Can psychedelic compounds play a part in drug dependence therapy?

Introduction

After a century of modern psychiatry, enduring remission from dependence on alcohol, opiates, stimulants and nicotine remains difficult to achieve. Although some pharmacological treatments exist, failure rates are substantial and consensus on the most efficacious approaches is lacking. Research into psychedelic drug-assisted therapy was substantial in the 1950s and 1960s but largely halted for sociopolitical reasons; interest has re-emerged and contemporary studies are now exploring psilocybin, ketamine, ibogaine and ayahuasca specifically for substance dependence. Harkins and colleagues set out to examine whether psychedelic compounds might contribute to drug-dependence therapy. The paper surveys historical and cross-cultural uses of psychedelics, outlines possible psychological and biological mechanisms, summarises contemporary clinical and observational findings, and discusses theoretical objections, practical limitations and regulatory barriers to clinical implementation. The aim is to make the case for renewed, rigorous research into psychedelic-assisted interventions for substance misuse.