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Psychedelic-Assisted Therapy for Substance Use Disorders and Potential Mechanisms of Action.

Nathalie M Rieser, Marcus Herdener, Katrin H Preller

Current Topics in Behavioral Neurosciences 2022 DOI: 10.1007/7854_2021_284 (opens in new tab)

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AI-extracted from the abstract
Characteristics Theoretical or philosophical paper Peer reviewed
Topics Addiction LSD Psilocybin Psychedelic-assisted therapy
Keywords Hallucinogen Mechanism of action Sud
Key points Argues that the clinical mechanisms of action of psychedelics in treating substance use disorders are not well understood, and proposes that induced neuroplasticity, altered brain network connectivity, reward and emotion processing, social connectedness, insight, and mystical experiences may inform psychotherapeutic embedding. Contends that developing and testing psychotherapeutic approaches that maximize synergy with substance effects is critical for evidence-based psychedelic-assisted therapy for addiction.

Abstract

Substance use disorders (SUD) represent a significant public health issue with a high need for novel and efficacious treatment options. In light of this high unmet need, recent results reporting beneficial outcomes of psychedelic-assisted therapy in SUD are particularly relevant. However, several questions remain with regard to this treatment approach. The clinical mechanisms of action of psychedelic substances in the treatment of SUD are not well understood. Closing this knowledge gap is critical to inform and optimize the psychotherapeutic embedding of the acute substance administration. In this chapter, we discuss potential mechanisms that have implications on psychotherapeutic approaches including induced neuroplasticity, alterations in brain network connectivity, reward and emotion processing, social connectedness, insight, and mystical experiences. Furthermore, we outline considerations and approaches that leverage these mechanisms in order to optimize the therapeutic embedding by maximizing synergy between substance effects and psychotherapy. Understanding the mechanisms of action, developing psychotherapeutic approaches accordingly, and evaluating their synergistic efficacy in scientific studies will be critical to advance the framework of psychedelic-assisted therapy for addiction, create evidence-based approaches, and achieve the best treatment outcome for patients with SUD.

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