Psychedelics are being studied as treatments for substance use disorders (SUDs), not just depression. A scoping review identified 34 clinical trials targeting alcohol, cannabis, cocaine, methamphetamine, nicotine, and opioid use disorders, mostly open-label without placebo controls. Alcohol use disorder was the most common target. From animal studies, four publications measured dopamine in the nucleus accumbens after psilocybin or MDMA. High-dose psilocybin caused a sustained mild increase in dopamine, suggesting it may help restore tonic dopamine levels, which could be relevant for treating addiction.
Psychedelics are being tested as treatments for substance use disorders, building on their promise for depression. A scoping review of clinical trials and publications identifies a potential new mechanism: restoring dopamine homeostasis. This process may reduce drug-seeking behavior and support abstinence, complementing previously known effects. The neurobiological basis of psychedelics' therapeutic action remains incompletely understood, but this dopamine-related pathway offers a novel target for treating addiction.
A review of 165 ongoing clinical trials using classic psychedelics reveals that most are early-phase, U.S.-based studies for depression. Psychedelics are typically administered once, with designs either open-label single-arm or parallel-assignment quadruple-blinded active-placebo. Only six trials explicitly report blinding effectiveness, and 33 different placebos are used as controls. The review identifies a need for proper placebo selection and improved participant masking to address unanswered questions in the field.