The Role of Psychedelics in the Treatment of Substance Use Disorders: An Overview of Systematic Reviews.

Substance use disorders affect over 48.5 million Americans, and available treatments often fail even with adequate adherence. This overview of 16 systematic reviews examined evidence on serotonergic psychedelics and ketamine for treating substance use disorders. Preliminary evidence suggests these compounds may offer advantages over traditional treatments and could eventually become part of next-generation therapies under specific circumstances. However, significant challenges remain: high risk of bias and methodological limitations in existing studies warrant caution, and associated risks are not negligible. The use of psychedelic drugs for substance use disorders remains experimental, and current evidence is insufficient to support clinical practice.

Study at a glance

Abstract

Background: Substance use disorders (SUDs) are highly prevalent, affecting over 48.5 million Americans. Available treatments for SUD remain insufficient, and many patients do not respond to existing interventions despite adequate adherence to treatments. While novel therapies for SUD are urgently needed, the use of psychedelic drugs for the treatment of SUDs has shown promise. Objectives: This overview of systematic reviews summarizes existing evidence on hallucinogens—serotonergic psychedelics and ketamine—for the treatment of SUD. Methods: A comprehensive search of the literature was conducted to identify relevant evidence for using serotonergic and non-serotonergic psychedelics for the treatment of SUDs. After initial screening (n = 468 studies), 62 studies were retrieved and assessed for eligibility, and a total of 16 systematic reviews were included. Conclusions: Although preliminary, evidence suggests that the use of serotonergic and non-serotonergic psychedelics for the treatment of SUD may provide advantages over traditional therapeutics, and these compounds may eventually become part of the next generation of treatments for SUD under specific circumstances. Research with these drugs has faced significant challenges, though, and caution when interpreting results is warranted, given high risk of bias and several other methodological limitations from the studies to date. Furthermore, risks associated with these drugs are not negligible. For now, the use of psychedelic drugs for the treatment of SUDs remains experimental, and existing evidence is insufficient to support its use in clinical practice.