Mental health disorders and substance use disorders (SUDs) contribute greatly to the global burden of disease. Psychedelics, including entactogens and dissociative substances, are being explored for SUD treatment but have less clinical evidence than for depression or PTSD. This narrative review discusses current research, therapeutic potential, and safety of psilocybin, LSD, ketamine, MDMA, and ibogaine in SUD treatment. It provides a balanced overview of potential benefits and harms in clinical settings, highlights the need for more research, and points out limitations and challenges to be addressed in future studies.
A narrative review of psilocybin- and LSD-assisted treatment for alcohol use disorder (AUD) and major depressive disorder (MDD) finds growing evidence that psilocybin produces a sustained reduction in drinking frequency among people with AUD, and a recent meta-analysis shows psilocybin therapy yields a large and consistent decrease in depressive symptoms compared to no treatment. AUD and MDD frequently co-occur, and this comorbidity worsens symptoms of both disorders and complicates treatment. The authors argue that an integrated therapy addressing both conditions simultaneously could benefit such patients and call for more research on psilocybin in this dual-diagnosis population.