Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review

Classical psychedelics, which activate the serotonin-2A receptor and produce hallucinogenic and mystical-type experiences, show promise for treating substance use disorders, alcohol use disorder, and smoking cessation. Evidence indicates that one or two doses can yield remarkable and enduring positive outcomes. These agents modulate multiple neural networks, reorganizing disordered pathways in the default mode network and attenuating maladaptive signaling in mesolimbic reward circuitry. This review examines the current evidence on psychedelic psychopharmacology and provides an overview of their use and effectiveness for these conditions.

Study at a glance

Abstract

Classical psychedelics are a group of drugs characterized by their activation of the serotonin-2A (5-hydroxytryptamine-2A; 5-HT2A) receptor and the unique hallucinogenic and mystical-type experiences that result. After a substantial period of restrictions limiting investigations into the therapeutic potential of psychedelics, a relatively recent recommencement of interest has sparked the burgeoning possibility for these drugs to play a part in the treatment of a wide array of psychopathologies. One of the most promising is in the study of addiction. Evidence has emerged that psychedelic agents may provide a novel avenue for the clinical treatment of patients dealing with substance use disorders (SUD). These serotonergic hallucinogens have displayed remarkable and enduring positive outcomes in this area, even when administered as one or two doses. The neural targets for these psychedelics are varied and underlie a complex mechanism of action—modulating multiple neural networks. It is believed that these agents allow for the reorganization of disordered neural pathways in the default mode network and attenuate maladaptive signaling in mesolimbic reward circuitry. The aim of this review is to examine the current standing of evidence regarding psychedelic psychopharmacology and to provide an overview of the use and effectiveness of these drugs in the treatment of SUD, alcohol use disorder, and for smoking cessation.