Therapeutic mechanisms of classic hallucinogens in the treatment of addictions: from indirect evidence to testable hypotheses

Abstract

Alcohol and drug addiction are major public health problems, and existing treatments are only moderately effective. Although there has been interest for over half a century in the therapeutic use of classic hallucinogens to treat addictions, clinical research with these drugs was halted at an early stage in the early 1970s, leaving many fundamental questions unanswered. In the past two decades, clinical research on classic hallucinogens has resumed, although addiction treatment trials are only now beginning. The purpose of this paper is to provide a targeted review of the research most relevant to the therapeutic potential of hallucinogens, and to integrate this information with current thinking about addiction and recovery. On the basis of this information, we present a heuristic model which organizes a number of hypotheses that may be tested in future research. We conclude that existing evidence provides a convincing rationale for further research on the effects of classic hallucinogens in the treatment of addiction. Copyright © 2012 John Wiley & Sons, Ltd.

Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction

“…Two specific hypotheses that have been proposed in the literature, and in part borne out by these results, are that the high degree of personal meaning attributed to participants’ psilocybin session experiences are associated with subsequent decrease in temptation to use tobacco, and increase in self-efficacy to abstain from smoking [29]. Furthermore, the magnitude of the mystical qualities of the psilocybin experiences as measured with the SOCQ seem to be predictive of subsequent decrease in tobacco craving and use, as observed from reductions in QSU scores and urinary cotinine levels.…”

“…Effects of psychedelic-occasioned experiences on higher-order psychological constructs have also been implicated. For instance, reductions in craving and anxiety, increases in motivation and self-efficacy, and acute alterations in autobiographical recall and cognitive bias have been hypothesized to mediate potential efficacy of psychedelics in clinical treatment contexts [29-30]. Furthermore, the ability of psychedelics to elicit mystical, transcendent, or peak experiences has also been proposed as a potential psychological mechanism in precipitating insight and behavior change [1, 7, 10, 14, 17, 29, 31-32].…”

Classic hallucinogens in the treatment of addictions

“…A number of persisting psychological changes have been proposed as possible mediators of effects of classic hallucinogens in the treatment of addiction (Bogenschutz and Pommy, 2012). The published pilot studies of psilocybin for alcohol or nicotine dependence have reported decreases in craving and increases in self-efficacy (Bogenschutz et al, 2015;Johnson et al, 2014).…”

Potential Therapeutic Effects of Psilocybin/Psilocin are Minimized While Possible Adverse Reactions are Overrated

“…These compounds present therapeutic potentials in several psychiatric conditions, including obsessive-compulsive disorder, 2 anxiety associated with advanced-stage cancer, 3 and drug dependence. 4 In the case of obsessive-compulsive disorder and anxiety associated with advanced-stage cancer, pilot clinical trials have been conducted reporting promising results. 2,3 Although these pilot studies present limitations, like the small sample size, it should be noted that these are just the first proofof-concept, exploratory studies.…”