Psilocybin and MDMA in Couples Therapy: Investigating Treatment for Substance Use Disorders and Codependency
Contemporary Family Therapy December 11, 2025 Samuel Hosford, Heather Austin-Robillard
Substance use disorders harm not only the user but also their romantic partner, who may develop negative codependent traits. This narrative review examines how psilocybin-assisted therapy can treat substance use disorders and how MDMA, already used for PTSD, might also address codependency in a spouse affected by their partner's addiction. Combining both substances with couples therapy could reduce addictive behaviors in one partner while shifting codependent behaviors in the other. The review discusses clinical implications, limitations of current research, and suggests further study of psychedelic-assisted couples therapy.