Mindscape Collective is now The Consciousness Library. Same library, new name. You may need to sign in again. About the change
Skip to content

Addiction

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

State of the evidence

Synthesized

Synthesized from 25 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.

Psilocybin-assisted therapy shows promise for reducing alcohol and tobacco use, with pilot studies reporting high abstinence rates (e.g., 80% for smoking at 6 months) and a double-blind RCT finding reduced heavy drinking days in alcohol use disorder. However, evidence is preliminary due to small sample sizes, open-label designs, and limited long-term follow-up. Ketamine also shows potential for addiction but carries risks of abuse and tolerance, while mindfulness meditation may reduce substance use in incarcerated populations.

Evidence by study

Direction is which way each study's own result points, not our rating of the study.

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.
Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study 2015
Supports

Psilocybin administration significantly increased abstinence and reduced craving in alcohol-dependent participants, with gains largely maintained at 36-week follow-up.

proof-of-concept study Sample size: 10

Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction 2014
Supports

80% of participants showed biologically verified smoking abstinence at 6-month follow-up after psilocybin-assisted treatment, substantially exceeding typical cessation rates.

open-label pilot study Sample size: 15

Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder 2022
Supports

High-dose psilocybin improved the percentage of heavy drinking days compared to active placebo (diphenhydramine) in patients with AUD undergoing psychotherapy.

double-blind randomized clinical trial

Ketamine use: a review 2011
Opposes

Chronic ketamine use is associated with ulcerative cystitis, neurocognitive impairment, and addiction, with many frequent users reporting difficulty stopping use.

review

Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. 2019
Supports

Epidemiological studies suggest nonmedical naturalistic use of classic psychedelics is associated with positive mental health and prosocial outcomes, though causality is unclear.

integrative review

Mindfulness meditation and substance use in an incarcerated population. 2006
Supports

Vipassana meditation significantly reduced alcohol, marijuana, and crack cocaine use after release from jail compared to treatment-as-usual control.

controlled trial

Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction 2015
Supports

Psilocybin-occasioned mystical experiences were significantly correlated with smoking cessation, suggesting a mediating role of mystical experience in treatment.

open-label pilot study Sample size: 15

Psychedelics as Medicines: An Emerging New Paradigm 2016
Supports

Clinical studies show preliminary evidence of robust efficacy for psychedelics in treating addiction to tobacco and alcohol, with proposed mechanisms involving brain network resetting.

review

Mindfulness Meditation for Substance Use Disorders: A Systematic Review 2009
Mixed

Preliminary evidence suggests mindfulness meditation efficacy and safety for SUDs, but conclusive data are lacking due to significant methodological limitations.

systematic review

Psychedelics reopen the social reward learning critical period 2023
Supports

Psychedelics reopen the social reward learning critical period in mice, with reorganization of extracellular matrix as a common downstream mechanism.

preclinical study

Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada 2013
Supports

Ayahuasca-assisted therapy was associated with statistically significant improvements in factors related to problematic substance use.

observational study

Dynamic coupling of whole-brain neuronal and neurotransmitter systems 2020
Supports

Psilocybin stimulation of 5-HT2A receptors causally explains functional effects in the brain, providing a framework for understanding its therapeutic promise for addiction.

neuroimaging study

Psychedelics not linked to mental health problems or suicidal behavior: A population study 2015
Supports

Lifetime use of psychedelics was not associated with increased mental health problems or suicidal behavior, and psychedelics are not known to cause addiction.

population study Sample size: 135095

Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts 2018
Supports

Participants reported vivid insights into smoking reasons, persisting positive changes beyond cessation, and emphasized the role of preparatory counseling and rapport.

qualitative study Sample size: 12

Psychedelics as anti-inflammatory agents 2018
Supports

Psychedelics produce anti-inflammatory effects via 5-HT2A receptor activation, which may contribute to their therapeutic effects in addiction and other disorders.

review

Prescribing bias and adverse outcomes of esketamine in major depression comorbid substance. 2026
Opposes

Esketamine users had higher risks of comorbid substance use disorders, and those with SUD had higher risks of self-harm, suicide attempt, and hospitalization.

retrospective cohort study Sample size: 30670

S-ketamine, but not R-ketamine, transiently suppresses front-loaded binge-like alcohol self-administration in male rats 2026
Mixed

S-ketamine dose-dependently suppressed alcohol self-administration in rats, but efficacy rapidly declined with repeated administration, indicating tolerance.

preclinical study

Treating addiction with an addictive drug: the ketamine paradox revisited 2026
Mixed

Ketamine combined with psychotherapy shows promising reductions in craving and increases in abstinent days, but findings are limited by variability in dosing and follow-up, and abuse liability remains a concern.

narrative review

Toward a nuanced framework for the medical development of ibogaine and its analogues and derivatives: implications for psychopharmacology 2026
Supports

Ibogaine shows therapeutic potential across substance use disorders, but clinical translation is hindered by safety concerns and regulatory barriers.

review

Neuroestimulantes naturales: de rituales ancestrales a terapias de vanguardia 2026
Supports

Psilocybin and 5-MeO-DMT are recognized as promising therapies for addictions resistant to conventional treatments, acting on serotonin receptors and stimulating neuroplasticity.

review

MDMA-assisted PTSD and Alcohol Therapy Trial (MPATHY): study protocol for a double-blind, randomised, controlled outpatient trial of MDMA-assisted integrated exposure-based therapy for comorbid post-traumatic stress disorder and alcohol use disorder 2026
Unclear

This double-blind trial will examine MDMA-assisted integrated exposure therapy for comorbid PTSD+AUD, with outcomes including heavy drinking days and PTSD symptoms.

study protocol Sample size: 100

Self‑transcendence and identity transformation in recovery from substance use disorder 2026
Supports

A spiritually oriented intervention emphasizing self-transcendence and identity transformation helped a participant move away from an addiction-centered identity.

case study Sample size: 1

Decoding the serotonin–alcohol crosstalk: the role of central serotonergic dysregulation in alcohol use disorder 2026
Supports

Serotonergic psychedelic-assisted therapies have attracted interest as potential AUD treatments, with mechanisms involving raphe-prefrontal serotonergic projections.

review

Psychedelic Use, Microdosing, Motives, and Information and Product Sources Among Young Adults in the United States 2026
Mixed

Among young adults, mental health symptoms and adverse childhood events were associated with psychedelic use, microdosing, and higher use motives, despite half using exclusively for nonmedical purposes.

cross-sectional survey

Navigating the waves of cluster headache 2026
Mixed

People with cluster headache more often used psilocybin and LSD, with some reporting reduced attack frequency or duration, but risk-taking behavior varied by disease phase.

dissertation

Points of agreement

  • Psilocybin-assisted therapy shows consistent positive effects on reducing alcohol and tobacco use across multiple studies, including a double-blind RCT.
  • Mystical or self-transcendent experiences are identified as a potential mechanism for therapeutic change in psychedelic-assisted addiction treatment.
  • Ketamine shows potential for reducing alcohol use but is associated with risks of tolerance, abuse, and adverse effects.
  • Mindfulness meditation may reduce substance use, but evidence is preliminary and methodologically limited.

Conflicts

  • Ketamine's abuse liability and potential for addiction (article_id 25613) conflicts with its therapeutic potential for substance use disorders (article_id 28485).
  • Esketamine use was associated with higher risks of comorbid SUD and adverse outcomes (article_id 28670), contrasting with positive findings for other psychedelics.
  • One population study found no link between psychedelic use and mental health problems (article_id 16800), while another survey found associations with mental health symptoms (article_id 27692).

Gaps

  • Durability of treatment effects beyond 6-9 months is largely unstudied for psychedelic-assisted therapies.
  • Most studies have small sample sizes and lack active placebo or blinding, limiting generalizability.
  • Mechanisms of action (e.g., mystical experience vs. neuroplasticity vs. anti-inflammatory effects) are not fully disentangled.
  • Research on underrepresented populations (e.g., racial/ethnic minorities, adolescents, polysubstance users) is lacking.
  • Optimal dosing, number of sessions, and integration protocols are not established.
  • Long-term safety data, especially for repeated use, are insufficient.
Browse these studies in the library
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.

Ask your own question in the Research Synthesis Tool

Latest monthly recap: June 2026 →

5,394 articles · 1,922 from the last two years · 8,152,054 participants across 1,554 studies reporting sample size

Common study designs

review 920 experimental study 573 observational cohort 253 randomized controlled trial 224 theoretical or philosophical paper 811

Research

Synthesize the evidence → Search all →

Ketamine for substance use disorders: a systematic review and meta-analysis

Frontiers in Psychiatry July 17, 2026 Shu-Ping Fang, Xin Yang, Da-Cong Zhao et al.

A meta-analysis of 15 randomized controlled trials with 798 participants found that ketamine treatment for substance use disorder (SUD) significantly improved abstinence rates in the short term (less than one month), but not at one to six months. Dropout rates and adverse events did not differ significantly between ketamine and control groups, though the available evidence was too limited to establish safety conclusively. The authors conclude that current evidence suggests a short-term efficacy signal for ketamine in SUD, but remains insufficient to establish its efficacy and safety definitively.

DOI: 10.3389/fpsyt.2026.1835709 (opens in new tab) Ketamine Abstinence Adverse effect Randomized controlled trial +8

How Effective Are Mindfulness-Based Interventions (MBIs) for the Treatment of Substance Use Disorders (SUDs), Relapse Prevention, and Craving: An Umbrella Review Article.

Substance Use & Misuse July 15, 2026 Parvin Ajami Bakhtiarvand, Mohammad Reza Abedi

An umbrella review of 11 systematic reviews and meta-analyses published between 2017 and 2026 assessed the effectiveness of mindfulness-based interventions (MBIs) for substance use disorder treatment, relapse prevention, and craving reduction. The evidence suggests that MBIs, including Mindfulness-Based Relapse Prevention and Mindfulness-Oriented Recovery Enhancement, provide preliminary support for reducing relapse (effect sizes: d = 0.45–0.78) and craving for alcohol, opioids, and stimulants (Hedges' g = 0.52–0.71). Neuroimaging findings indicated increased prefrontal activation and reduced insular hyperactivity. Heterogeneity and study quality should be considered; standardization and longer follow-up are recommended for clinical application.

DOI: 10.1080/10826084.2026.2699442 (opens in new tab) Full text (opens in new tab) Substance use disorders Craving reduction Meta-analysis Mindfulness-based interventions +2

Reflective Control in Gaming Addiction: A Paradox?

Human Arenas July 10, 2026 A. Kovács

Gaming addiction disrupts reflective awareness, attentional control, and selfhood in a way that differs from other addictions: reflective control remains intact but becomes misaligned, confined to gaming while failing to extend to broader life concerns. The study integrates Husserl's active and passive synthesis, Heidegger's existential structures, and Arvidson's conceptualization of attention to argue that this misalignment indicates a disruption in Husserlian synthesis, the existential projection of Dasein, and attentional transformation. Understanding this interplay can inform therapeutic strategies aimed at restoring reflective flexibility and self-directed transformation.

DOI: 10.1007/s42087-026-00680-5 (opens in new tab) Full text (opens in new tab) Addiction Conceptualization Existentialism Phenomenology philosophy +7

Treating addiction with an addictive drug: the ketamine paradox revisited

Frontiers in Psychiatry July 9, 2026 Alqassem Y. Hakami

Ketamine, a drug that rapidly alters brain connections, shows promise for treating both treatment-resistant depression and substance use disorders, particularly alcohol and cocaine addiction. When combined with psychotherapy, small-to-moderate Phase 2 trials found it reduced cravings and increased days of abstinence. However, results vary widely due to differences in dosing, comparison treatments, and follow-up lengths, and effects on preventing relapse have been inconsistent. Ketamine works by blocking NMDA receptors and boosting synaptic plasticity, which may help disrupt harmful reward memories. While supervised use causes only temporary side effects, the drug carries a clear risk of misuse, especially without supervision. Larger, longer studies are needed before it becomes standard care.

DOI: 10.3389/fpsyt.2026.1866092 (opens in new tab) Addiction Ketamine Neuroplasticity Treatment-resistant depression +17

MDMA-assisted PTSD and Alcohol Therapy Trial (MPATHY): study protocol for a double-blind, randomised, controlled outpatient trial of MDMA-assisted integrated exposure-based therapy for comorbid post-traumatic stress disorder and alcohol use disorder

BMJ Open July 1, 2026 Kirsten Morley, S Arunogiri, Katherine L. Mills et al.

Combining MDMA with an integrated exposure-based therapy may improve outcomes for people with both post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD), a comorbidity where standard treatments help only about half of patients. This double-blind trial will randomly assign 100 participants to receive either MDMA (80–160 mg) or an active control (niacin 250 mg) alongside 12 sessions of Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE). The primary PTSD outcome is the clinician-administered PTSD Scale for DSM-5; the primary drinking outcome is heavy drinking days per week, validated by phosphatidylethanol. Secondary measures include depression, sleep disturbances, adverse events, and cost-effectiveness. Results will provide first data on safety, efficacy, and cost-effectiveness of MDMA-augmented therapy for this comorbidity.

DOI: 10.1136/bmjopen-2025-114896 (opens in new tab) Full text (opens in new tab) Alcohol use disorder Major depressive disorder Dosing Randomized controlled trial +13

Safety, Efficacy, and Blinding Integrity of Psilocybin-Assisted Therapy for Substance Use Disorders: A Systematic Review of Randomized Controlled Trials

Open MIND June 26, 2026 Max Courtney

Substance use disorders remain a major public health challenge, and existing treatments often have limited long-term success. Psilocybin-assisted therapy (PAT) has recently attracted renewed research interest as a potential treatment for addictions including alcohol, tobacco, and opioids. Most prior studies have been observational or non-randomized, but the number of randomized controlled trials (RCTs) has grown rapidly. This systematic review will examine only RCTs to evaluate the safety, efficacy, and blinding integrity of PAT for substance use disorders. It will assess changes in substance use, adverse events, and how well double-blinding works given psilocybin's strong psychoactive effects. A narrative synthesis is planned, organized by substance type, safety outcomes, and blinding, using the SWiM reporting guideline.

DOI: 10.17605/osf.io/n4y2w (opens in new tab) Addiction Blinding Randomized controlled trial Adverse effect +11

Self‑transcendence and identity transformation in recovery from substance use disorder

American Journal of Medicine and Health Studies June 26, 2026 Mehrdad F. Falavarjani

A spiritually oriented intervention that emphasizes self-transcendence and identity transformation helped a person with substance use disorder move from an addiction-centered identity toward a more integrated spiritual self. Through narrative reconstruction and contemplative practices, the participant became better able to engage with everyday life, suggesting that reorganizing identity through spiritual approaches may be an important mechanism of change in treatment.

DOI: 10.32674/5p5crr47 (opens in new tab) Addiction Identity music Contemplation Existentialism +16

Decoding the serotonin–alcohol crosstalk: the role of central serotonergic dysregulation in alcohol use disorder

Pharmacological Reports June 22, 2026 Magdalena Zaniewska

Serotonin (5-HT) is a key neuromodulator involved in mood, appetite, aggression, and impulse control. Dysregulation of central 5-HT function is implicated in alcohol use disorder (AUD) and comorbid depression. Reduced 5-HT activity increases the risk of developing AUD, particularly Cloninger's type II, characterized by early onset, violent, and antisocial behaviors. Tph2-deficient mice, which lack central 5-HT, exhibit increased ethanol consumption and behavioral features resembling type II alcohol dependence. Alcohol-preferring rat lines show reduced 5-HT levels, decreased serotonergic projections to the cortex, and reduced prefrontal 5-HT2A receptor binding. The efficacy of selective 5-HT reuptake inhibitors (SSRIs) is limited, with beneficial effects only in less severe, later-onset forms. Serotonergic psychedelic-assisted therapies may activate 5-HT2A receptors in the prefrontal cortex, a region dysfunctional in AUD.

DOI: 10.1007/s43440-026-00860-8 (opens in new tab) Full text (opens in new tab) Serotonergic Alcohol use disorder Tph2 Prefrontal cortex +10

Attitudes of Mental Healthcare Professionals Towards the Use of Psychedelics in the Treatment of Substance Use Disorders: A Systematic Review

Journal of Psychoactive Drugs June 17, 2026 F. van Dalen, S. C. Tap, S. D. Venema et al.

Mental healthcare professionals generally hold cautiously optimistic views about psychedelic-assisted therapy for substance use disorder, though a minority express hesitancy due to concerns about safety, efficacy, and practical integration challenges. A systematic review of six studies with 966 participants found that greater knowledge and familiarity with psychedelic-assisted therapy predict more positive attitudes. The limited knowledge among professionals highlights a need for targeted education and training to support the responsible integration of this treatment into clinical care.

DOI: 10.1080/02791072.2026.2685514 (opens in new tab) Substance use Health professionals Perception Medline +14

Integrating psychedelic-assisted psychotherapy into addiction care in the Czech Republic: Clinical evidence, safety, and regulatory developments

Journal of Psychedelic Studies June 12, 2026 Zuzana Postránecká, Matyáš Lucký, Viktor Mravčík et al.

Psychedelic-assisted psychotherapy (PAP) shows cautious clinical potential for treating substance use disorders, but the evidence remains heterogeneous and largely from observational, open-label, or historical studies rather than strong randomized controlled trials. In the Czech Republic, recent developments include ketamine-assisted psychotherapy initiatives, inclusion of PAP in national addictology guidance, publication of national psychiatry guidelines for psilocybin-assisted psychotherapy, and a 2025 legislative reform introducing psilocybin for medical use from January 2026. Broader integration will require clearer indications, accredited training, longitudinal outcome monitoring, and transparent communication of benefits and risks.

DOI: 10.1556/2054.2026.00514 (opens in new tab) Addiction treatment Psychological intervention Czech Inclusion mineral +11

Clinical trials

All Addiction trials →