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Psychedelic Treatments for Substance Use Disorder and Substance Misuse: A Mixed Methods Systematic Review

Raman Sharma, Rachel Batchelor, Jacqueline Sin

Journal of Psychoactive Drugs March 18, 2023 DOI: 10.1080/02791072.2023.2190319 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Qualitative Peer reviewed
Population Adults with substance use disorder or substance misuse
Interventions psilocybin ibogaine ayahuasca
Topics Addiction Ayahuasca Psilocybin
Keywords Craving Abstinence Substance abuse Clinical psychology Substance dependence Substance use Hallucinogen
Citations 25
Key findings There is insufficient research evidence to suggest the effectiveness of any psychedelic for any specific substance use disorder or substance misuse.

Abstract

Renewed interest in psychedelic substances in the 21st century has seen the exploration of psychedelic treatments for various psychiatric disorders including substance use disorder (SUD). This review aimed to assess the effectiveness of psychedelic treatments for people with SUD and those falling below diagnostic thresholds (i.e. substance misuse). We systematically searched 11 databases, trial registries, and psychedelic organization websites for empirical studies examining adults undergoing psychedelic treatment for SUD or substance misuse, published in the English language, between 2000 and 2021. Seven studies investigating treatment using psilocybin, ibogaine, and ayahuasca, alone or adjunct with psychotherapy reported across 10 papers were included. Measures of abstinence, substance use, psychological and psychosocial outcomes, craving, and withdrawal reported positive results, however, this data was scarce among studies examining a wide range of addictions including opioid, nicotine, alcohol, cocaine and unspecified substance. The qualitative synthesis from three studies described subjective experience of psychedelic-assisted treatments enhanced self-awareness, insight, and confidence. At present, there is no sufficient research evidence to suggest effectiveness of any of the psychedelics on any specific substance use disorder or substance misuse. Further research using rigorous effectiveness evaluation methods with larger sample sizes and longer-term follow-up is required.

Comparable studies

Other systematic reviews and meta-analyses on ayahuasca for addiction, most cited first.

Study Year Design Participants
Effects of Ayahuasca and its Alkaloids on Drug Dependence: A Systematic Literature Review of Quantitative Studies in Animals and Humans 2016 Systematic review
Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies. Rodents and humans (healthy ritual ayahuasca users and patients with substance use... 2022 Systematic review n = 9
[Efficacy of psychedelics in psychiatry, a systematic review of the literature]. Patients with psychiatric conditions (anxiety, depression, major depressive disorder,... 2021 Systematic review n = 25
The current state of ayahuasca research in animal models: A systematic review. Rodents, primates, and zebrafish 2023 Systematic review n = 32
The therapeutic effects of psychedelics for opioid use disorder: A systematic review of clinical studies. 2025 Systematic review

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