The Viability of Psychedelics as a Treatment for Substance Use Disorder

From a clinical standpoint, the use of psychedelic drugs has long been tabled. Lawmakers labeled these drugs harmful due to their addictive qualities. Though these drugs were heavily researched in the past for their ability to help with other conditions, in 1970, that stopped. Now, there’s growing evidence that these hallucinogenic drugs, once thought to be nothing more than drugs of misuse, may find their way into treatment for numerous conditions, including substance use disorders (SUDs).

Those in the behavioral health industry may wish to remain up to date on this new potential option for traditionally hard-to-treat conditions.

It’s important to note that the use of psychedelics in a treatment program requires extensive care. Providers must document sessions with video to refer to later. A good electronic medical records (EMR) solution allows health care providers to reflect on effective treatment and the possibility of implementing these drugs into more treatment plans.

What are psychedelics?

Psychedelics are hallucinogens – a group of drugs that alter a person’s awareness of their surroundings, often leading to a break from reality. They are commonly noted for their ability to change a person’s thoughts, feelings, and expressions.

The drugs are plant or mushroom extracts or synthetic products made in a lab. People have used them for religious experiences, healing rituals, recreational purposes, and stress relief. Yet, they’ve been considered high-risk substances for a long time due to their addictive nature. For this reason, they are not used for therapeutic purposes.

There are two forms of psychedelics: classic psychedelics, such as LSD, and dissociative psychedelics, such as PCP. Both forms cause hallucinations, but dissociative drugs can also change how a person feels and cause them to feel disconnected from their environment and body, typically creating more of a profound effect.

Common classic psychedelic drugs include:

• • LSD (d-lysergic acid diethylamide), a synthetic, Schedule 1 mind-altering chemical
  • Psilocybin (4-phosphoryloxy-N, N-dimethyltryptamine), a naturally occurring product
  • Peyote (mescaline), which comes from a small, spineless cactus
  • DMT (N, N-dimethyltryptamine), a chemical found in plants in the Amazon

Common dissociative drugs include:

• • PCP (phencyclidine), used as an anesthetic for surgical procedures
  • Ketamine, a surgery anesthetic often sold illegally
  • DXM (dextromethorphan), a cough suppressant sold in over-the-counter medications
  • Salvia (Salvia divinorum), a plant from Mexico

It’s important to note that many of these drugs have been used in the past for medical treatments. Yet, in the 1970s, medical professionals stopped using these drugs therapeutically in the United States after they noticed the high potential for misuse. Now, things may be changing.

Are hallucinogens addictive?

The National Institute on Drug Abuse notes that there are conflicting opinions about the addictiveness of psychedelics. It is possible to develop a tolerance to certain hallucinogens, which leads to increased doses of the drugs to obtain the same results. Some psychedelics do not have the same potential for addiction and misuse. For example, LSD is not thought to be addictive because it does not create drug-seeking behavior in most users. However, it does create tolerance, which leads to increased use and the possibility of overdose. PCP is considered highly addictive. When people stop using it, they may experience withdrawal symptoms and cravings and exhibit drug-seeking behavior.

How do psychedelics work?

To better understand how these drugs may play a role in treating substance use disorders, it’s essential to know how they impact the brain. Research shows that these drugs work by temporarily disrupting the communication in the brain’s chemical systems, which are located throughout the brain and spinal cord. Depending on the drug, it may interfere, to some degree, with the way serotonin, a type of brain chemical, regulates mood, sleep, hunger, and body temperature.

Dissociative psychedelics work a bit differently. They interfere with glutamate, another type of neurotransmitter. This chemical is responsible for environmental responses, emotion, and pain perception. It also impacts the function of memory and learning.

Two drugs have been shown to be effective at treating SUDs include psilocybin and LSD. These drugs have an impact on brain activity. LSD and psilocybin hit the brain receptor (a brain chemical) called serotonin 2A. The two drugs interact with and change the function of this chemical. Science has shown that psilocybin may be more effective for the treatment of SUD because its impact lasts longer.

There is still a lot of research needed to fully understand how these drugs interact with the brain. Yet, researchers recognize that brain activity changes significantly in those who use these substances.

Using Psychedelics for Substance Use Disorder

In a research study conducted at Johns Hopkins University, Matthew Johnson, an associate professor of psychiatry and behavioral sciences, conducted a trial that used psychedelics to control tobacco use. The study enrolled 15 people in a trial. Those who participated had, on average, smoked 19 cigarettes a day for the last 31 years and had six failed attempts to quit in their past. The trial involved 15 weeks of structured smoking cessation treatment. During that time, each participant received ongoing cognitive behavioral therapy. At week 5 and week 7, they received a dose of psilocybin. There was an optional third dose at week 13. Gordon McGlothin was a 65-year-old participant in the study. Prior to it,  he’s smoke 20 cigarettes a day for 15 years. During the study, he was given a blue pill and told he would be able to stop smoking right away. On the days he received treatment, he stayed at the clinic for the day, listened to music, and worked with the therapists. McGlothin’s experience was much like the others. At six months out, 80 percent of the patients in the trial were not smoking.Of the study, Johnson stated, “The results are not conclusive, but we strongly suspect that it is the psilocybin playing a role, because the quit rates are so much higher than even the best current psychological or pharmacological treatments for tobacco addiction, which are typically around 35 percent.” Some studies show that psychedelics may help people gain more control over their use of other substances. That may be a way to treat SUDs and other mental disorders, including anxiety and depression. Over the last decade, numerous studies have looked specifically at how psychedelics work in addiction treatment. Multiple trials have shown that there is a possibility that psychedelics could be used in a controlled environment to treat addiction. A separate study, published in the Journal of Psychopharmacology, found that a single dose of LSD could help to decrease alcohol misuse as a component of an alcoholism treatment program.

Research Studies in the 1950s, 1960s, and 1970s

LSD and psilocybin made their public appearance around 1960 when college students began using the substances to create out-of-this-world experiences. Some tragically jumped to their deaths from buildings because they thought they could fly while using these substances.

LSD wasn’t new then. It was first developed in the 1930s after researchers learned of its psychoactive agents that could significantly change a person’s consciousness. They found, too, that the drug interacted with serotonin. As such, it could play a significant role in mood regulation. Used in these studies, LSD made substantial changes in mood control and didn’t have any strong adverse reactions.

As a result, researchers believed it to be an incredible breakthrough that would aid in the treatment of many mental illnesses in the 1950s and 1960s.

The deaths from recreational use of LSD, though, led to the drug’s demise as a therapeutic agent. It was listed as a Schedule 1 drug, making it unavailable for use as a medical treatment.

Effects of Psychedelic Drugs

It’s not fully understood what occurs when a person takes psychedelic drugs, nor if that reaction is the same from one person to the next. However, evidence indicates some level of psychological change occurs during its use, and that’s what’s proved to be interesting for substance use disorder treatment. As noted previously in the Johns Hopkins study, up to 80 percent of people who had a tobacco addiction were able to maintain long-term abstinence with the use of psilocybin. The lead researcher noted that people expressed changes after using the drug in his study. After the use of psilocybin, it was easier for users to make decisions that were more in line with long-term best interests. Tobacco use is not the only area of significant improvement in these studies. A researcher at New York University conducted another small-scale study. The focus this time was on the use of psilocybin and alcohol use. Treating alcoholism with psychedelics has various benefits. It’s important to note that this is not about trading one addiction for another. Instead, these drugs create noticeable changes in the brain. For example, a 2016 study of a group of people with cancer looked at how psychedelic therapy could reduce anxiety and depression. A single dose of psilocybin mushrooms relieved feelings of hopelessness and depression related to cancer. Nearly 7 months later, 60% to 80% of those individuals reported continued improvement of anxiety and depression. As noted, it’s not clear what happens to create these changes. Researchers noted that psilocybin “reduced amygdala response to negative effective stimuli,” in a study published by the National Library of Medicine. The amygdala is the area of the brain that controls emotion. The drug also stimulates a positive mood. It’s also related to how neural patterns break down when people use these drugs. This action changes the connectivity of various parts of the brain. The result is more diverse.

Which types of psychedelics should be used to treat SUDs?

Not all psychedelics work in the same way. That is why only a few of them may be beneficial to treating SUDs or mental health conditions. LSD and psilocybin are the drugs most commonly used in studies to treat substance use disorders and mental health disorders. Another is ibogaine. There is some evidence to suggest that the use of ibogaine may be effective in opioid addiction treatment. Unfortunately, this psychoactive drug is not accessible in much of the modern world. Researchers in New Zealand, where the drug is legal, took a closer look at how ibogaine may impact addiction. The study, which was published in the American Journal of Drug and Alcohol Abuse, was conducted over 12 months and involved patients receiving ibogaine as a specific treatment for opioid dependence. The researchers found that a single treatment “reduced opioid withdrawal symptoms and achieved opioid cessation or sustained reduced use in dependent individuals as measured over 12 months.” Addiction treatment using ibogaine would require an update to legalized use in most areas. Yet, evidence suggests it may offer significant improvements.

Is the use of psychedelics for addiction
treatment safe?

It is critical to determine whether psychedelics are safe to use in the long term and understand the side effects that may accompany the drugs. Because no comprehensive study has focused on adverse patient outcomes, researchers and medical professionals have not established best practices for the use of these drugs just yet. There are risks inherent in the extended use of psychedelic drugs. According to Medical News Today, risks of psychedelic therapy include:

Psychosis: These drugs cause some level of disassociation in some people. In some, that may create long-term psychosis.

Cardiovascular problems: Psychedelics elevate heart rate. They can also increase blood pressure. Those with heart disease may be at risk for complications from the use of these drugs.

Fear: Some people will experience frightening thoughts and feelings, anxiety and despair.

More research is necessary to determine the positive and negative aspects of using psychedelics for the treatment of substance use disorders.

How Treatment Centers Can Incorporate Psychedelics

The potential of psychedelics to treat substance use disorders make it essential that researchers examine their effects in a carefully controlled environment. Behavioral health programs that wish to incorporate psychedelics into their treatment must do so safely.

One way to do that is with a single-platform behavioral health solution. This tool allows for documentation of the outcomes from various treatments. It presents therapists with the ability to try different methods, record sessions, and share information with others.

This technology assists with monitoring and tracking the success and potential risks associated with psychedelic treatment over time and allows health care providers to identify patterns that develop among patients.

For example, hallucinations are a common adverse effect of these drugs. During sessions, providers can monitor and record videos of sessions for later review. Done through the EMR, these recordings adhere to compliance requirements because the software protects against the sharing of private information.

It protects the patient’s privacy while allowing medical professionals to evaluate outcomes. Monitoring for a period of time after administering these drugs may be essential to understanding how they work. They may also monitor hallucinations that could be traumatizing to patients.

Currently, there are few hands-on resources available for knowing when to prescribe these medications or how much to use. A comprehensive software solution opens the door to opportunities to better monitor these needs. That may include in-session monitoring. It may also include the use of teletherapy that allows providers to check in with patients over time to better understand the implications of use and contribute to a better understanding of how these drugs work.

Sunwave Offers Technology to Change
the Path of Addiction Treatment

Sunwave offers an EMR solution that does more than just monitor patient records. It gives health care providers the ability to offer new treatments, such as psychedelics for addiction. It’s a secure, reliable, and fully compliant tool that empowers behavioral health therapists with insightful reporting. To learn more about how Sunwave can help your practice provide an award winning level of service to its patients, reach out to us today. Request a demo to learn more about our products.