Informed by the principles of harm reduction and community-based research, the Canadian Psychedelic Survey gathered comprehensive real world evidence (RWE) from Canadian adults who have used psychedelics. This 650 question cross-sectional online survey gathered data on participant characteristics; access to psychedelics; detailed patterns of medical and non-medical use; the use of other substances before/during/after psychedelic use; changes in the use of alcohol, cocaine, tobacco, other substances related to psychedelic use; and peak positive and negative experiences. CPS received 2393 responses. The mean age of participants was 39 years old, and 56.3% identified as female, and 4.1% as non-binary. 73% identified past year psychedelic use, and a variety of reasons were cited for use, with “fun” (76.4%), “spiritual exploration” (71.7%) and improvement of “mental well-being” (61.1%) being the most common. While over half used psychedelics therapeutically, only 12% benefitted from the guidance of a health professional. CPS is the most comprehensive study of psychedelic use to date, providing a better understanding of psychedelic use and associated impacts on public health and the use of other substances. These findings may inform policy developments impacting access to psychedelics and treatment options for both patients and physicians.