Use and abuse of dissociative and psychedelic drugs in adolescence

Adolescence involves major behavioral, neural, and hormonal changes and a heightened tendency for risk-taking and drug use. This review of human and preclinical studies on dissociatives (PCP, ketamine, DXM), classic psychedelics (LSD, psilocybin), and MDMA finds that very little is known about their effects in adolescents. Emerging evidence suggests dissociatives and MDMA produce both reinforcing and aversive effects, and the balance between these may differ between adolescents and adults, potentially affecting drug use and addiction. However, many studies have not directly compared age groups, preventing firm conclusions. Sex differences and long-term consequences of adolescent use remain largely unexplored. Addressing these gaps is crucial given widespread adolescent use and potential therapeutic applications.

Study at a glance

Abstract

Adolescence is a period of profound developmental changes, which run the gamut from behavioral and neural to physiological and hormonal. It is also a time at which there is an increased propensity to engage in risk-taking and impulsive behaviors like drug use. This review examines the human and preclinical literature on adolescent drug use and its consequences, with a focus on dissociatives (PCP, ketamine, DXM), classic psychedelics (LSD, psilocybin), and MDMA. It is the case for all the substances reviewed here that very little is known about their effects in adolescent populations. An emerging aspect of the literature is that dissociatives and MDMA produce mixed reinforcing and aversive effects and that the balance between reinforcement and aversion may differ between adolescents and adults, with consequences for drug use and addiction. However, many studies have failed to directly compare adults and adolescents, which precludes definitive conclusions about these consequences. Other important areas that are largely unexplored are sex differences during adolescence and the long-term consequences of adolescent use of these substances. We provide suggestions for future work to address the gaps we identified in the literature. Given the widespread use of these drugs among adolescent users, and the potential for therapeutic use, this work will be crucial to understanding abuse potential and consequences of use in this developmental stage.