A Perspective on Psychedelics as Treatments for Addictions

Psychedelics have been used across different cultures for thousands of years, with historical evidence of substances like ayahuasca in South America, mescaline from cacti in North and South America, and ibogaine in West Africa. Despite this, psychedelics only entered Western scientific research in the late 19th century, starting with the identification of mescaline. The article outlines recent research on psychedelics in addiction treatment, acknowledging their long and at times controversial history.

The pivotal influence of psychedelics on addiction came when Bill Wilson, co-founder of Alcoholics Anonymous, had a transformative experience with atropine that contributed to his recovery. Later, Wilson explored LSD, believing it could help others gain the spiritual insight needed for overcoming addiction. Despite significant research on LSD in the 1950s, social, cultural, and political factors, including the association with the counterculture movement, led to most psychedelics being banned in the 1970s.

Since the early 2000s, research has resurged, driven by advancements in understanding serotonin receptor pharmacology and brain imaging techniques. Studies have found psychedelics like psilocybin and DMT disrupt brain networks, potentially helping treat conditions like depression and addiction. Meanwhile, ketamine, traditionally used as an anesthetic, has shown promise in treating substance use disorders, particularly through its effects on neural plasticity.

MDMA, while not a true psychedelic, has also been researched for alcohol dependence, showing potential benefits in helping patients process trauma and reduce their need for alcohol. Overall, these substances seem to work by breaking entrenched brain circuits that drive addiction and enhancing the effectiveness of psychotherapy during treatment sessions.

Despite promising results, challenges remain, such as methodological inconsistencies, small sample sizes, and potential biases from private funding. The article calls for more rigorous, large-scale studies to build a stronger evidence base. The revival of psychedelic research has been gaining support from several governments, and there are calls to learn from both past mistakes and Indigenous knowledge. Establishing standardized protocols and training for psychedelic-assisted therapy is seen as crucial to its integration into mainstream medical practice.