consolidated belief in reincarnation or the afterlife, often due to vivid encounters with deceased loved ones or spiritual beings. These experiences were frequently described as resolving long-standing grief, survivor guilt, or existential fear. For example, one respondent described seeing deceased family members who \u0026ldquo;assured me that they were OK,\u0026rdquo; while another felt a newfound sense of peace following the death of a parent by recalling a vision of \u0026ldquo;a beautiful, uncapped land where the hand of God was waiting for him.\u0026rdquo; Such experiences often reinforced the perception that death represents a transition rather than an endpoint of consciousness. Notably, these beliefs were again framed as experiential knowledge rather than speculative belief, contributing to a broader sense of existential reassurance and meaning.\u003c/p\u003e"},{"header":"Discussion","content":"\u003ch2\u003e\u003cstrong\u003ePsychedelic experience was associated with increased belief in a higher power\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eOur outcomes indicated a robust shift toward increased spiritual beliefs, coupled with a decline in explicit nonbelief. The odds of endorsing active belief in a higher power after the experience were more than 11 times greater than before (OR=11.5, 95% CI: 6.7\u0026ndash;19.9). Notably, no participants who endorsed active belief prior to their experience shifted away from this position afterward. In contrast, explicit nonbelief declined sharply, with the vast majority of participants who reported \u0026ldquo;no belief\u0026rdquo; at the before time point transitioning to another belief category. These findings are consistent with outcomes reported by previous studies assessing belief in God or a higher power across psychedelic use. Specifically, several quantitative and qualitative analyses have shown that classic psychedelic use is associated with increased belief in a higher power (Davis et al., 2020; Gezon \u0026amp; Bartlett, 2025; Griffiths et al., 2019; Kavensk\u0026aacute; \u0026amp; Simonov\u0026aacute;, 2015; Nayak et al., 2023; Schutt et al., 2024). A notable exception is Nayak et al. (2025), which prospectively assessed belief before and after psychedelic use and found no change in belief in a higher power. Additional prospective studies are needed to determine whether this result reflects a true null effect or reduced retrospective bias.\u003c/p\u003e\n\u003cp\u003eSeveral contemporary studies have confirmed that psychedelics frequently evoke mystical experiences (Holze et al., 2020, 2021; Ley et al., 2023). Qualitative analysis of participant\u0026apos;s free responses in the current study indicated mystical experiences were well-represented. For example, participants\u0026rsquo; descriptions of profound encounters with God or other spiritual beings as well as experiences with a \u0026ldquo;noetic\u0026rdquo; quality of connecting with a universal truth are all encompassed under current conceptualization of the \u0026ldquo;mystical experience\u0026rdquo; (Barrett et al., 2015; James, 2003; Stace, 1960). It appears likely that these mystical experiences directly contributed to increased endorsement of belief in God or a higher power following the psychedelic experience. However, the occurrence of mystical experiences and their relationship with spiritual beliefs was not quantified in this sample.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAspects of the psychedelic protocols undertaken by many of the participants represented in this survey may have predisposed them towards experiences with spiritual content. The VETS organization supports access for grant recipients to therapists with experience in spiritual integration. Therefore, given that psychedelics appear to amplify the effect of therapeutic context on participant\u0026rsquo;s psyche, these preparatory therapy sessions may have predisposed participants to have spiritual experiences (Dupuis, 2021; Hartogsohn, 2016).\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003ePsychedelic experience and stability of religious affiliation\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eDespite a clear increase in belief in a higher power, affiliation with organized religion remained largely stable. Neither overall religious affiliation nor Christian identification demonstrated statistically significant shifts. Most participants retained their original affiliation, as reflected by the strong diagonal patterns in the affiliation heatmap (see Figure 2). Outcomes from previous studies regarding changes in spiritual or religious affiliation following psychedelic use have been mixed. For example, Cherniak and Granqvist (2025) presented results from two large-sample survey studies; the first study found evidence of an association between psychedelic use and a greater likelihood of transitioning away from religious affiliation, but the second study did not replicate this finding. A qualitative study by Gezon and Bartlett (2025) found evidence for two paths of deepening spiritual connection: 1) increased closeness to one\u0026rsquo;s faith tradition of origin, or 2) increased spiritual connection accompanied by distancing from organized religion. We did not observe evidence for the latter in our analysis, but it is possible that in larger studies these patterns may be observable in different subsamples of participants. It is also notable that the qualitative analysis of our sample discovered a theme of increased personal connection with God or a higher power that was felt to supersede institutional dogma, which, as noted above, is consistent with classical accounts of mystical experience (James, 2003). Our qualitative outcomes suggest that the increased belief in God or a higher power observed in quantitative analyses was driven by reinforcement of a personal connection with one\u0026rsquo;s faith, as opposed to by reinforced attachment to religious doctrine.\u003c/p\u003e\n\u003cp\u003eDespite the absence of significant change in spiritual affiliation, several lines of evidence suggest one\u0026rsquo;s most memorable psychedelic experience may be associated with a more expansive spiritual affiliation. Specifically, the heatmap tracking affiliation before and after one\u0026rsquo;s most memorable psychedelic experience (Figure 2) shows an increase in the proportion of participants who endorsed \u0026ldquo;Spiritual\u0026rdquo; and \u0026ldquo;Buddhist\u0026rdquo; from before to after their most memorable psychedelic experience, while explicit Christian affiliation showed only modest net change (Note: we include discussion of Buddhism alongside \u0026ldquo;Spiritual\u0026rdquo;, as Buddhism is generally considered to be a non-dogmatic religion; additionally, versions of Buddhism practiced in the US tend to emphasize a spiritual but not religious philosophy and way of life; (Cheah, 2017; \u003cem\u003eThe Conversation\u003c/em\u003e, 2018). However, we must note that formal statistical testing of this pattern was not conducted.\u003c/p\u003e\n\u003cp\u003eAdditional evidence for increased expansiveness of spiritual affiliation following psychedelic experience emerges from the qualitative analysis. This analysis noted a theme of \u0026ldquo;perennialism\u0026rdquo;, or belief in a shared universal truth that traverses categories of religious affiliation, in participants\u0026rsquo; free-form survey responses. These outcomes are consistent with the notion that salient spiritual experiences can preferentially reshape beliefs about the sacred, without necessarily prompting changes in institutional or identity-based religious affiliation (Park, 2010). Overall, our findings align with the idea that psychedelic experiences facilitate spiritual expansion rather than religious conversion (Griffiths et al., 2006).\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eSpecific associations between ibogaine and spiritual beliefs\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eGiven that the majority of participants in this study (69% of the sample) based their response on an experience with ibogaine or ibogaine + 5-MeO-DMT, we examined our primary outcomes in this subsample. The main patterns outlined above were also observed in this group, namely 1) increased endorsement of belief in a higher power and decreased endorsement of no belief, and 2) lack of significant change in identification with organized religion or Christianity following one\u0026rsquo;s most memorable psychedelic experience.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe trend of increased belief in a higher power is consistent with findings from a recent qualitative analysis of narrative self-reports from 30 Special Operations Forces veterans who underwent ibogaine treatment (Olash et al., 2026; Note: there may be some overlap in sample participants across Olash et al., 2026 and the current study.). The narratives reviewed in Olash et al. (2026) frequently included elements consistent with mystical experiences, including interactions with a divine presence. The ibogaine experiences appeared to facilitate healing through profound experiences of forgiveness, compassion, and restoration of meaning. Overall, the participant\u0026rsquo;s experiences during ibogaine were rich in spiritual content and appeared to play a meaningful role in the therapeutic effects that followed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe association between ibogaine treatment and increased spiritual connectedness in this majority-veteran sample suggests exciting potential for the treatment of moral injury (Nichter et al., 2021). Moral injury describes a set of effects that can follow perpetrating and/or witnessing actions that violate ones deeply held values; it is associated with increased distress, suicidality, and social withdrawal (Griffin et al., 2019). Recent estimates suggest approximately one third of combat veterans have experienced at least one potentially morally injurious event (Nichter et al., 2021). Moral injury is inextricably linked with spirituality, and spiritual support appears to be an integral part of effective treatment (Br\u0026eacute;mault-Phillips et al., 2019; Wortmann et al., 2017). In other words, ibogaine appears capable of supporting spiritual healing in combat veterans, a group at high risk for moral injury. This is especially exciting given recent evidence for profound effects of ibogaine treatment on mental health and TBI-related disability of combat veterans (Cherian et al., 2024). Future studies will be needed to validate this putative relationship between experiences under ibogaine and healing of moral injury, as well as to explore how spiritual healing interacts with general clinical improvement.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eInterpretation and Broader Implications\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eTaken together, our findings support models of psychedelic experiences acting as catalysts for spiritual reorientation, particularly among individuals who previously identified as doubting or nonbelieving (Griffiths et al., 2006). Rather than producing a strong association with organized religion, psychedelic experiences appear to foster a sense of connection, transcendence, and existential meaning that participants interpret within their existing or newly developing spiritual frameworks (Griffiths et al., 2006). Additionally, psychedelic-associated belief change is better conceptualized as a transformation in how spiritual meaning is constructed and experienced, rather than what formal religious identity is endorsed. These findings carry clinical implications as spiritual changes may represent meaningful components of therapeutic response, especially in scenarios marked by hopelessness, existential distress, or moral injury (Griffiths et al., 2016; Kelly \u0026amp; Eddie, 2020).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBecause psychedelics tended not to change religious affiliation in this survey, our results may alleviate concerns among clinicians, religious communities and the public that psychedelic therapies inherently undermine religious identity, promote ideological conversion, or erode faith. Instead, our data suggests that profound psychedelic experiences tended to support personal spiritual exploration, while largely preserving preexisting religious identities. This distinction may be relevant for the responsible integration of psychedelic-assisted therapies in culturally and religiously diverse populations. Future prospective studies will be critical for clarifying the durability of these changes, their relationship to clinical outcomes, and the ways in which preparation, integration, and cultural context shape the interpretation of spiritual experiences.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eSeveral limitations warrant consideration. First, belief and religious affiliation were assessed retrospectively, raising the possibility of recall bias or post-hoc reinterpretation of pre-experience beliefs. Prospective designs that assess belief and spirituality both before and after psychedelic experiences are needed to avoid retrospective bias. Second, the sample was self-selected, consisting of individuals who voluntarily participated in the program. These individuals may be more predisposed to reporting meaningful or positive psychedelic effects than the general population. We also note that the survey process prioritized anonymity over verified responses; specifically, survey recipients had the option to remain fully anonymous (i.e., not enter email address for raffle participation), which may have facilitated more honest responding, but at the cost of verified responses. In other words, it is possible that recipients entered duplicate responses or even forwarded the survey to non-intended recipients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe observational design of the current study precludes causal inference, and unmeasured contextual factors such as set, setting, cultural background, or integration practices, may have influenced reported changes (Hartogsohn, 2016). Additionally, the categorical nature of belief and affiliation measures may obscure more nuanced shifts in belief intensity or spiritual practice. Regarding the qualitative analysis, while rich and informative, qualitative analyses are inherently interpretive and may be influenced by analytic framing. Although thematic patterns among participants\u0026rsquo; narrative responses were consistent and conceptually coherent, these responses may reflect culturally idiosyncratic views on spirituality. Finally, the durability of reported belief and spiritual changes remain uncertain. The present study did not systematically assess long-term stability of belief change, leaving possibility that some shifts may attenuate or evolve over time\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eFuture Directions\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eFuture research would benefit from prospective, longitudinal designs, inclusion of validated multidimensional spirituality measures, as well as qualitative interview-based studies of experience both before and after psychedelics (Park, 2010). Future studies should also examine how specific features of psychedelic experiences such as mystical-type phenomena, emotional intensity, or perceived insight relate to subsequent spiritual belief change (Griffiths et al., 2008). Longitudinal studies assessing durability of these changes, their relationship to mental health outcomes, and their interaction with cultural or religious context shape the interpretation and integration of psychedelic experiences, as well as the acceptability and ethical implementation of psychedelic-assisted interventions across diverse populations. Such work may help identify contexts in which spiritual change is experienced as supportive rather than disruptive and inform culturally sensitive clinical practices (Griffiths et al., 2016). Clinically, understanding how spiritual transformations intersect with therapeutic benefit may help inform ethical guidelines for psychedelic-assisted interventions (Thal et al., 2024).\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank VETS: Veterans Exploring Treatment Solutions, Inc. (VETS), a non-profit organization committed to advancing healthcare options for veterans, for generously sharing their de-identified survey data with us for completion of this project. We also must acknowledge late Dr. Nolan R. Williams, without whose leadership and vision this work would not have been possible.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Several authors of this manuscript are employed by the WOMEN CoE and/or WRIISC at the VA Palo Alto Healthcare System. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.\u003c/p\u003e\n\u003cp\u003eAuthor D.O. was formerly employed by VETS from October 2021 to June 2025; D.O. developed and disseminated the survey analyzed in this manuscript but was not involved in direct data analyses presented in the current manuscript (de-identified data were shared directly with Stanford BSL by VETS). D.O.\u0026apos;s contributions to this manuscript were made as an independent scholar and not as a representative of VETS.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions: CRediT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRandi Brown:\u003c/strong\u003e Conceptualization, Methodology, Formal analysis, Data curation, Visualization, Writing - original draft, Writing - Review \u0026amp; Editing. \u003cstrong\u003eKenneth Shinozuka:\u003c/strong\u003e Conceptualization, Formal analysis, Writing - original draft, Writing - Review \u0026amp; Editing. \u003cstrong\u003eIrakli Kaloiani:\u003c/strong\u003e Conceptualization, Validation, Writing - original draft, Writing - Review \u0026amp; Editing. \u003cstrong\u003eLena Kozyr:\u003c/strong\u003e Conceptualization, Data curation, Writing - original draft, Writing - Review \u0026amp; Editing. \u003cstrong\u003eDylan Orion:\u0026nbsp;\u003c/strong\u003eMethodology, Investigation, Writing - original draft, Writing - Review \u0026amp; Editing. \u003cstrong\u003eAfik Faerman:\u003c/strong\u003e Conceptualization, Writing - Review \u0026amp; Editing. \u003cstrong\u003eMaheen Adamson:\u003c/strong\u003e Supervision, Writing - Review \u0026amp; Editing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDe-identified survey data were provided by VETS, for the purpose of this project. Any data sharing is accordingly managed by VETS; please contact VETS directly for any data-sharing requests (https://vetsolutions.org/pages/contact/).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Stanford Institutional Review Board has confirmed that this research does not involve human subjects as defined in 45 CFR 46.102(e) or 21 CFR 50.3(g) and so ethical approval is not required. Consent for anonymized release of survey responses and testimonial data was collected prior to survey participation by VETS when participants were awarded their grants through VETS. Stanford received de-identified data for analysis.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003eAhmed, S. K., Mohammed, R. A., Nashwan, A. J., Ibrahim, R. H., Abdalla, A. Q., M. Ameen, B.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eM., \u0026amp; Khdhir, R. M. (2025). 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Religiosity\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eand health: A global comparative study. \u003cem\u003eSSM - Population Health\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e, 100322.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ehttps://doi.org/10.1016/j.ssmph.2018.11.00\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Stanford University School of Medicine","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"psychedelics, spiritual beliefs, religious affiliation, ibogaine, veterans","lastPublishedDoi":"10.21203/rs.3.rs-8960226/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8960226/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe acute effects of psychedelic medicines include shifts in perception and awareness that can often include mystical or spiritual elements. Research suggests that these experiences can also extend into more persisting changes in spirituality, yet this area is underexplored. This study examined the effects of psychedelic experiences on spiritual beliefs using a survey of \u003cem\u003eN\u003c/em\u003e = 151 people who had received funding to attend a psychedelic-based treatment. Participants were primarily United States (US) veterans who retrospectively completed an online survey assessing the impact of their most memorable psychedelic experience on thoughts, emotions, and behavior. When comparing beliefs reported after one’s most memorable psychedelic experience with those reported before, the proportion of participants who endorsed an active belief in God or a higher power was significantly higher, and the proportion who denied a belief in God or a higher power was significantly lower. We did not observe significant changes in affiliation with spiritual or religious groups after the psychedelic experience, but qualitative analysis suggested that the nature of the participants’ relationship with spirituality exhibited some shifts. These findings suggest that psychedelic experiences can act as a catalyst for increased spiritual connection and reorientation, particularly among individuals who previously identified as doubting or nonbelieving.\u003c/p\u003e","manuscriptTitle":"Psychedelics are associated with changes in spiritual beliefs and orientations in US veterans","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-27 14:09:14","doi":"10.21203/rs.3.rs-8960226/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d940b738-97b6-43d0-b8f7-cc896f327ad1","owner":[],"postedDate":"February 27th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":63471694,"name":"Psychology"}],"tags":[],"updatedAt":"2026-02-27T14:09:15+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-27 14:09:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8960226","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8960226","identity":"rs-8960226","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}