The sum of this research points towards medicinal psychedelics as a potential new class of psychiatric treatments when used within a medically supervised framework with integrated psychotherapeutic support. However, before widespread translation into clinical use can occur, appropriately designed and sufficiently powered trials are required to detect both potential positive and negative outcomes. As for any new medical therapy, psychedelic research needs to be conducted in a rigorous manner, through the dispassionate lens of scientific enquiry.
Mental Health Services
It is not only licensed physicians who are interested in psychedelics practice, and it remains unclear who else may play leading roles and what licensure regimes might look like. Given promising clinical-trial results, many stakeholders are attempting to patent psychedelic compounds and methods of producing and administering them. Regularly assess the demographics of patients accessing psychedelic treatments to ensure equitable representation and adjust practices as needed. One approach would center psychedelics within a prescription model that requires licensed prescribers, typically physicians.
This working mechanism would also explain why psychedelics seem effective in different SUDs as opposed to the currently approved pharmacological treatments for SUD, which have a different working mechanism and are, in most cases, only effective in a specific SUD (e.g., disulfiram in alcohol use disorder). The serotonergic system has been targeted with the goal of treating specific symptoms of CUD and cannabis withdrawal, notably anxiety. This was partially the rationale behind trials using the 5HT1A agonist buspirone and serotonin reuptake inhibitors as potential treatments for CUD (26). Relatedly, cannabidiol, which can temper some effects of THC, likely mediates some of its anxiolytic, antidepressant, and antiepileptic properties via 5HT1A receptors (55, 56).
Alcohol
Some claim patenting psychedelics exploits the traditional knowledge of Indigenous communities without acknowledgment or compensation, a practice called ‘biopiracy’. However, as this Comment was going to print, the National Institute on Drug Abuse funded a trial to investigate the use of psilocybin for smoking cessation, possibly reflecting an encouraging policy shift. Due to the schedule I status of most psychedelics, federal funding for research is nearly non-existent. Psychedelics have shown great promise in treating mental-health conditions, but their use is severely limited by legal obstacles, which could be overcome. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Marks said there are efforts in some cities and states across the U.S. to decriminalize psilocybin.
- All four studies combined psilocybin with some form of psychotherapy and showed a beneficial effect of psilocybin-assisted therapy on SUD, but the risk of bias ranged from some concerns to critical.
- Broadly, the psychedelics discussed hitherto are regarded as generally having a wide therapeutic index and favorable safety profile when administered in doses within the therapeutic range under controlled and comfortable settings.
- However, there are social and legal obstacles to making psychedelics a viable treatment option1.
- Lorcaserin also decreased craving during abstinence conditions, and co-morbid tobacco smokers decreased their tobacco use, even though they were not intending to (34).
Bias and quality assessments of the clinical studies yielded good to excellent outcomes (Table 1). Studies were generally strong in essential reporting items, and variably limited by incomplete or lacking probability reporting, power analysis, blinding, randomization, and adjustment for confounding factors. As a clinical report and not a hypothesis driven study, it was lacking in most of the data reporting pertinent to such studies. BID, twice daily; CUD, cannabis use disorder; DUDIT, drug use disorder identification test; HPPD, hallucinogen-persisting perception disorder; LSD, lysergic acid diethamide; MBRP, mindfulness-based relapse prevention; MDMA, 3,4-methylenedioxymethamphetamine; MET, motivational enhancement therapy.
Great Expectations: recommendations for improving the methodological rigor of psychedelic clinical trials
While interpretations are hampered by the limited AUD and SUD severity and small size of the sample, that AUD and PTSD symptom improvements were correlated allows for speculation if co-morbid CUD how to get someone fired at work could improve following successful treatment of PTSD with MDMA. Cannabis use disorder (CUD) is prevalent in ~2–5% of adults in the United States and is anticipated to increase as restrictions to cannabis decrease and tetrahydrocannabinol (THC) content in cannabis products increase. No FDA-approved medications for CUD are currently available, despite trials of dozens of re-purposed and novel drugs.
During that time, studies provided preliminary data on the safety and feasibility of psychedelic use in treatment liberty cap lookalikes poisonous of SUD and smoking cessation (28), but assessment of psychedelics in the treatment of CUD has largely remained unexplored. It is important to find long-lasting treatment options for addiction and mental health disorders. While more research is being conducted on the use of psychedelics as therapeutic treatment, it is vital to move ahead with care and to focus on the scientific rigor of the research. Further clinical research is necessary to establish which psychedelic drugs are most effective, how they should be administered, and who is most likely to benefit. It is crucial for treatment providers and others to be aware of the current state of research in order to have informed conversations with their clients and provide the best care possible. The latter proposed working mechanism seems especially important in SUD as the mystical-type experience seems to induce behavioral change in a patient with SUD.
Associated Data
Weak psychedelic patents could potentially be invalidated in court, but that does not make them harmless, because patent holders can still wield them offensively. Defending against patent-infringement claims is expensive, and the prospect discourages action by smaller startups and non-profit research organizations, even when they are in the right. Others argue does alcohol bother gallbladder that patents make a small number of companies gatekeepers for the emerging psychedelics industry, which could inhibit research, stifle innovation and restrict access to needed therapies. Develop policies to provide these innovative treatments regardless of a client’s socioeconomic status, thus avoiding disparities in access. Train staff in cultural sensitivity to appropriately address the diverse backgrounds of clients seeking psychedelic therapy.
