Alcohol Use Disorder (AUD)Tobacco/Nicotine Use Disorder (TUD)Substance Use Disorders (SUD)

Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review

This article (2020) reviews the current evidence regarding the psychopharmacology of psychedelics and their promise as treatments for a variety of forms of addictions or substance use disorder (SUD).

Authors

  • DiVito, A. J.
  • Leger, R. F.

Published

Molecular Biology Reports
meta Study

Abstract

Classical psychedelics are a group of drugs characterized by their activation of the serotonin-2A (5-hydroxytryptamine-2A; 5-HT2A) receptor and the unique hallucinogenic and mystical-type experiences that result. After a substantial period of restrictions limiting investigations into the therapeutic potential of psychedelics, a relatively recent recommencement of interest has sparked the burgeoning possibility for these drugs to play a part in the treatment of a wide array of psychopathologies. One of the most promising is in the study of addiction. Evidence has emerged that psychedelic agents may provide a novel avenue for the clinical treatment of patients dealing with substance use disorders (SUD). These serotonergic hallucinogens have displayed remarkable and enduring positive outcomes in this area, even when administered as one or two doses. The neural targets for these psychedelics are varied and underlie a complex mechanism of action-modulating multiple neural networks. It is believed that these agents allow for the reorganization of disordered neural pathways in the default mode network and attenuate maladaptive signaling in mesolimbic reward circuitry. The aim of this review is to examine the current standing of evidence regarding psychedelic psychopharmacology and to provide an overview of the use and effectiveness of these drugs in the treatment of SUD, alcohol use disorder, and for smoking cessation.

Available with Blossom Pro

Research Summary of 'Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review'

Introduction

Psychedelics are serotonergic compounds that alter perception, cognition and consciousness and commonly produce mystical-type experiences. After an early period of intense clinical interest followed by decades of regulatory restriction, clinical research with classical psychedelics (defined largely by agonism at the 5-HT2A receptor) has re-emerged. Divito and Leger frame this resurgence against the public-health burden of substance use disorders (SUD), noting rising overdose deaths, large numbers of people using illicit drugs and major global mortality from tobacco and alcohol, and they argue that existing pharmacotherapies for many addictions leave considerable room for improvement. This review aims to appraise the current state of evidence on psychedelic pharmacology and the clinical literature concerning their use in SUD, alcohol use disorder (AUD) and smoking cessation. The authors also examine proposed neurobiological mechanisms—particularly effects on mesolimbic reward circuitry, cortical networks and the default mode network (DMN)—and they highlight gaps in the evidence base and priorities for future research.

Expert Research Summaries

Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.

Study Details

References (33)

Papers cited by this study that are also in Blossom

The serotonin 5-HT2C receptor and the non-addictive nature of classic hallucinogens

Canal, C. E., Murnane, K. S. · Journal of Psychopharmacology (2016)

Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

Noorani, T., Garcia-Romeu, A., Swift, T. C. et al. · Journal of Psychopharmacology (2018)

Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey

Garcia-Romeu, A., Davis, A. K., Griffiths, R. R. et al. · Frontiers in Psychiatry (2020)

121 cited
Cessation and reduction in alcohol consumption and misuse after psychedelic use

Garcia-Romeu, A., Davis, A. K., Fire Erowid et al. · Journal of Psychopharmacology (2019)

211 cited
Current perspectives on psychedelic therapy: use of serotonergic hallucinogens in clinical interventions

Richards, W. A., Garcia-Romeu, A. · International Review of Psychiatry (2018)

Psychedelics: Where we are now, why we got here, what we must do

Belouin, S. J., Henningfield, J. E. · Neuropharmacology (2018)

Psilocybin for treating substance use disorders?

de Veen, B. T. H., Schellekens, A., Verheij, M. M. et al. · Expert Review of Neurotherapeutics (2016)

Can MDMA Play a Role in the Treatment of Substance Abuse?

Jerome, L., Schuster, S., Yazar-Klosinski, B. · Current Drug Abuse Reviews (2013)

Show all 33 references
Psychedelics as anti-inflammatory agents

Flanagan, T. W., Nichols, C. D. · International Review of Psychiatry (2018)

Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects

Griffiths, R. R., Johnson, M. W., Richards, W. A. et al. · Psychopharmacology (2011)

Human hallucinogen research: guidelines for safety

Johnson, M. W., Richards, W. A., Griffiths, R. R. · Journal of Psychopharmacology (2008)

Lysergic acid diethylamide: side effects and complications

Cohen, S. · Journal of Nervous and Mental Disease (1980)

Psychedelic Psychiatry’s Brave New World

Nutt, D. J., Erritzoe, D., Carhart-Harris, R. L. · Cell (2020)

Psychedelics as Medicines: An Emerging New Paradigm

Nichols, C. D., Nichols, D. E., Johnson, M. W. · Clinical Pharmacology and Therapeutics (2016)

The Effects of Hallucinogens on Gene Expression

Martin, D. A., Nichols, C. D., Nichols, Á. C. D. · Current Topics in Behavioral Neurosciences (2017)

Increased global functional connectivity correlates with LSD-induced ego dissolution

Tagliazucchi, E., Roseman, L., Kaelen, M. et al. · Current Biology (2016)

Acute effects of lysergic acid diethylamide on circulating steroid levels in healthy subjects

Strajhar, P., Schmid, Y., Liakoni, E. et al. · Journal of Neuroendocrinology (2016)

Acute effects of lysergic acid diethylamide in healthy subjects

Schmid, Y., Enzler, F., Gasser, P. et al. · Biological Psychiatry (2015)

A systematic study of microdosing psychedelics

Polito, V., Stevenson, R. J. · PLOS ONE (2019)

197 cited
Self-Rated Effectiveness of Microdosing With Psychedelics for Mental and Physical Health Problems Among Microdosers

Hutten, N. P. W., Mason, N. L., Dolder, P. C. et al. · Frontiers in Psychiatry (2019)

65 cited
Preliminary report on the effects of a low dose of LSD on resting-state amygdala functional connectivity

Bershad, A. K., Preller, K. H., Lee, R. et al. · Biological Psychiatry (2020)

88 cited
Emotions and brain function are altered up to one month after a single high dose of psilocybin

Barrett, F. S., Doss, M. K., Sepeda, N. D. et al. · Scientific Reports (2020)

Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials

Krebs, T. S., Johansen, P. Ø. · Journal of Psychopharmacology (2012)

Potential Therapeutic Effects of Psilocybin

Johnson, M. W., Griffiths, R. R. · Neurotherapeutics (2017)

Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study

Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A. et al. · Journal of Psychopharmacology (2015)

Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction

Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P. et al. · Journal of Psychopharmacology (2014)

The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act

Johnson, M. W., Griffiths, R. R., Hendricks, P. S. et al. · Neuropharmacology (2018)

Long-term follow-up of psilocybin-facilitated smoking cessation

Johnson, M. W., Garcia-Romeu, A., Griffiths, R. R. · The American Journal of Drug and Alcohol Abuse (2016)

562 cited
An online survey of tobacco smoking cessation associated with naturalistic psychedelic use

Johnson, M. W., Garcia-Romeu, A., Johnson, P. S. et al. · Journal of Psychopharmacology (2017)

117 cited

Cited By (13)

Papers in Blossom that reference this study

An Integrated theory of false insights and beliefs under psychedelics

McGovern, H., Grimmer, H. J., Doss, M. K. et al. · Communications Psychology (2024)

Changed Substance Use After Psychedelic Experiences Among Individuals in Canada

Boehnke, K. F., Kruger, D. J., Lucas, P. · International Journal of Mental Health and Addiction (2023)

11 cited
The association between naturalistic use of psychedelics and co-occurring substance use disorders

Rabinowitz, J., Lev-Ran, S., Gross, R. · Frontiers in Psychiatry (2023)

Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis

Kopra, E., Cleare, A. J., Rucker, J. et al. · Journal of Affective Disorders (2022)

Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy

Sekula, A. D., Downey, L., Puspanathan, P. · Frontiers in Psychology (2022)

19 cited
Beating Pain with Psychedelics: Matter over Mind?

Elman, I., Borsook, D., Pustilink, A. · Neuroscience and Biobehavioral Reviews (2022)

Ayahuasca and tobacco smoking cessation: results from an online survey in Brazil

Maia, L. O., Massarentti, C. M., Tófoli, L.F. · Psychopharmacology (2022)

28 cited
Show all 13 papers
Neural Plasticity in the Ventral Tegmental Area, Aversive Motivation during Drug Withdrawal and Hallucinogenic Therapy

Vargas-Perez, H., Grieder, T. E., Van Der Kooy, D. · Journal of Psychoactive Drugs (2022)

Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective

Dursun, S. M., Kelly, J. R., Gillan, C. M. et al. · Frontiers in Psychiatry (2021)

Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

Corrigan, K., Haran, M., Mccandliss, C. et al. · Irish Journal of Medical Science (2021)

Your Personal Research Library

Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.