Journal of substance use and addiction treatment
August 1, 2025
Reinhard Janssen-Aguilar, Shakila Meshkat, Ilya Demchenko et al.
12 citations
Ketamine may offer short-term benefits for treating substance use disorders, including alcohol, cocaine, opioid, and cannabis use disorders. In alcohol use disorder, it reduced withdrawal symptoms and the need for benzodiazepines. For cocaine use disorder, it decreased craving and increased abstinence rates. In opioid use disorder, high-dose ketamine combined with psychotherapy improved abstinence and reduced craving. For cannabis use disorder, it reduced weekly use and increased confidence in abstinence. However, the evidence is limited by small sample sizes and a lack of randomized trials. Larger, well-controlled studies are needed to determine optimal dosing, mechanisms, long-term efficacy, and risks before broader clinical use can be recommended.
Journal of Clinical Medicine
February 20, 2025
Shakila Meshkat, Taha Malik, Jennifer Swainson et al.
3 citations
A systematic review examined whether psychedelic therapies can rapidly reduce suicide risk. Four randomized controlled trials reported significant reductions in suicidal ideation with psilocybin (three studies) and MDMA-assisted therapy (one study), with effect sizes (Cohen's d) ranging from 0.52 to 1.25 and no safety issues. Five additional randomized trials also showed reductions. Among 24 non-randomized and cross-sectional studies, results were mixed: psilocybin reduced suicidal ideation (odds ratios 0.40–0.75), MDMA-assisted therapy for PTSD showed a pooled effect of d = 0.61, while LSD was associated with increased odds of suicidality (odds ratios 1.15–2.08). DMT studies showed no significant effects. The evidence remains inconclusive, underscoring the need for further trials.
Neurorehabilitation
September 27, 2024
Walter Dunn, Anya K. Bershad, David E. Krantz et al.
2 citations
MDMA-assisted therapy for PTSD, supported by late-stage clinical trials, may be especially beneficial for military populations. MDMA's pro-social and fear-regulating properties could enhance the therapeutic alliance and patient engagement during neurorehabilitation. The molecular mechanism of MDMA is outlined, and a novel application for neurorehabilitation is proposed. Similarities in patient-therapist dynamics between PTSD treatment and neurorehabilitation suggest that MDMA's ability to downregulate fear, increase cognitive flexibility, and improve alliance could aid military personnel both with and without PTSD.
American Journal of Bioethics
January 1, 2025
Katrina Debonis, Walter Dunn, Thomas B. Strouse
The resurgence of psychedelic research raises ethical questions about whether facilitators should have personal psychedelic experience. Some argue that such experience is essential for effective and ethical facilitation, while others contend that it is unnecessary and may introduce bias. The authors examine these competing perspectives, weighing arguments about empathy, trust, and professional competence. They conclude that requiring personal experience could undermine scientific objectivity and equitable access to therapy, but also acknowledge that experiential knowledge may enhance therapeutic rapport. The paper calls for clearer ethical guidelines that balance these concerns without mandating personal use.