Tripping up addiction: the use of psychedelic drugs in the treatment of problematic drug and alcohol use

Abstract

 Psychedelic drugs may have their therapeutic qualities due to anti-depressant effects, stimulating neuroplasticity and long-term psychological changes.3 Abstract Psychedelic drugs have been used as treatments in indigenous cultures for thousands of years. Yet, due to their legal status, there has been limited scientific research into the therapeutic potential of these compounds for psychiatric disorders. In the absence of other effective treatments however, researchers have begun again to systematically investigate such compounds and there is now evidence pointing to the use of psychedelic drugs in the treatment of addiction. In this review we focus on human evidence for the effectiveness of preparations used by indigenous cultures in the Amazon (ayahausca) and Africa (ibogaine) and worldwide (psilocybin), and more recently synthetised drugs such as the serotonergic hallucinogen LSD and the dissociative anaesthetic ketamine. Potential mechanisms explored are anti-depressant effects, changes in neuroplasticity and existential psychological effects of these drugs. [Francis Hartigan, Bill W., Chapter 25, p. 190-197 and p. 170-171, St. Martins Press, 2000,] The founder of alcoholics anonymous, Bill Wilson, is reported to have been treated with lysergic acid diethylamide (LSD) to help him stay abstinent from alcohol (1) and he credited it with helpful therapeutic properties. Yet the idea that illicit drugs can be used in the treatment of drug and alcohol addiction sits uncomfortably with many clinicians and researchers. It can appear paradoxical: illicit drugs are allegedly controlled due to their high abuse potential so it seems unethical to give them to people who already have a propensity for problematic alcohol and other drug use. Will they not then become addicted to the very substances that are being used to treat them?Centuries of practise and decades of research suggest that this is not the case. And now with emerging neurobiological understanding of their mechanisms, these compounds are poised to change the future of addiction treatment. Lysergic acid diethylamideLSD was first synthesised in 1938 from ergotamine, a chemical from the ergot fungus.LSD's psychological effects, usually last between 6 and 12 hours and can vary greatly in content across sets and settings (2). Pharmacologically, LSD is a classic serotonergic hallucinogen, with its psychedelic effects attributed to its 5HT-2A receptor agonism (3).In the 1950s and 60s, there was substantial research into LSD being used as a treatment for alcohol dependence (4). In recent years, this interest has been reignited. A number of review papers and one meta-analysis have reviewed studies from the height of LSD research (5-7) . The meta-analysis (6) combined the results of 6 randomised controlled trials, to assess efficacy of LSD as a treatment for alcoholism (536 participants in total).Across the studies included, 59% of active treatment participants vs. 38% of controls showed reliable improvement during the first follow up (1-2 months) and these dif...

Motives for Classical and Novel Psychoactive Substances Use in Psychedelic Polydrug Users

“…The observed ability of psychedelics to facilitate self-exploration through the enhancement self-awareness and reliving of autobiographic memories has been proposed as a key mechanism in early psychotherapeutic research with LSD (Vollenweider & Kometer, 2010). The question raised by this relationship, that is, what functional role self-medication might play in psychedelic use, stands out as a particularly relevant one in a time where psychedelic compounds are increasingly being reconsidered as psychotherapeutic tools (Carhart-Harris & Goodwin, 2017; Morgan, McAndrew, Stevens, Nutt, & Lawn, 2017; Tupper, Wood, Yensen, & Johnson, 2015) and should be explored in future research.…”

Broadening Your Mind to Include Others - The relationship between serotonergic psychedelic experiences and maladaptive narcissism_PREPRINT

“…Clinical research suggests that CSP-assisted therapyin which patients take a relatively mild or a large dose of psychedelics under the supervision of a therapist -can help to alleviate psychological distress and different mental health problems (see Carhart-Harris and Goodwin 2017 for an overview), including distress associated with life-threatening illness (Griffiths et al 2016); various forms of addiction including alcoholism and tobacco addiction (Bogenschutz et al 2015;Johnson et al 2017;Morgan et al 2017), and recurrent and treatment-resistant anxiety and depression disorders (Carhart-Harris et al 2018a;Palhano-Fontes et al 2019). Such effects on mental health are likely mediated by the extent to which participants have mystical-type and self-transcendent experiences during their CSP 'trip' (Bogenschutz et al 2015;Griffiths et al 2016;Johnson et al 2017;Roseman et al 2018;Ross et al 2016).…”

“…In recent years, there has been a steady increase in research suggesting that certain drugs typically classified as recreational drugs may be used effectively in mental health research and care, in particular for depression (Carhart-Harris et al 2018a;Singh et al 2016), post-traumatic stress disorder (Mithoefer et al 2018), and substance addiction (Morgan et al 2017). Psychedelic drugs in particular hold a great potential not only for treating a wide range of clinical disorders (Carhart-Harris and Goodwin 2017), but also for fostering prosocial behaviour and helping to address non-clinical but problematic interpersonal styles and behaviours.…”

Ceremonial ‘Plant Medicine’ use and its relationship to recreational drug use: an exploratory study

“…However, in the past decade, there has been a resurgence of interest in psychedelics among medical researchers. Recent clinical trials have suggested that these plants may be effective treatments for smoking cessation (Johnson et al, 2016), anxiety, depression and post-traumatic stress disorder (PTSD) (Carhart-Harris et al, 2016; Griffiths, 2010, Grob et al, 2011; Ross et al, 2016), addiction (Bogenschultz et al, 2015; Griffiths, 2010; Loizaga-Velder & Verres, 2014; Morgan et al, 2017), obsessive-compulsive disorder (OCD) (Moreno et al, 2006) and cluster headaches (Davenport, 2016; Sewell et al, 2006). MDMA was approved by the Federal Drug Administration (FDA) for Phase III clinical trials in 2016 and psilocybin is currently being considered for Phase III clinical trials.…”

“…The potential impact of plant medicines on physical health has been largely unexplored. Clinical trials to date have not made definitive conclusions on the potential mental, spiritual and physical benefits of plant medicine use, although studies of ayahuasca and psilocybin have shown promising results for depression, anxiety, PTSD, addiction, OCD, and headaches (Bogenschultz et al, 2015; Carhart-Harris et al, 2016; Davenport, 2016; Griffiths, 2010, Grob et al, 2011; Johnson et al, 2016; Loizaga-Velder & Verres, 2014; Moreno et al, 2006; Morgan et al, 2017; Ross et al, 2016). Significant gaps in the literature exist regarding the risks and possible benefits of these plants across the spectrum of health.…”