Substance Use Disorders (SUD)Public Health, Prevention & Behaviour Change

Novel Treatment Approaches for Substance Use Disorders: Therapeutic Use of Psychedelics and the Role of Psychotherapy

This review (2022) explores how psychedelics can be used to treat substance use disorders (SUDs) Specifically, the authors discuss the role of different forms of psychotherapy such as psychodynamic and cognitive behavioural.

Authors

  • Matthew Johnson
  • Gerhard Gründer

Published

Current Addiction Reports
meta Study

Abstract

Purpose of Review: The use of psychedelics in a therapeutical setting has been reported for the treatment of various diagnoses in recent years. However, as psychedelic substances are still commonly known for their (illicit) recreational use, it may seem counterintuitive to use psychedelic therapy to treat substance use disorders. This review aims to discuss how psychedelics can promote and intensify psychotherapeutic key processes, in different approaches like psychodynamic and cognitive behavioural therapy, with a spotlight on the treatment of substance use disorders (SUD).Recent Findings: There is promising evidence of the feasibility, safety, and efficacy of psychedelic therapy in SUD. In the whole process of former and current psychedelic therapy regimes that have shown to be safe and efficacious, various psychotherapeutic elements, both psychodynamic and behavioural as well as other approaches, can be identified, while a substantial part of the assumed mechanism of action, the individual psychedelic experience, cannot be distinctly classified to just one approach.Summary: Psychedelic therapy consists of a complex interaction of pharmacological and psychological processes. When administered in well-defined conditions, psychedelics can serve as augmentation of different psychotherapy interventions in the treatment of SUD and other mental disorders, regardless of their theoretical origin.

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Research Summary of 'Novel Treatment Approaches for Substance Use Disorders: Therapeutic Use of Psychedelics and the Role of Psychotherapy'

Introduction

Psychedelics are serotonergic hallucinogens (not including ketamine, MDMA, ibogaine or new psychoactive substances) that primarily act via 5-HT2A receptor stimulation and produce profound, hours-long alterations in perception, emotion and autobiographical memory. Although recreational use is the most familiar public context in Europe and many psychedelics are internationally controlled, their addiction potential appears negligible and earlier clinical work and recent trials have suggested therapeutic benefits across a range of mental disorders, including substance use disorders (SUD). Despite this apparent paradox—using an illicit psychoactive compound to treat addiction—there is growing evidence that psychedelics can augment psychotherapeutic processes and support sustained behaviour change. Koslowski and colleagues set out to review how psychedelic-assisted interventions may promote and intensify core psychotherapeutic mechanisms, with a particular spotlight on psychodynamic and cognitive behavioural therapy (CBT) frameworks as applied to SUD. The paper aims to synthesise historical and contemporary clinical findings, neurobiological models and psychotherapeutic concepts to explain why and how psychedelic therapy might aid addiction treatment, and to identify gaps that warrant further empirical study.

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