The opioid crisis has driven a search for new treatments for opioid use disorder (OUD). A systematic review of 40 preclinical animal studies found that the psychedelic compounds 18-methoxycoronaridine (18-MC), ibogaine, noribogaine, and ketamine generally reduced opioid self-administration, eased withdrawal symptoms, and altered conditioned place preference. However, seven studies showed no improvement over controls. Most research has focused on iboga derivatives, which appear effective but carry higher cardiovascular risk than other psychedelics. The review calls for more translational and clinical studies that test a broader range of psychedelic agents and explore mechanisms, safety, dosing, and treatment frequency.
A review of trials on psychedelics for opioid use disorder (OUD) found no studies directly comparing different types of psychotherapy or testing psychedelics with versus without concurrent psychotherapy. Most research on alleviating opioid withdrawal symptoms did not include psychotherapy. The few studies on ketamine and LSD for opioid use and abstinence used a psychedelic-assisted therapy model. There is insufficient high-quality evidence to determine whether concurrent psychotherapy is necessary in psychedelic trials for OUD. Future trials should explore the interplay between psychedelic treatment and psychotherapy.