Purpose of Review
Substance use disorders (SUDs) and other addictive behaviors such as gambling disorder are globally prevalent and remain significant public health concerns. Since the 1950s, studies have examined psychedelics in the treatment of addictive behaviors with these studies demonstrating safety, feasibility, and potential therapeutic benefit. This review aims to synthesize research reports from peer-reviewed sources investigating the use of psychedelic substances as a potential treatment for SUDs and behavioral addictions.
Recent Findings
Overall, 132 records met criteria for inclusion. One hundred ten records investigated psychedelic use and SUDs (2 meta-analyses, 1 tabulated synthesis of clinical trials, 33 clinical trials, 60 observational studies, 14 case studies) and the remaining 22 were relevant to gambling disorder (1 clinical trial, 1 observational study, 4 case studies, 16 literature reviews), with literature reviews also describing the potential clinical utility of psychedelics in the treatment of behavioral addictions. Overall, the most commonly studied psychedelic substances in clinical trials include ketamine, LSD, and psilocybin. Ibogaine, DMT, and mescaline were primarily investigated via observational and case studies. There is an emerging literature for MDMA.
Summary
Based on a synthesis of the available literature, the most robust evidence for the use of psychedelics in the treatment of SUDs is for the therapeutic use of LSD and ketamine in the treatment of alcohol use disorder. Preliminary and mixed results along with lower quality of evidence in some areas indicates a need for more systematic investigation. Although putative mechanisms of action for the treatment of SUDs and behavioral addictions have been proposed, there is a need for additional research empirically evaluating these hypothesized therapeutic mechanisms while studying differences between specific psychedelic substances.
Link to study: https://link.springer.com/article/10.1007/s40429-025-00629-8