A Tragedy of Errors: The State of Psychedelic Research in the Treatment of Alcohol Use Disorder.
A. Benjamin Srivastava, Mark S. Gold
Brain Sciences November 4, 2025 DOI: 10.3390/brainsci15111190 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Addiction |
| Key findings | Several fundamental limitations—including functional unblinding, ambiguous definitions of psychedelic-assisted psychotherapy, and the relationship between mystical and spiritual experiences—restrict conclusions about the therapeutic potential of psychedelics for alcohol use disorder. |
Abstract
The past two decades have seen the reemergence of research investigating the therapeutic potential of psychedelic drugs across neuropsychiatric illnesses. One condition, alcohol use disorder (AUD), is of relevance given the broad public health implications and both limited effectiveness and attrition associated with currently available treatments. While emerging research has suggested that the benefits of psychedelic drugs in the treatment of AUD may be considerable, several fundamental aspects of this work limit the conclusions that can be drawn. These limitations include those that apply to research involving psychedelics generally-including functional unblinding and the role and definition of "psychedelic assisted psychotherapy" and some unique to AUD, including the nature of the mystical experience and how it relates to the "spiritual experience" as described in the literature of Alcoholics Anonymous (AA), of which the history of psychedelic research in AUD is closely intertwined. Additionally, current mechanistic neuroimaging studies examining the therapeutic effects of psychedelics in AUD are limited by design and do not directly interrogate the cognitive and circuit-level processes likely underlying treatment response. This review describes these limitations in detail by bridging historical, conceptual, and mechanistic aspects of psychedelic research in AUD and offers suggestions for future studies, the results of which may more clearly specify the role and utility of psychedelic drugs in the treatment of AUD.
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 |
Citations in the library
Cites 34
- A default mode of brain function Proceedings of the National Academy of Sciences January 16, 2001
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study Journal of Psychopharmacology January 13, 2015
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder JAMA Psychiatry August 24, 2022
and 29 more in the library