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Psychedelics as a Treatment for Substance Abuse Disorder by Megan Funck

 

Psychedelics have had somewhat of a negative stigma attached to them ever since the Hippie movement of the 60’s, which was notorious for its widespread (and perhaps reckless) use of mind-altering drugs. In the 70’s, they became illegal and classified as Schedule 1 Substances in the U.S, and the research that was being conducted on various psychedelic substances was halted. Subsequently, their potential therapeutic applications in psychology and medicine were largely forgotten about. Recently, there has been a reemergence of scientific interest on psychedelics and their potential to treat various disorders, such as anxiety in cancer-patients, substance abuse disorder, and depression. The following paper will briefly survey some of the psychedelics which have shown some evidence of being effective treatments for substance abuse and anxiety disorders.

What are Psychedelics

Psychedelics are drugs, both of natural and synthetic origins, which result in an alteration of perceptions and cognitions. Psychedelics have a very low chance of causing any long-term side effects and are non-addictive (Winkleman 2014: 114). They are very safe when administered to carefully screened patients with supervision. Psychedelics are said to produce profound visions and epiphanies, and can create intense  feelings of euphoria and peace. The specific mechanisms detailing the way these drugs work in the brain is out of the scope of this paper. However, it is shown that all of the psychedelics increase serotonin levels in the brain. In turn, “serotonin acts as a neuromodulator, with direct effects upon other neurotransmitter systems”, and “enables serotonin enhancement to cascade into other neurotransmitter systems affected by addictions” (Winkleman 103).  Those who are suffering from addiction typically have very low serotonin levels. Additionally, it seems that psychedelics have some action on the brain, by increasing activity in certain areas, which allows for the user to access repressed emotions and memories, and to view their life choices from a different perspective.

LSD

            From the early 1950’s to 70’s, the federal government funded 116 studies on LSD (Pollan 2015). It was tested on people for a number of different conditions, such as terminal cancer, alcoholism, and obsessive-compulsive disorder. The results were frequently positive; however, by today’s standards, many of the tests were poorly designed and controlled. When psychedelics became banned and (wrongly) classified as Schedule 1 substances  (which means they have no therapeutic uses and a high potential for abuse), the research was halted on LSD, and because of the poorly designed studies, the results were dismissed  and forgotten (Pollan). Recently, in 2012, a study (this time, a well-designed and controlled study) was conducted on LSD as a treatment for alcoholism (Krebs 2012). The results showed that just a single dose of LSD is associated with a decrease in alcohol use, and that compared to other drug treatments for alcoholism, like naltrexone, LSD was superior (Krebs). The results showed significant positive effects for around six months after the single dose. After six months, the positive effects seemed to diminish, and patients returned to drinking.

It seems there needs to be further research which periodically administers LSD sessions to patients (perhaps twice yearly), to determine if the positive results can be sustained. LSD can have some negative side effects, such as a “bad trip”, anxiety and confusion, and the psychedelic experience lasts much longer than other similar psychedelic compounds, such as psilocybin. However, it has a very high safety profile and there is no scientific reason as to why some patients should not be treated with LSD for alcoholism (Winkleman 102). LSD appears to provide a “fundamental shift in consciousness that provides a profound motivation for positive change”, and can produce a “vivid awareness of one’s personal problems, presenting graphic images of the immediate and long-term deleterious effects of the alcohol” (Winkleman 102). Many of the patients who benefited from LSD attributed their positive changes to the “spiritual affects” of the drug.

Ayahuasca

Ayahuasca is a medicinal and sacramental tea which originates from South America. It has a strong history of use in shamanic healing rituals. It normally consists of two main ingredients: the leaves of the chacruna tree, which provide the psychedelic compound dimthyltryptamine, and the vine baanisteriopsis caapi, which provide a MAO inhibitor which allows the DMT to become orally active.

There is a plethora of anecdotal, ethnographic, and some scientific data which indicates that ayahuasca can useful and successful in treating addiction and other psychological disorders. Ayahuasca has anti-addictive properties via its “direct and indirect actions on dopaminergic and serotonergic neurons in the mesolimbic pathway”, which balances brain chemistry “between the low levels associated with withdrawal and the elevated levels associated with initiation and reinforcement of addictive behavior” (Winkleman 110). In order words, ayahuasca can essentially promote a neurological rewiring of the brain’s reward pathways, making addictive substances and behaviors less desirable. While ayahuasca is currently illegal in the U.S. (except for use by some religious groups), there are many treatment centers around the world which use ayahuasca-based therapy. Because of the unreliable dosages of DMT/MAOI’s in ayahuasca (being made from whole leaves and bark, which may have differing levels of the compounds), it is hard to do dose-controlled studies with ayahuasca.

However, studies and observations on various ayahuasca- based religious groups and treatments have shown very positive effects in participants. For example, studies on the members of the ayahuasca church Uniao do Vegetal, in Brazil, showed that “people with a history of alcoholism underwent profound life changes leading to sobriety shortly after joining the church” (Winkleman 108). In addition, case-controlled studies revealed that long-term religious ayahuasca users had less cases of drug abuse and psychiatric disorders compared to the general population (Winkleman 108). However, some of these positive effects may be from the other factors surrounding the ayahuasca use, such as the strong community support aspect. While there  needs to be more research on ayahuasca, so far, the evidence of its positive benefits is impressive, and it should be included as a potential treatment.

Ibogaine

            Ibogaine is a compound which comes from the bark of a tree in West Africa. It has shown  evidence of being a useful treatment for substance abuse disorder, especially for individuals who suffer from opiate  and cocaine addiction and withdrawal (Winkleman 112). Some non-medical clinical studies showed that ibogaine resulted in “attenuation of opioid withdrawal symptoms within several hours of ingestion, and lasting resolution of the acute opioid withdrawal syndrome within 12 to 18 hours”  (Winklem 107). In addition, animal studies showed that when addict-rats were administered ibogaine, they stopped self-administering the addictive drug for at least several days (Winklem 107).

There has been some controversy about the safety of ibogaine, after a handful of deaths related to it occurred. However, the individuals who died either had preexisting medical conditions that should have excluded them from ibogaine treatment (cardiac issues), or had used cocaine or opiates within a short time before or after using ibogaine (Winkleman 112). Ibogaine is similar to the other psychedelics, in that the experience produces “visions that provide psychological insight into their drug use, particularly understandings that helps overcome psychological blocks” (Winkleman 112).

Psilocybin

            Psilocybin is a compound found naturally in certain species of mushrooms. It has been found to be very safe and is not hazardous to physical health (Grob 2011). A recent double-blind study on patients with terminal cancer and acute anxiety showed a reduction in anxiety and an improvement in mood (Grob). In another psilocybin study, individuals with obsessive-compulsive disorder experienced reductions in OCD symptoms (Grob 2011).  The results on this compound are so far promising. More studies should be conducted on psilocybin as treatment for various psychological disorders.

Conclusion

There are no valid scientific reasons as to why some of these psychedelics should be excluded as legal and potential treatment options for substance abuse disorder and anxiety. They have proven to be very safe when administered carefully to the right candidates with proper supervision. There is very little potential for abuse with these substances, and they are “more ethical than maintenance/treatment programs employing drugs of high abuse or substitutes (e.g. methadone treatment) because of their abuse and overdose potential” (Winkleman 113-114). Additionally, the rates of effectiveness of psychedelics for treating addiction is substantial- in comparison, the actual rates of those who attribute their remissions to conventional treatments is about the same as those who have spontaneous remissions without treatment (Winkleman 114). Hopefully, with more research, psychedelics will lose their negative stigma and become included as legal treatments for those suffering from substance abuse disorder and anxiety.

 

 

 

Resources

 

 

 

Charles S. Grob, MD; Alicia L. Danforth, MA; Gurpreet S. Chopra, MD; Marycie Hagerty, RN, BSN, MA; Charles R. McKay, MD; Adam L. Halberstadt, PhD; George R. Greer, MD  (2011). Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer .Arch Gen Psychiatry. 2011;68(1):71-78

 

Krebs Ts, Johansen PO (2012). Lysergic acid diethylamide (LSD) for Alcoholism; Meta-analysis of Randomized Controlled Trials. Journal of Psychopharamacology. 26(7): pp994-1102.

 

Pollan, Michael. “The Trip Treatment.” New Yorker. New Yorker, 9 Feb. 2015. Web. 10 Dec. 2015.

 

Winkleman, Michael (2014). Psychedelics as Medicines for Substance Abuse Rehabilitation.

Current Drug Abuse Reviews, 2014, Vol. 7, No. 2. pp.101-116.

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