Classic psychedelic-assisted therapies show initial promise for treating substance use disorders (SUDs) and may become legally available options. This article describes how these therapies could fit within current evidence-based SUD treatments, suggesting broad compatibility with most mainstream clinical approaches.
Classic psychedelics may treat mood and substance use disorders by reversing learned helplessness, a well-studied phenomenon across mammals. The neural circuits underlying resilience to learned helplessness, including the dorsal raphe nucleus, overlap with those activated by psychedelics. Preclinical data show psychedelics improve performance in rodent behavioral despair tasks, supporting this hypothesis. The learned helplessness paradigm offers a robust model for investigating psychedelic mechanisms across behavioral, neurobiological, and clinical levels, potentially explaining transdiagnostic therapeutic effects.
Classic psychedelics like psilocybin show promise for treating substance use disorders, and if larger trials confirm efficacy, psychedelic-assisted psychotherapy might be integrated into existing treatments such as cognitive behavioral therapy and twelve-step facilitation programs like Alcoholics Anonymous. Although AA has historically rejected medication-assisted treatments, the authors argue that classic psychedelics and their subjective experiences may be more compatible than conventional medications. They describe Bill Wilson's, the founder of AA, little-known experiences with psychedelics, suggesting aspects of psychedelic treatments could complement AA. A review of clinical trials evaluating psychedelics for substance use disorders is provided, along with discussion of potential large-scale impact if integrated into AA.