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Addiction research: what the evidence shows

Studies of how psychedelics, medications, and behavioral approaches affect substance dependence and craving.

State of the evidence

Synthesized

Synthesized from 22 studies in the library · AI-generated, grounded in the abstracts below

Found by searching the library for Addiction, substance use disorder, dependence, alcohol use disorder, opioid use disorder, then ranked by relevance.

Research on addiction here centers on psychedelic-assisted therapy, especially psilocybin for alcohol and tobacco use, where a randomized trial and a meta-analysis of six trials (N=202) report moderate short-term reductions in heavy drinking and higher odds of abstinence, though advantages shrink at longer follow-up. Small open-label and single-group studies report high quit rates (80% smoking abstinence; sustained drinking reductions), but these lack control groups. Ketamine, ayahuasca, ibogaine, and mindfulness approaches show preliminary or mixed signals, and the main caveats are small samples, open-label designs, limited durability data, and reliance on observational or animal evidence for several compounds.

Evidence by study

Direction is which way each study's own result points, not our rating of the study. All 25 matching studies were reviewed; the 22 that directly address the question are shown here.

What the directions mean
Supports:
the study found the intervention worked, or its hypothesis held.
Opposes:
it found the opposite, no benefit or a harm.
No effect:
no significant difference either way.
Mixed:
effects in both directions within the same study.
Unclear:
the abstract does not report a direction.
Study Design Sample size Direction Finding
Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study 2015 single-group proof-of-concept study 10 Supports Abstinence did not increase before psilocybin but rose significantly after psilocybin administration, with gains largely maintained to 36 weeks and no significant treatment-related adverse events.
Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction 2014 open-label pilot study 15 Supports Twelve of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up after psilocybin within a structured smoking cessation protocol, a rate the authors note exceeds typical behavioral or pharmacological quit rates.
Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder 2022 RCT 95 Supports Psilocybin plus psychotherapy produced 9.7% heavy drinking days over 32 weeks versus 23.6% with active placebo plus psychotherapy, a significant reduction.
Ketamine use: a review 2011 systematic review Opposes Chronic frequent ketamine use is associated with ulcerative cystitis, working and episodic memory deficits, and addiction concerns, with many users reporting failed attempts to stop.
Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. 2019 review Supports Reviews report promising results for classic psychedelics in treating addiction and end-of-life distress, and suggest nonmedical naturalistic use may be associated with positive mental health outcomes.
Mindfulness meditation and substance use in an incarcerated population. 2006 quasi-experimental with treatment-as-usual control Supports After release from jail, Vipassana meditation course participants showed significant reductions in alcohol, marijuana, and crack cocaine use and alcohol-related problems compared with treatment-as-usual controls.
Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction 2015 open-label pilot study 15 Supports Twelve of 15 participants (80%) had biologically verified smoking abstinence at 6 months, and abstainers scored significantly higher on psilocybin-occasioned mystical experience than non-abstainers, with no difference in general drug intensity.
Psychedelics as Medicines: An Emerging New Paradigm 2016 theoretical Supports Argues that psychedelics may exert therapeutic effects by destabilizing brain network hubs and enabling network resetting, citing preliminary evidence of efficacy in tobacco and alcohol addiction.
Mindfulness Meditation for Substance Use Disorders: A Systematic Review 2009 systematic review Mixed Across 25 studies, preliminary evidence suggests mindfulness meditation may be efficacious and safe for substance use disorders, but conclusive data are lacking due to significant methodological limitations.
Psychedelics reopen the social reward learning critical period 2023 experimental study in mice Supports Psychedelic drugs reopen the social reward learning critical period in mice, with a time course proportional to human subjective effects, mediated by oxytocin-dependent plasticity and extracellular matrix reorganization.
Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada 2013 observational study Supports Ayahuasca-assisted therapy was associated with statistically significant improvements in several factors related to problematic substance use.
Dynamic coupling of whole-brain neuronal and neurotransmitter systems 2020 observational neuroimaging study Unclear Stimulation of 5-HT2A receptors with psilocybin causally explained functional brain effects, which the authors suggest could help understand why psilocybin shows promise for depression, anxiety, and addiction.
Mindfulness meditation–based pain relief: a mechanistic account 2016 review Supports Reviews findings that mindfulness meditation significantly attenuates pain through multiple mechanisms, framed as a nonpharmacological alternative amid the opioid misuse and addiction epidemic.
Psychedelics not linked to mental health problems or suicidal behavior: A population study 2015 observational cohort 135095 No effect Lifetime psychedelic use was not significantly associated with increased likelihood of past-year mental health problems, suicidal thoughts or attempts, depression, or anxiety; the authors note psychedelics are not known to cause addiction or compulsive use.
Mindful Awareness as a Mediator Between Social Appearance Anxiety and Social Media Addiction in Adolescents. 2026 cross-sectional survey 383 Supports Mindful awareness was negatively related to social media addiction and partially mediated the positive relationship between social appearance anxiety and social media addiction.
Adjunctive ketamine for affective symptoms, craving, and relapse prevention in opioid use disorder: protocol for a randomised, double-blind, placebo-controlled clinical trial 2026 clinical protocol Unclear Describes a planned double-blind placebo-controlled trial of six intravenous ketamine infusions (0.5 mg/kg) targeting depressive symptoms and relapse-associated outcomes in opioid use disorder; no outcome data are reported.
Ibogaine for Substance Use Disorders. 2026 review Mixed Argues that ibogaine is a promising candidate for rapidly reducing withdrawal and cravings after a single administration, but that evidence rests on small observational studies and case reports and carries significant cardiotoxicity, neurological, and fatality risks.
Efficacy and safety of psilocybin-assisted therapy for alcohol use disorder: A systematic review and meta-analysis 2026 systematic review and meta-analysis 202 Supports Across six trials, psilocybin-assisted therapy showed moderate short-term advantages over controls on drinks per day, percent drinking days, and percent heavy drinking days, higher odds of maintaining abstinence (OR 2.78), and mostly mild transient adverse events, with only percent drinking days superior at longer follow-up.
Perception of clients and staff on Indian traditional and spiritual practices in de-addiction centres in Delhi: A qualitative study 2026 qualitative study 15 Supports Clients and staff generally viewed traditional and spiritual practices such as yoga and meditation as useful additions to alcohol recovery programmes, with calls for voluntary, transparent introduction and continued care after discharge.
Assess the effectiveness of holotropic breath work on anxiety among alcohol dependence syndrome patients admitted in selected de-addiction centers 2026 quasi-experimental pre-test post-test control group study 80 Mixed Holotropic breathwork plus routine care was associated with a significant anxiety reduction, but control-group scores fell by a nearly identical amount, which the authors report as not statistically significant.
Ayahuasca treatment reduces 50-kHz ultrasonic vocalizations and modifies mesocorticolimbic monoamine neurochemistry in rats. 2026 randomized controlled trial in rats Supports Ayahuasca reduced 50-kHz ultrasonic vocalizations, especially trill calls, and altered mesocorticolimbic monoamine metabolism, which the authors interpret as attenuating drug-induced positive affective responses relevant to addiction.
Mechanisms of anti-depressant and anti- alcohol effects of ketamine in patients with alcohol use disorder 2026 secondary analysis of a randomized triple-blinded controlled trial Supports Ketamine reduced anhedonia and repetitive negative thoughts at 3 months but not 6 months, and among those with a family history of alcohol use disorder craving reduction mediated its effect on percentage of abstinent days.

Points of agreement

  • Psilocybin-assisted therapy shows consistent short-term reductions in drinking and higher abstinence odds in alcohol use disorder, supported by a randomized trial and a meta-analysis.
  • Open-label and single-group studies of psilocybin in tobacco and alcohol dependence report high abstinence rates and sustained gains.
  • Several reviews and mechanistic papers converge on psychedelics as promising addiction therapeutics acting through network or plasticity mechanisms.
  • Mindfulness-based approaches are repeatedly described as promising but methodologically under-supported for substance use disorders.

Conflicts

  • The meta-analysis finds only percent drinking days remains superior at longer follow-up, while the single-group study reports gains largely maintained to 36 weeks.
  • Open-label smoking and alcohol studies report very high abstinence rates, whereas controlled comparisons show more moderate advantages.
  • Ketamine is framed both as a potential anti-addiction adjunct and, in review, as a drug of misuse with addiction concerns and cognitive harms.
  • Ibogaine is presented as a promising rapid anti-craving agent while also carrying reported fatalities and cardiotoxicity.

Gaps

  • Durability beyond 6-12 months is largely unestablished for psilocybin, ketamine, and ayahuasca.
  • Most positive findings come from small, open-label, or single-group designs without placebo control.
  • Blinding integrity in psychedelic trials is not addressed.
  • Optimal dose, number of sessions, and psychotherapy components are not established.
  • Populations studied are narrow (mostly alcohol and tobacco; largely healthy volunteers or specific communities).
  • Ibogaine evidence rests on observational studies and case reports; ketamine in opioid use disorder is still only a trial protocol.
Browse these studies in the library

Common questions

What does the research agree on about addiction?
  • Psilocybin-assisted therapy shows consistent short-term reductions in drinking and higher abstinence odds in alcohol use disorder, supported by a randomized trial and a meta-analysis.
  • Open-label and single-group studies of psilocybin in tobacco and alcohol dependence report high abstinence rates and sustained gains.
  • Several reviews and mechanistic papers converge on psychedelics as promising addiction therapeutics acting through network or plasticity mechanisms.
  • Mindfulness-based approaches are repeatedly described as promising but methodologically under-supported for substance use disorders.
Where do studies on addiction conflict?
  • The meta-analysis finds only percent drinking days remains superior at longer follow-up, while the single-group study reports gains largely maintained to 36 weeks.
  • Open-label smoking and alcohol studies report very high abstinence rates, whereas controlled comparisons show more moderate advantages.
  • Ketamine is framed both as a potential anti-addiction adjunct and, in review, as a drug of misuse with addiction concerns and cognitive harms.
  • Ibogaine is presented as a promising rapid anti-craving agent while also carrying reported fatalities and cardiotoxicity.
What is still unknown about addiction?
  • Durability beyond 6-12 months is largely unestablished for psilocybin, ketamine, and ayahuasca.
  • Most positive findings come from small, open-label, or single-group designs without placebo control.
  • Blinding integrity in psychedelic trials is not addressed.
  • Optimal dose, number of sessions, and psychotherapy components are not established.
  • Populations studied are narrow (mostly alcohol and tobacco; largely healthy volunteers or specific communities).
  • Ibogaine evidence rests on observational studies and case reports; ketamine in opioid use disorder is still only a trial protocol.
How we analyze this

This synthesis reads the 15 most-cited and 10 most recent studies whose primary subject is Addiction, up to 25 in all. The most-cited set anchors the established evidence, and the recent set surfaces work that is too new to have gathered citations yet.

A study qualifies only when Addiction or a known alias appears in its title or keywords, so broad reviews that mention it only in passing are left out. Each study is read from its abstract, strongest evidence first, and the summary reports the direction of the results along with any conflicts and gaps.

The full method, including what a person does and does not review, is on the methods page.

Ask your own question in the Research Synthesis Tool

Latest monthly recap: September 2026 →

8,547 articles · 2,544 from the last two years · 9,271,217 participants across 2,536 studies reporting sample size

Common study designs

review 1217 experimental study 640 observational cohort 316 randomized controlled trial 365 theoretical or philosophical paper 1518

Compounds studied for addiction

Data updated

Studies whose primary subject is both the compound and addiction, with reviews counted by the study design extracted from each abstract. Registered trials are from ClinicalTrials.gov, and each count links to that compound's full trial pipeline. This maps how much research exists, not how well anything works.

Compounds studied for addiction: studies, meta-analyses and systematic reviews, registered clinical trials, the highest trial phase, and studies from the last two years. Most studies first.
Compound Studies Meta-analyses and systematic reviews Registered trials Highest phase From the last two years
Psilocybin 184 studies 24 meta-analyses and systematic reviews 36 registered trials up to Phase 3 56 from the last two years
Ketamine 143 studies 14 meta-analyses and systematic reviews 21 registered trials up to Phase 2/3 65 from the last two years
Ibogaine 95 studies 8 meta-analyses and systematic reviews 3 registered trials up to Phase 2 20 from the last two years
Cannabis 87 studies 4 meta-analyses and systematic reviews 34 registered trials up to Phase 4 12 from the last two years
MDMA 80 studies 6 meta-analyses and systematic reviews 6 registered trials up to Phase 2/3 18 from the last two years
Ayahuasca 59 studies 7 meta-analyses and systematic reviews 0 registered trials 11 from the last two years
LSD 59 studies 11 meta-analyses and systematic reviews 2 registered trials up to Phase 2 17 from the last two years

Research volume by year

Compare topics →

1,043 studies whose primary subject is addiction since 2002

Studies about addiction per year, 2002 to 2026, peaking at 156 in 2025 Bar chart: one bar per year, taller where more studies were published that year. 0 100 200 2005 2010 2015 2020 2025
2026 is partial
Show the numbers
Studies about addiction per year, 2002 to 2026, peaking at 156 in 2025
Year Studies
2002 6
2003 3
2004 3
2005 6
2006 7
2007 5
2008 10
2009 11
2010 12
2011 22
2012 11
2013 16
2014 20
2015 22
2016 35
2017 42
2018 52
2019 38
2020 37
2021 61
2022 89
2023 114
2024 114
2025 156
2026 151

Research

Synthesize the evidence → Search all →

Beyond the Identity Paradigm: Self-Addiction, Anti-Self Psychology, and Psychedelic Ego-Dissolution

Theory & Psychology October 27, 2026 Brian Nuckols

Contemporary psychology treats the construction, maintenance, and enhancement of a coherent self-concept as the implicit telos of therapeutic intervention, an assumption so thoroughly embedded in clinical training, diagnostic frameworks, and outcome measurement that it functions less as a theoretical commitment than as a perceptual habit. This article argues that compulsive identity maintenance...

DOI: 10.1177/09593543261485252 (opens in new tab)

Mindful Awareness as a Mediator Between Social Appearance Anxiety and Social Media Addiction in Adolescents.

Journal of Psychosocial Nursing and Mental Health Services October 19, 2026 Suheyla Yurt, Şeyma Laloğlu, Nurgul Karakurt et al.

Purpose: Adolescence is a critical period for identity formation and social development, and social media can shape appearance perceptions and social acceptance. Social appearance anxiety may be associated with greater vulnerability to social media addiction, whereas mindful awareness may be linked to lower levels of this risk. The current study tested mindful awareness as a mediator between...

DOI: 10.3928/02793695-20261009-01 (opens in new tab) Full text (opens in new tab)

Adjunctive ketamine for affective symptoms, craving, and relapse prevention in opioid use disorder: protocol for a randomised, double-blind, placebo-controlled clinical trial

BMC Psychiatry October 16, 2026 Morfeas Koumas, Markos Apostolakis, Evanthia Bella et al.

Abstract Background Opioid use disorder (OUD) is a chronic relapsing condition associated with substantial mortality. Although medications for opioid use disorder (MOUD) can be effective in reducing opioid use and improving treatment outcomes, relapse to drug use remains common, highlighting the need for adjunctive interventions that address relapse-relevant symptoms not fully targeted by MOUD...

DOI: 10.1186/s12888-026-08628-3 (opens in new tab)

Why a "Digital Soul" Cannot Exist Without a Source: A Critique of Substrate-Independence Theories

PhilPapers (PhilPapers Foundation) October 15, 2026 Akbarzadeh Alireza preprint

This paper offers a fundamental critique of "substrate-independence" theories concerning the "digital soul" and "uploaded consciousness." It argues that these theories often simplify the issue by reducing consciousness primarily to an informational pattern while underemphasizing the continuous existential conditions required for it—namely energy, data, fundamental laws, and control. The paper...

DOI: 10.5281/zenodo.23386663 (opens in new tab) Full text (opens in new tab)

Ibogaine for Substance Use Disorders.

Advances in Therapy October 14, 2026 Ahmed I Anwar, Abdul-Rahman A Hegazi, M Farris Sawaya et al.

Substance use disorders (SUDs) are a major global health burden, and psychedelic-assisted therapies are now gaining scientific interest, with ibogaine being considered as a candidate for anti-addictive effects across multiple substance classes. Ibogaine is a multi-target indole alkaloid acting on opioid, glutamatergic, serotonergic, and sigma systems with potential to rapidly reduce withdrawal...

DOI: 10.1007/s12325-026-03814-x (opens in new tab) Full text (opens in new tab) Addiction Mental illness Methamphetamine Opioid +2

Efficacy and safety of psilocybin-assisted therapy for alcohol use disorder: A systematic review and meta-analysis

Journal of Psychopharmacology October 8, 2026 Gianluca A. Florineth, Anna L. Boeker, Tobias Bracht et al.

Background: Psilocybin-assisted therapy (PAT) has emerged as a promising intervention for alcohol use disorder (AUD), yet contemporary clinical evidence has not been systematically synthesized to validate its clinical utility and safety profile. Methods: Contemporary clinical trials of PAT for AUD were identified systematically from PubMed, PsycINFO, and Scopus by two independent reviewers....

DOI: 10.1177/02698811261490221 (opens in new tab)

Causal Provenance and the Epistemology of Artificial Minds: Construct Validity, Inferential Non-Transferability, and Measurement Dependence in Artificial-Mind Attribution

Zenodo (CERN European Organization for Nuclear Research) October 5, 2026 Marcelo Maximiliano Filippin preprint

Artificial systems are increasingly evaluated with behavioural, computational, and mechanistic indicators of cognitive constructs such as metacognition, self-modelling, global availability, and potentially consciousness. A problem arises when the evaluated system has itself been exposed, in training or deployment, to descriptions of those constructs, to their proposed indicators, and to the...

DOI: 10.5281/zenodo.23167621 (opens in new tab)

Assess the effectiveness of holotropic breath work on anxiety among alcohol dependence syndrome patients admitted in selected de-addiction centers

International Journal of Nursing and Health Sciences October 1, 2026 N Saraswathi, S Ganga Lakshmi

Alcohol Dependence Syndrome is a major health problem that affects the physical, psychological, social, and emotional well-being of individuals. Patients with Alcohol Dependence Syndrome commonly experience psychological problems such as anxiety, which may adversely affect treatment adherence, interpersonal relationships, quality of life, and recovery. Therefore, effective non-pharmacological...

DOI: 10.33545/26649187.2026.v8.i10a.220 (opens in new tab) Full text (opens in new tab)

Perception of clients and staff on Indian traditional and spiritual practices in de-addiction centres in Delhi: A qualitative study

International Journal of Applied Research October 1, 2026 Akshay ., N Ramya

Background: Alcohol use disorder (AUD) is a major public health concern in India. Many people in India also use traditional and spiritual practices such as yoga, meditation, Ayurveda, prayer, and religious rituals. However, little is known about how these practices are viewed within formal de-addiction settings. Objective: This study explored how clients and treatment staff in Delhi perceive...

DOI: 10.22271/allresearch.2026.v12.i10b.14209 (opens in new tab) Full text (opens in new tab)

Mechanisms of anti-depressant and anti- alcohol effects of ketamine in patients with alcohol use disorder

Research Square September 30, 2026 Merve Mollaahmetoglu, Joy Krecké, Charlie Oldfield et al. preprint

Abstract Ketamine is known to have anti-depressant effects and is suggested to reduce substance use. However, little is known about the mechanism of these effects. Given evidence from studies in depression of a greater therapeutic effect in those with a family history of AUD, this latter factor was also investigated as a moderating factor. We used data from the KARE trial, a randomised...

DOI: 10.21203/rs.3.rs-11194569/v1 (opens in new tab) Full text (opens in new tab)

Clinical trials

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