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Psychedelics for the Treatment of Substance Use Disorders: A Narrative Review of the Literature.

Olivia Marcus, Brian Rush

Substance use & addiction journal 2026 DOI: 10.1177/29767342251351123 (opens in new tab)

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Characteristics Narrative review Peer reviewed
Population Individuals with substance use disorders
Topics Addiction Psychedelic-assisted therapy
Keywords Narrative review Psychedelics Public health Scoping review Substance use disorders
Key findings Research across population surveys, observational studies, and clinical trials indicates that psychedelics may reduce symptoms of substance use disorders through pharmacological, spiritual, and interpersonal processes, though methodological concerns limit validity and generalizability.

Abstract

There is an increasing interest in the use of psychedelics for the treatment of substance use disorders (SUDs) and to improve overall health and wellbeing. We aimed to update and complement research syntheses that have focused only on results from clinical trials by synthesizing the research across diverse methods to discuss implications from a broad and multi-faceted literature. We conducted a narrative review of research focused on substance use and SUDs and both classic and non-classic/atypical psychedelics published between 1990 and 2025, synthesizing the evidence across population/survey studies, observational research, and clinical trials. There is growing investment in clinical research on psychedelics, yet methodological concerns within and across studies present challenges to the validity and generalizability of results. Research across population/survey studies, observational studies, as well as clinical trials suggest that symptom reduction is associated with a range of pharmacological, spiritual, and interpersonal processes. Findings from population surveys and observational studies align with growing clinical evidence in support of the use of psychedelics in the treatment of SUDs, indicating a need for more research to improve generalizability, understanding of safety concerns, the role of psychotherapies, and ethical implications of giving psychedelics to vulnerable populations. There is a need for more transparency in clinical research design and reporting, as well as for larger studies that track long-term outcomes. Studies with diverse methodological approaches are important to fill in knowledge gaps concerning treatment safety, tolerability, real-world effectiveness, accessibility, and respect for religious, traditional, and Indigenous communities. We specifically encourage more investment in observational, naturalistic, population-level, and survey research that can provide broad public health data on psychedelic-related SUD treatments and/or highly contextualized and historicized data on treatment methods, delivery, and experiences.

Comparable studies

Other narrative reviews on addiction, most cited first.

Study Year Design Participants
Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population 2019 Integrative review
Mindfulness meditation–based pain relief: a mechanistic account 2016 Review
Psychedelics as anti-inflammatory agents Animal models and cellular studies 2018 Review
A narrative review of yoga and mindfulness as complementary therapies for addiction. 2013 Review
The neuropsychopharmacology of cannabis: A review of human imaging studies 2018 Review

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