Psychedelic therapy in the treatment of addiction: the past, present and future
Summary & key facts
This paper reviews research on using psychedelic drugs to treat addiction. The authors say scientific and medical interest has grown a lot in the last ten years and that early evidence is starting to show these treatments can be safe and may help with psychiatric problems including addiction. The review describes older studies from the mid 1900s, real-world surveys and observations, and modern clinical trials up to early phase two studies. It also explains how brain scans and other lab tools can help scientists learn how these treatments work, but it says more detailed research is still needed before we know how well they help most people.
- Scientists have renewed strong interest in psychedelic therapy over the last decade.
- The review says evidence is building that some psychedelic therapies can be safe and might help with psychiatric problems, including addiction, but this is not yet settled.
- The paper summarizes three kinds of research: historical studies from the mid 1900s, real-world observational and survey studies, and modern clinical trials up to early phase two studies.
- Researchers also use brain imaging methods such as functional magnetic resonance imaging and positron emission tomography to study how psychedelic treatments affect the brain.
- The authors argue that a more detailed understanding of how these treatments work in people will help developers improve the therapies and could lead to better patient outcomes in the future.
- The review stresses uncertainty and the need for more controlled, detailed studies before psychedelic therapy can be considered a proven standard treatment for addiction.
Abstract
Psychedelic therapy has witnessed a resurgence in interest in the last decade from the scientific and medical communities with evidence now building for its safety and efficacy in treating a range of psychiatric disorders including addiction. In this review we will chart the research investigating the role of these interventions in individuals with addiction beginning with an overview of the current socioeconomic impact of addiction, treatment options, and outcomes. We will start by examining historical studies from the first psychedelic research era of the mid-late 1900s, followed by an overview of the available real-world evidence gathered from naturalistic, observational, and survey-based studies. We will then cover modern-day clinical trials of psychedelic therapies in addiction from first-in-human to phase II clinical trials. Finally, we will provide an overview of the different translational human neuropsychopharmacology techniques, including functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), that can be applied to foster a mechanistic understanding of therapeutic mechanisms. A more granular understanding of the treatment effects of psychedelics will facilitate the optimisation of the psychedelic therapy drug development landscape, and ultimately improve patient outcomes.