Opioid Use Disorder (OUD)Substance Use Disorders (SUD)

Psychedelic use is associated with reduced daily opioid use among people who use illicit drugs in a Canadian setting

This longitudinal study (2021) assessed data from three ongoing open prospective cohorts of people who use drugs (PWUD) in Vancouver, Canada to investigate the relationship between psychedelic use and daily opioid use. This is the first study to find that recent psychedelic use was associated with 55% reduced odds of daily opioid use.

Authors

  • Elena Argento

Published

International Journal of Drug Policy
individual Study

Abstract

Background

Research into the therapeutic and naturalistic uses of psychedelics for improving outcomes related to mental health disorders has generated increasing interest in recent years. While controlled clinical trials of psychedelics have signaled benefits for treating substance use disorders, this area has not been well studied in the context of naturalistic psychedelic use. This study sought to investigate the possible relationship between recent naturalistic psychedelic use and subsequent daily illicit opioid use among people who use drugs (PWUD).

Methods

Data (2006-2018) were drawn from three harmonized prospective cohorts of community-recruited PWUD in Vancouver, Canada. We used multivariable generalized linear mixed-effects modeling (GLMM) to estimate the independent association between psychedelic use and subsequent daily illicit opioid use.

Results

Among 3813 PWUD at baseline, 1093 (29%) reported daily use of illicit opioids and 229 (6%) reported psychedelic use in the past six months. Over study follow-up after adjusting for a range of potential confounders, psychedelic use remained independently associated with a significantly reduced odds of subsequent daily opioid use (Adjusted Odds Ratio: 0.45; 95% Confidence Interval: 0.29 to 0.70).

Conclusion

While confirmation in other settings is required, these findings align with growing evidence that psychedelic use may be associated with detectable reductions in subsequent substance use including illicit opioid use.

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Research Summary of 'Psychedelic use is associated with reduced daily opioid use among people who use illicit drugs in a Canadian setting'

Introduction

Opioid use disorder (OUD) causes major morbidity and mortality and remains difficult to treat in many settings, in part because of toxic contamination of the illicit supply and barriers to sustained engagement with conventional treatments such as opioid agonist therapy. Recent renewed scientific interest has examined whether classic psychedelics — primarily 5-HT2A agonists such as LSD, psilocybin, DMT/ayahuasca and mescaline — might have therapeutic potential for mental health and substance use problems. Proposed mechanisms include enhanced neural plasticity and profound subjective experiences (often described as mystical experiences) that may mediate enduring changes in mood, behaviour and motivation to use substances. Argento and colleagues set out to examine whether recent naturalistic use of classic psychedelics is associated with subsequent daily illicit opioid use among people who use drugs (PWUD) in Vancouver, Canada. The study aimed to address a gap in prospective, individual-level observational evidence by analysing harmonised cohort data with repeated measures of substance use and a broad set of potential confounders, using lagged exposure modelling to strengthen temporal inference.

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Study Details

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