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The American Journal of Psychiatry

Psychedelics for Substance Use Disorders: Updates for the Psychiatric Trainee

A review of psychedelics as emerging treatments for substance use disorders, discussing efficacy, safety, and key research findings.

Matt Hallowes

• 2 min read
Psychedelics for Substance Use Disorders: Updates for the Psychiatric Trainee

Title & Introduction

  • Paper Title: Psychedelics for Substance Use Disorders: Updates for the Psychiatric Trainee
  • Published In: The American Journal of Psychiatry Residents’ Journal
  • Publish date: March 6, 2025
  • Authors: Lauren Wilseck, D.O., M.P.H., Preet Chatha, B.S., Lawrence Canale, B.S., Dhvanit Raval, B.S., Jeremy Weleff, D.O.
  • Objective: To critically evaluate the literature on the use of psychedelics for substance use disorders (SUDs), exploring their efficacy, safety, and risks.
  • Importance: Given the increasing burden of substance use disorders and the limitations of current treatments, psychedelics offer a novel pharmacological approach to managing addiction.

Summary & Takeaways

Key Takeaway: Emerging research suggests that serotonergic psychedelics, such as LSD and psilocybin, may offer therapeutic benefits in reducing substance use and cravings in individuals with SUDs.

Practical Application: Psychedelic-assisted therapy could be integrated into addiction treatment programs, particularly for alcohol and tobacco use disorder, provided further clinical validation confirms safety and efficacy.

Key Background Information

  • Context: Substance use disorders are a major public health issue, with rising mortality rates from alcohol and drug-related causes. Traditional treatment approaches, such as pharmacotherapy and behavioral interventions, often yield limited long-term success.
  • Hypothesis: Serotonergic psychedelics exert therapeutic effects on SUDs by modulating neural circuits related to addiction, enhancing neuroplasticity, and disrupting maladaptive behavioral patterns.

Methodology

  • Study Design: Narrative review of clinical and preclinical studies on psychedelic-assisted therapy for substance use disorders.
  • Participants: Review includes data from various studies on individuals with alcohol, tobacco, and opioid use disorders.
  • Intervention/Exposure: Treatment with serotonergic psychedelics such as psilocybin, LSD, and ibogaine.
  • Controls: Some reviewed studies included placebo or standard treatment comparisons.
  • Duration: Studies reviewed included both short-term and long-term follow-ups on psychedelic treatment effects.

Key Findings

Primary Outcomes:

  • LSD has shown promise in increasing alcohol abstinence rates in early clinical trials.
  • Psilocybin has demonstrated efficacy in reducing tobacco and alcohol dependence.
  • Ibogaine has potential in opioid use disorder treatment but presents safety concerns.

Secondary Outcomes:

  • Psychedelics enhance neuroplasticity, potentially aiding behavioral change.
  • Patients report reduced cravings and greater motivation for abstinence post-treatment.
  • Psychological insights gained during psychedelic experiences may contribute to long-term recovery.

Interpretation & Implications

  • Conclusion: Psychedelics may offer an effective alternative or adjunctive treatment for substance use disorders, but further research is required to determine long-term safety and efficacy.
  • Implications: The resurgence of psychedelic research may lead to novel addiction treatments, particularly in patients with treatment-resistant SUDs.
  • Limitations: Many studies are small-scale and lack rigorous controls; more randomized controlled trials are needed.

Researchers & Publication