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
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.
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.
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- APA Citation
DiVito, A. J., & Leger, R. F. (2020). Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review. Molecular Biology Reports, 47(12), 9791-9799. https://doi.org/10.1007/s11033-020-06009-x
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