Sleep disturbances are common in people with substance use disorders and often persist after stopping use. This systematic review and meta-analysis of 43 studies with about 7500 participants examined sleep abnormalities linked to alcohol, benzodiazepine, cannabis, cocaine, methamphetamine, nicotine, and opioid use disorders. Total sleep time was reduced in alcohol, nicotine, and opioid use disorders. Slow-wave sleep was reduced in alcohol and cocaine use disorders. Sleep quality, measured by the Pittsburgh Sleep Quality Index, was poorer in alcohol, cocaine, and nicotine use disorders. No studies met criteria for benzodiazepine or methamphetamine use disorders. Results suggest specific substances relate to distinct sleep problems, highlighting areas for further research.
The opioid crisis has driven a search for new treatments for opioid use disorder (OUD). A systematic review of 40 preclinical animal studies found that the psychedelic compounds 18-methoxycoronaridine (18-MC), ibogaine, noribogaine, and ketamine generally reduced opioid self-administration, eased withdrawal symptoms, and altered conditioned place preference. However, seven studies showed no improvement over controls. Most research has focused on iboga derivatives, which appear effective but carry higher cardiovascular risk than other psychedelics. The review calls for more translational and clinical studies that test a broader range of psychedelic agents and explore mechanisms, safety, dosing, and treatment frequency.