1. Combining Psychedelic Treatments with Current Substance Use Disorder Treatments

Classic psychedelics have shown potential for the treatment of substance use disorders (SUDs). However, there are open questions regarding the integration of psychedelic treatments into existing SUD treatment options. For example, how might psychedelic treatments complement medication assisted treatments (MAT), psychological interventions like cognitive-behavioral therapy (CBT), and behavioral interventions like contingency management (CM)?

We reviewed the evidence for classic psychedelics in the treatment of SUDs based on the existing literature to date, with an emphasis on clinical trials with psilocybin for alcohol use disorder, tobacco use disorder, and opioid use disorder. We then focused on several of the most common existing treatments of SUDs – such as forms of MAT, CBT, and CM – and explored how psychedelic treatments might be integrated into each of these existing approaches, including a review of facilitators and barriers that may impact integration.

There is preliminary evidence for the efficacy of psychedelics in SUD treatment. Based on the current literature, we suggest that, if carefully integrated, psychedelic treatments could usefully complement existing SUD treatments. We found that in many cases, the timing of psychedelic treatments forms an important consideration, so as not to interfere with ongoing treatment nor to precipitate withdrawal. We provide clinical recommendations regarding psychedelic treatments for each of the common SUD treatment approaches based on our review.

It appears likely that psychedelic-assisted treatments can be usefully integrated into most mainstream SUD treatment approaches. Findings suggest that classic psychedelics such as psilocybin are likely to have broad applicability in contemporary SUD treatment contexts. Funding: Support for Dr. David Yaden through the Johns Hopkins Center for Psychedelic and Consciousness Research was provided by Tim Ferriss, Matt Mullenweg, Blake Mycoskie, Craig Nerenberg, and the Steven and Alexandra Cohen Foundation.