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A proposal to evaluate mechanistic efficacy of hallucinogens in addiction treatment

Brittany Vasae Burdick, Bryon Adinoff

The American Journal of Drug and Alcohol Abuse August 22, 2013 DOI: 10.3109/00952990.2013.811513 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Proposed clinical trial Peer reviewed
Population Prescription opioid abusers
Interventions Psilocybin Holotropic Breathwork Niacin
Topics Addiction Cannabis Psilocybin
Keywords Hallucinogen Drug Abstinence Population Pharmacology
Key findings No clinical comparisons of drug-induced and non-drug-induced altered states for addiction treatment have been conducted, and a trial is proposed to evaluate abstinence outcomes in prescription opioid abusers.

Abstract

Current treatments for addiction are frequently ineffective. Hallucinogenic therapy has been indicated as helpful for a range of substance use disorders, yet this approach remains understudied and publicly unavailable. It is nonetheless a promising treatment, which has significant, long-term beneficial effects with single doses and a profile characterized by general safety, low toxicity, and non-addictiveness. However, pharmacological interventions, such as hallucinogens, should not be offered if the same effects (e.g. psychological insights/mystical experiences) and outcomes (e.g. decreased drug use) could be achieved absent pharmacological intervention. To date, there have been no clinical comparisons of drug-induced altered states with non-drug-induced states for addiction treatment. We propose and then outline a clinical trial to address this gap in knowledge. The proposed design would evaluate abstinence outcomes in a population of prescription opioid abusers after exposure to one of three conditions: a drug-induced altered state using psilocybin, a non-drug-induced altered state via hyperventilation (Holotropic Breathwork), and an active placebo with niacin. The outcomes of such a study would reveal important differences in therapeutic potential by discriminating hallucinogen-dependent effects from those psychological effects resulting from altered states.

Comparable studies

Other non-randomized and open-label trials on addiction, most cited first.

Study Year Design Participants
Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction Psychiatrically healthy nicotine-dependent smokers 2014 Open-label pilot study n = 15
Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction Smokers 2015 Open-label pilot study n = 15
Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research Alcoholic patients 1997 Controlled clinical trial n = 211
First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Patients with alcohol use disorder (AUD) following community alcohol detoxification 2021 Open-label safety and tolerability proof-of-concept study n = 14
The Psychedelic Debriefing in Alcohol Dependence Treatment: Illustrating Key Change Phenomena through Qualitative Content Analysis of Clinical Sessions Participants in a psilocybin-assisted treatment study for alcohol dependence 2018 Open-label pilot (proof-of-concept) study with qualitative content analysis n = 17

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