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  • Writer's pictureDr. Harold Pierre

Psychedelic Therapy: A Revolutionary New Treatment for Addiction?

Updated: Dec 5, 2023



Psychedelic therapy is emerging as a potentially groundbreaking new treatment option for individuals struggling with addiction and substance use disorders. Psychedelics - including psilocybin, LSD, ayahuasca, peyote, mescaline, MDMA, ketamine, and ibogaine - are being studied as tools to help people overcome addictions when used in combination with psychotherapy and spiritual guidance.


Though still in the early phases of research, the initial results are extremely promising. Early clinical trials and pilot studies have found that psychedelic-assisted therapy may help people achieve abstinence and long-term recovery from drug and alcohol addiction.


While not a panacea or cure-all, psychedelic therapy offers new hope for those who have repeatedly tried and failed to overcome addiction through conventional treatments. This comprehensive guide will explore the history, current research, proposed mechanisms of action, and future potential of using psychedelics to treat addiction.


What are Psychedelics and How Do They Work?


Psychedelic eye on blue face. Symbolize the use of psychedelic therapy

Psychedelics are a class of psychoactive substances that alter consciousness, mood, cognition, and perception of the environment. The word "psychedelic" comes from the Greek words for "mind manifesting."


Unlike many recreational drugs, psychedelics typically do not lead to physical dependence or addiction. However, they remain classified as Schedule I controlled substances with no currently accepted medical use.


Some of the most studied psychedelics proposed for addiction treatment include:

  • Psilocybin: the active compound found in psychedelic mushrooms

  • LSD: a semi-synthetic psychedelic drug

  • Ayahuasca: a brew containing DMT made from Amazonian plants

  • MDMA: also known as "ecstasy" or "Molly"

  • Ibogaine: a psychoactive compound derived from the iboga plant

  • Ketamine: a Food and Drug Administration approved dissociative anesthetic with psychedelic effects at low doses

  • Salvia divinorum: a dissociative hallucinogen derived from the Salvia plant

  • DOM: 2,5-Dimethoxy-4-methylamphetamine, a psychedelic amphetamine

  • DXM: dextromethorphan, a dissociative found in some cough medicines

  • 2C-B: a psychedelic phenethylamine

These substances all work primarily by activating certain serotonin receptors in the brain, leading to heightened senses, hallucinations, mystical states, and ego dissolution.

However, each psychedelic drug has a slightly different mechanism of action and subjective effects. By combining them with psychotherapy techniques, researchers believe psychedelic therapy may "reset" maladaptive patterns of thinking and behavior associated with addiction. They may also treat mental health diseases.


A Historical Perspective on Psychedelic Therapy


While research was largely halted for decades, interest in psychedelic therapy began over 70 years ago. Throughout the 1950s and 1960s, over 1000 clinical papers described the use of psychedelics to treat addiction and other conditions. Researchers primarily focused on using LSD to treat alcoholism, reporting promising results.


For example, a 2012 meta-analysis of randomized trials from this era found a single dose of LSD was significantly more effective at reducing alcohol misuse compared to placebo. The effects lasted up to 6 months. However, research into the therapeutic effects of psychedelics stalled in the 1970s after these substances were made illegal. Their potential medical value was dismissed for decades.


Fortunately, scientists have slowly begun studying psychedelic therapy again over the past 20 years. Modern research practices and technology are illuminating how psychedelics impact the brain, potentially paving the way for new addiction treatments.


Renewed Medical Interest and Therapeutic Potential


Despite lingering legal and social stigma, an exciting renaissance in psychedelic research has emerged in the 21st century. Rigorous clinical trials are testing various psychedelic-assisted therapies on conditions like depression, anxiety, PTSD, substance abuse, smoking, and more. Research into psychedelic therapies are taking place at top universities like Johns Hopkins, Imperial College London, NYU, Yale, and Mount Sinai.


Researchers are focused on proving safety, measuring efficacy, and uncovering mechanisms of action. The initial published results showcase psychedelics' promising therapeutic effects when expertly administered in controlled settings.

For example, in 2016, two clinical trials found psilocybin produced substantial and sustained reductions in anxiety and depression in cancer patients. A pivotal 2020 study found MDMA-assisted psychotherapy led to significant PTSD symptom reductions in veterans, firefighters, and police officers.


These successful pilots have paved the way for ongoing Phase 2 and 3 trials that may lead to FDA approval. Similar large-scale studies are now underway to test psilocybin and other psychedelics for treating major addictions.


Key Benefits of Psychedelic Therapy for Treating Addiction


Researchers have identified several reasons why psychedelic therapy may successfully treat addiction when other methods fail:

Psychedelic mushrooms. Psilocybe mexicana copy

  • Profound changes in perspective and outlook: Psychedelics can trigger mystical or spiritual experiences that shift awareness and attitudes in a positive direction. This renewed meaning and purpose may help break entrenched addictive behaviors.

  • Increased insight and self-reflection: Psychedelics allow people to examine their lives more objectively. Seeing how addiction negatively impacts relationships and goals can enhance motivation for change.

  • Disruption of addictive patterns: Psychedelics appear to "shake up" habitual neural pathways underlying addiction. This neurological reset provides a window to establish new healthy behaviors with therapy.

  • Improved emotional regulation: Psychedelics may help people better tolerate and cope with difficult emotions that often trigger relapse like anxiety, depression, and cravings.

  • Strengthened social connections: Psychedelics increase empathy, patience, and closeness to others. Improving social support systems aids recovery.

  • Lasting neuroplastic changes: Psychedelics may stimulate growth of new neural connections and restore brain function. This could explain their long-term anti-addictive effects.

By targeting multiple biological, psychological, and social drivers of addiction simultaneously, psychedelic therapy offers significant advantages over one-dimensional treatment methods.


Psilocybin for Addiction Treatment


Psilocybin - the psychoactive compound in "magic mushrooms" - is the most studied psychedelic in addiction research currently.

Several pilot studies indicate psilocybin-assisted therapy can effectively treat alcohol, nicotine, cocaine, and opioid addictions:

  • A 2015 study of 10 people with alcohol dependence found psilocybin reduced drinking over 36 weeks. Heavy drinking days decreased by over 25% after treatment.

  • In a 2014 pilot, 12 out of 15 heavy smokers achieved abstinence from cigarettes for over 6 months after psilocybin therapy. Most quit after just one dose.

  • Ongoing studies at Johns Hopkins, NYU, University of Alabama, and Imperial College London are further testing psilocybin for alcohol, cocaine, opioid, and nicotine addictions.

How does psilocybin exhibit anti-addictive effects in the brain? Research shows it activates serotonin receptors and increases communication between brain regions. This may "liberate" people from restricted patterns of thinking and behavior underlying their addiction.

Unlike other psychedelics, psilocybin is non-toxic, non-addictive, and has a relatively short duration of action. Combined with therapy, it offers a promising new strategy for addiction treatment. Larger randomized trials are still needed to confirm efficacy.


Other Psychedelic Drugs Being Studied


In addition to psilocybin, researchers are also exploring the therapeutic potential of other psychedelics for treating addiction:


Ketamine

Ketamine is an FDA-approved anesthetic drug that has psychedelic effects at low doses. Ketamine for the treatment of resistant depression has grown in popularity. Recent studies found ketamine-assisted therapy improved abstinence rates and reduced drinking in people with severe alcohol use disorder. Researchers believe ketamine may "rewrite" addictive drinking memories when administered alongside therapy. Ongoing studies are further testing its ability to reduce cravings and promote long-term recovery.


MDMA

MDMA (also known as ecstasy or Molly) enhances feelings of empathy, compassion, and connection to others. A 2021 pilot study found MDMA-assisted therapy was safe and well-tolerated in people recovering from alcohol addiction. Participants reported substantial decreases in drinking after treatment. Additional clinical trials are underway. MDMA also shows promise when combined with therapy for treating PTSD - a condition frequently linked to addiction.


Ibogaine

Ibogaine is a psychedelic compound derived from the iboga plant. It has a long history of use in spiritual ceremonies in Africa. Observational studies indicate ibogaine therapy can ease opioid withdrawal symptoms and reduce drug cravings. However, safety concerns due to its cardiotoxic effects have slowed clinical research. With medical screening and oversight, ibogaine may eventually offer another addiction treatment option.


Ayahuasca

Ayahuasca is a ceremonial tea containing DMT that has traditionally been used by indigenous Amazonian cultures. Surveys show ritual ayahuasca use is associated with less problematic alcohol and substance use compared to the general population. Therapeutic elements like personal introspection, spiritual connections, and community support may underlie these benefits. Clinical studies are still needed.


LSD and Others

While less research exists currently, scientists are also exploring classic psychedelics like LSD and mescaline (peyote) for addiction treatment applications, along with emerging compounds like 5-MeO-DMT. Ongoing and future studies will shed more light on their various therapeutic potentials.


Adverse Reactions, Safety, and Side Effects


Psychedelics are not completely risk-free substances. Their unique psychological effects make certain environmental precautions and medical screenings necessary.

Potential adverse reactions may include:

  • Anxiety, fear, panic attacks

  • Psychotic reactions (very rare)

  • Dangerous behavior if unsupervised

  • Exacerbation of certain psychiatric conditions like schizophrenia

  • Serotonin toxicity when combined with certain medications

However, clinical trials demonstrate psychedelic therapy can be administered safely with proper protocols. These include:

  • Careful screening and exclusion criteria to avoid contraindications

  • Establishing trust and rapport between patient and therapists

  • Preparation sessions to identify treatment goals and expectations

  • Offering psychological support, supervision, and a peaceful setting during sessions

  • Integrating sessions afterward to make sense of psychedelic experiences

When used responsibly in controlled settings, psychedelics do not exhibit dependence or abuse potential. In research, reported side effects are generally mild like headache, nausea, and fatigue.


Nonetheless, more data is still needed on long-term effects of repeated use. Current evidence indicates psychedelic therapy is reasonably safe when given intermittently alongside therapy.


Future Directions and Challenges


Psychedelic medicine offers hope for revolutionizing addiction treatment, but many challenges remain:


Doctor on blurred background holding digital analysis result icons 3D rendering copy

  • Legal restrictions: Despite promising research, psychedelics remain Schedule I illegal drugs. Advocacy is needed to facilitate medical access.

  • Social acceptance: Stigma and misconceptions about psychedelics need to be addressed through public education. Their medical value must be distinguished from recreational use.

  • Access: Trained providers, treatment centers, and affordable costs are required to bring psychedelic therapy to the mainstream. Virtual options could expand access.

  • Commercialization: For-profit interests could compromise patient protections, equitable access, and the therapy components that make psychedelic treatment effective.

  • Additional research: Larger clinical trials are required to obtain regulatory approval. Mechanisms of action also need further exploration to optimize psychedelic therapy protocols.

The psychedelic renaissance represents an exciting frontier for mental health treatment. Continued scientific rigor paired with compassionate, ethical implementation will help realize their vast healing potential.


With an open yet critical perspective, psychedelic therapy could revolutionize how we treat addiction - saving lives lost annually to drug abuse and overdose. This new paradigm deserves an opportunity, guided by both evidence and prudence.


Frequently Asked Questions:


What are the most common psychedelic drugs being researched for addiction treatment?

The most studied psychedelics for addiction so far are psilocybin ("magic mushrooms"), LSD, ayahuasca, MDMA, ketamine, and ibogaine. Each has slightly different mechanisms of action but may help treat addiction and mental health disorders.


How long do the effects of psychedelic drugs last?

Psychedelic experiences typically last 4-12 hours depending on the substance and dosage. Shorter-acting options like DMT or 5-MeO-DMT induce effects for 15 minutes up to an hour.

Can psychedelics cure addiction completely?

While promising, psychedelics should not be considered a "cure" or magic bullet for addiction. When combined with therapy, they can powerfully augment recovery from addiction and reduce relapse over the long-term.

What are the risks or side effects of using psychedelics?

Potential adverse reactions may include anxiety, panic, dangerous behavior if unsupervised, and very rarely, psychotic reactions in predisposed individuals. Most side effects are mild (nausea, headache, fatigue). Long term impacts need further study.

How is psychedelic therapy administered?

Psychedelic therapy protocols involve preparation sessions, professionally supervised dosing sessions, and integrative psychotherapy to help make sense of psychedelic experiences over multiple weeks or months.

Are psychedelics legal?

No, psychedelics remain Schedule I illegal substances at the federal level in the United States and most countries worldwide. Researchers must obtain special licenses to study psychedelic therapy.

Where can I seek psychedelic therapy if I'm struggling with addiction?

Legal psychedelic therapy is not yet available to the general public outside of clinical trials. However, results of these pioneering studies are extremely promising. Expanded access is hopefully on the horizon pending continued progress.

Can psychedelic therapy be combined with other treatments like medications?

Yes, psychedelic therapy aims to complement existing evidence-based treatments, not replace them entirely. Integrating different modalities may offer the best chance for overcoming addiction.

How accessible and affordable will psychedelic therapy be in the future?

Advocates are working to avoid restrictive, for-profit monopolies on psychedelics when licensed as legal medicines. Compassionate, equitable access alongside therapy remains a priority.

Is ketamine psychedelic therapy available?

This form of treatment is readily available for patients with treatment-resistant depression. As of 2023, ketamine infusion clinics are in most US cities. It's as easy as a "ketamine infusion clinic near me" Google search.

Do I have to have a "mystical" experience for psychedelic therapy to work?

While they can catalyze profound spiritual insights, patients do not need to have a stereotypical "psychedelic trip" experience to benefit. The impact psychedelics have varies person-to-person.

Are there individual differences that make someone more or less likely to respond to psychedelic therapy?

Response likely depends on multiple factors from biology to personality to openness to the experience itself. Ongoing research aims to identify who responds best to optimize treatment approaches.


In summary, psychedelics represent a promising new avenue for addiction treatment that deserves rigorous but open-minded exploration. Blending modern science with ancient plant wisdom may herald a much-needed shift in mental healthcare for the 21st century. This article was for information only. Please consult with your physician before making any decisions about your health.


About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.


This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.






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