The association of psychedelic use and opioid use disorders among illicit users in the United States

Pisano, Vincent D.; Putnam, Nathaniel P; Kramer, Hannah M.; Franciotti, Kevin; Halpern, John H.; Holden, Selma

doi:10.1177/0269881117691453

Cited by 53 publications

(34 citation statements)

References 49 publications

(49 reference statements)

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“…Building on these findings, Argento et al (2017) found that psychedelic drug use, broadly defined (i.e., not restricted only to 5HT2A agonists but also including MDMA) prospectively predicted a reduced likelihood of suicide ideation or attempts among 290 marginalized Canadian women (aHR = 0.40). Moreover, consistent with pilot studies of psilocybin-assisted psychotherapy for drug dependence (Bogenschutz et al, 2015; Johnson et al, 2014), Pisano et al found that lifetime classic psychedelic use was associated with a reduced risk of past year opioid dependence (weighted risk ratio = 0.73) and past year opioid abuse (weighted risk ratio = 0.60) among over 44,000 illicit opioid users who completed the NSDUH in years 2008 through 2013 (Pisano et al, 2017). Finally, a growing literature suggests protective effects for individuals in the criminal justice system, who suffer from numerous comorbid psychopathologies including depression, anxiety, and drug dependence that exacerbate criminal behavior.…”

Section: Evaluation Of the Abuse Potential Of Psilocybin According Tomentioning

confidence: 78%

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

et al. 2018

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This review assesses the abuse potential of medically-administered psilocybin, following the structure of the 8 factors of the US Controlled Substances Act (CSA). Research suggests the potential safety and efficacy of psilocybin in treating cancer-related psychiatric distress and substance use disorders, setting the occasion for this review. A more extensive assessment of abuse potential according to an 8-factor analysis would eventually be required to guide appropriate schedule placement. Psilocybin, like other 5-HT2A agonist classic psychedelics, has limited reinforcing effects, supporting marginal, transient non-human self-administration. Nonetheless, mushrooms with variable psilocybin content are used illicitly, with a few lifetime use occasions being normative among users. Potential harms include dangerous behavior in unprepared, unsupervised users, and exacerbation of mental illness in those with or predisposed to psychotic disorders. However, scope of use and associated harms are low compared to prototypical abused drugs, and the medical model addresses these concerns with dose control, patient screening, preparation and follow-up, and session supervision in a medical facility. CONCLUSIONS: (1) psilocybin has an abuse potential appropriate for CSA scheduling if approved as medicine; (2) psilocybin can provide therapeutic benefits that may support the development of an approvable New Drug Application (NDA) but further studies are required which this review describes; (3) adverse effects of medical psilocybin are manageable when administered according to risk management approaches; and (4) although further study is required, this review suggests that placement in Schedule IV may be appropriate if a psilocybin-containing medicine is approved. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.

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Section: Evaluation Of the Abuse Potential Of Psilocybin According Tomentioning

confidence: 78%

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

et al. 2018

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“…Participants in the present research were adult (≥18 years old) respondents of the NSDUH pooled across years 2002 through 2014 (the maximum number of survey years providing the same variables for analysis; unweighted Ns for all analyses > 480,000). Similar approaches have been employed by five prior investigations evaluating population-level associations of classic psychedelic use with indices of mental health (Hendricks et al, 2015a, b;Johansen and Krebs, 2015;Krebs and Johansen, 2013;Pisano et al, 2017). Detailed information on the NSDUH can be found elsewhere (https:// nsduhweb.rti.org/respweb/homepage.cfm).…”

Section: Methodsmentioning

confidence: 98%

The relationships of classic psychedelic use with criminal behavior in the United States adult population

et al. 2017

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Criminal behavior exacts a large toll on society and is resistant to intervention. Some evidence suggests classic psychedelics may inhibit criminal behavior, but the extent of these effects has not been comprehensively explored. In this study, we tested the relationships of classic psychedelic use and psilocybin use per se with criminal behavior among over 480,000 United States adult respondents pooled from the last 13 available years of the National Survey on Drug Use and Health (2002 through 2014) while controlling for numerous covariates. Lifetime classic psychedelic use was associated with a reduced odds of past year larceny/theft (aOR = 0.73 (0.65-0.83)), past year assault (aOR = 0.88 (0.80-0.97)), past year arrest for a property crime (aOR = 0.78 (0.65-0.95)), and past year arrest for a violent crime (aOR = 0.82 (0.70-0.97)). In contrast, lifetime illicit use of other drugs was, by and large, associated with an increased odds of these outcomes. Lifetime classic psychedelic use, like lifetime illicit use of almost all other substances, was associated with an increased odds of past year drug distribution. Results were consistent with a protective effect of psilocybin for antisocial criminal behavior. These findings contribute to a compelling rationale for the initiation of clinical research with classic psychedelics, including psilocybin, in forensic settings.

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“…Biologically verified continuous abstinence was significantly greater in the LSD than control conditions at 6 month (32% vs. 8%) and 12 month (25% vs 5%) follow-ups (46). Epidemiological data from the 2008-2013 National Survey on Drug Use and Health showed lifetime serotonin 2A agonist psychedelic use was associated with 27% reduced risk of past year opioid dependence and 40% reduced risk of past year opioid abuse when controlling for relevant covariates (43). Preliminary observational data have shown significant reductions in cocaine use in a small sample (n = 6) after participation in a ceremonial ayahuasca retreat geared toward addressing substance misuse (47).…”

Section: Introductionmentioning

confidence: 92%

“…Use of serotonin 2A (5-HT2A) agonist psychedelics such as lysergic acid diethylamide (LSD), psilocybin-containing mushrooms (hereafter referred to as psilocybin), peyote, and the dimethyltryptamine (DMT) containing admixture ayahuasca in both naturalistic and clinical settings have been implicated in decreased substance misuse (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). The strongest evidence is for LSD in the treatment of alcoholism, with six randomized studies showing an aggregated statistically significant effect for LSD improving outcomes in meta-analysis (49).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background: Observational data and preliminary studies suggest serotonin 2A agonist psychedelics may hold potential in treating a variety of substance use disorders (SUDs), including opioid use disorder (OUD). Aims: The study aim was to describe and analyze self-reported cases in which naturalistic psychedelic use was followed by cessation or reduction in other substance use. Methods: An anonymous online survey of individuals reporting cessation or reduction in cannabis, opioid, or stimulant use following psychedelic use in non-clinical settings. Results: Four hundred forty-four respondents, mostly in the USA (67%) completed the survey. Participants reported 4.5 years of problematic substance use on average before the psychedelic experience to which they attributed a reduction in drug consumption, with 79% meeting retrospective criteria for severe SUD. Most reported taking a moderate or high dose of LSD (43%) or psilocybin-containing mushrooms (29%), followed by significant reduction in drug consumption. Before the psychedelic experience 96% met SUD criteria, whereas only 27% met SUD criteria afterward. Participants rated their psychedelic experience as highly meaningful and insightful, with 28% endorsing psychedelic-associated changes in life priorities or values as facilitating reduced substance misuse. Greater psychedelic dose, insight, mystical-type effects, and personal meaning of experiences were associated with greater reduction in drug consumption. Conclusions: While these cross-sectional and self-report methods cannot determine whether psychedelics caused changes in drug use, results suggest the potential that psychedelics cause reductions in problematic substance use, and support additional clinical research on psychedelic-assisted treatment for SUD.

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The association of psychedelic use and opioid use disorders among illicit users in the United States

Cited by 53 publications

References 49 publications

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

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

The relationships of classic psychedelic use with criminal behavior in the United States adult population

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

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