Journal of addiction psychiatry
January 1, 2024
Gianni Martire, Daniel Sipple, David Baron et al.
341 citations
Borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) share overlapping neurobiological mechanisms, particularly reward deficiency and stress-like anti-reward processes. The authors propose reclassifying BPD as a "traumatic personality stress disorder" (TPSD) to unify therapeutic strategies that may stabilize dopaminergic reward function, such as psychedelic-assisted therapy (PAT). They argue that PAT could treat trauma-induced personality disorders by addressing these shared mechanisms. Reframing BPD as TPSD may lead to more effective, personalized interventions, reduce stigma, and improve understanding of underlying mechanisms, benefiting conditions characterized by anhedonia, negative affect, hypervigilance, and dissociation.
Addiction Biology
October 2, 2007
Firas Kobeissy, Jennifer A. Jeung, Matthew Warren et al.
47 citations
Acute administration of MDMA (ecstasy) and methamphetamine to adult male rats altered serum levels of appetite-regulating hormones in a dose- and time-dependent manner. MDMA caused transient decreases in leptin and growth hormone and increases in ghrelin, with levels returning to baseline after 24 hours. Both MDMA and methamphetamine produced a steady decrease in neuropeptide-Y. These hormone changes may help explain the reduced eating observed in humans who abuse these drugs.
Frontiers in Public Health
January 25, 2024
Yu Kyung Lee, Mark S. Gold, Kenneth Blum et al.
45 citations
Opioid use disorder remains a major public health crisis, with overdose deaths at an all-time high despite increased access to naloxone, buprenorphine, and harm reduction strategies. The COVID-19 pandemic worsened substance use and disrupted treatment. Current medications have not reversed the rising death toll, indicating a need for different prevention and treatment approaches. This article reviews recent trends and limitations of existing medications and briefly examines novel treatments that may be more durable and effective. These include interventional treatments, psychedelics, neuroimmune, nutraceutical, and electromagnetic therapies, which are at various stages of investigation and FDA approval and may reduce overdoses, attenuate OUD, and address comorbid disorders.
Brain Sciences
March 20, 2024
Muhammet Celik, Mark S. Gold, Brian S Fuehrlein
22 citations
Alcohol use disorder contributes to over 140,000 annual deaths in the United States, over 200 related diseases globally, and 5.1% of the global disease burden, yet remains undertreated with few approved medications. This narrative review describes the current treatment landscape and novel strategies for alcohol withdrawal syndrome and AUD, including psychedelics combined with psychotherapy, noninvasive neural-circuit-based interventions, phosphodiesterase-4 inhibitors, and GLP-1 receptor agonists. Recent studies show promising results for these approaches, but further research is needed to fully understand their effectiveness. The shortage of approved medications and other treatment modalities highlights the urgent need for continued investigation.
Journal of the Neurological Sciences
September 15, 2022
Sabrina Correa Da Costa, Tyler Oesterle, Teresa A Rummans et al.
21 citations
Existing psychiatric drugs often work slowly, have limited effectiveness, and cause side effects. Recent human studies with psychedelics such as psilocybin, MDMA, and LSD show rapid and lasting clinical benefits for conditions like alcohol use disorder, anxiety, and depression in terminal illness. These compounds have been used in spiritual ceremonies for millennia, and early research suggested their therapeutic potential. After a research pause following the 1970 Controlled Substance Act, interest revived in the 1990s. Although preliminary findings are encouraging, current evidence is insufficient for routine clinical use; long-term safety and efficacy remain unclear, and ongoing trials aim to clarify these questions. This article provides an overview of the evidence to date.
JAMA
February 9, 1994
Mark S. Gold
12 citations
A large annual survey of over half a million U.S. junior and senior high school students in 1993 found that hallucinogen use rose slightly from 4.9% to 5.3% compared to the previous year. Among hallucinogen users, 83% reported typically getting high or stoned, a higher proportion than among beer drinkers (24%), marijuana smokers (66%), or cocaine users (74%). The authors suggest many young people view cocaine as very dangerous but see LSD as spiritually uplifting; 55% of seniors believed trying LSD a few times is not harmful.
Psychiatric Annals
March 1, 1994
Mark S. Gold
11 citations
Surveys of high school students indicate that use of LSD and other hallucinogens appears to be increasing.
Brain Sci
September 28, 2025
Sabrina Correa Da Costa, Nicholas L. Bormann, Tyler Oesterle et al.
3 citations
Substance use disorders affect over 48.5 million Americans, and available treatments often fail even with adequate adherence. This overview of 16 systematic reviews examined evidence on serotonergic psychedelics and ketamine for treating substance use disorders. Preliminary evidence suggests these compounds may offer advantages over traditional treatments and could eventually become part of next-generation therapies under specific circumstances. However, significant challenges remain: high risk of bias and methodological limitations in existing studies warrant caution, and associated risks are not negligible. The use of psychedelic drugs for substance use disorders remains experimental, and current evidence is insufficient to support clinical practice.
Substance Use & Misuse
February 1, 2026
Kai-Uwe Lewandrowski, Kenneth Blum, Sergio Schmidt et al.
Since 2000, suicide and opioid overdose rates have risen sharply. About one-third of people with major depressive disorder have treatment-resistant depression, creating an urgent need for new therapies. This narrative review synthesizes key preclinical and clinical findings on low-dose ketamine's rapid antidepressant effects. Low-dose ketamine quickly alleviates depressive symptoms, even in refractory depression. Proposed mechanisms include modulation of dopamine signaling via epigenetic neuroadaptation, interactions with D1/D2 receptor systems, optogenetic activation of D1 pathways, and changes in D2/D3 receptor availability. No consensus exists on its definitive mechanism of action. Ketamine's psychoactive properties and abuse potential underscore the need for enhanced clinical oversight and regulation.
Brain Sci
November 4, 2025
A. Benjamin Srivastava, Mark S. Gold
Research into psychedelic drugs for treating alcohol use disorder (AUD) has revived, but several fundamental limitations restrict the conclusions that can be drawn. These include general issues like functional unblinding and the ambiguous definition of psychedelic-assisted psychotherapy, as well as AUD-specific challenges such as how the mystical experience relates to the spiritual experience described in Alcoholics Anonymous literature. Current neuroimaging studies are also limited in design and fail to directly examine the cognitive and circuit-level processes likely underlying treatment response. This review bridges historical, conceptual, and mechanistic aspects of this research and offers suggestions for future studies to more clearly specify the role of psychedelics in AUD treatment.