Addiction
Emerging Treatments for Substance Use and Mental Health Disorders
The renaissance of psychedelic research.
Posted October 10, 2024 Reviewed by Jessica Schrader
Key points
- Psychedelics are being studied in the treatment of addiction, depression, and post-traumatic stress disorder.
- Psychedelics may work by enhancing brain neuroplasticity.
- Psychedelics are available legally in only two states.
The landscape of addiction treatment is experiencing a fascinating transformation, with psychedelic-assisted therapies emerging as a promising frontier. This approach, once considered taboo, is gaining traction in scientific circles and showing potential for treating various substance use disorders. Understanding the nuances of this evolution is crucial for enhancing your treatment offerings.
The Renaissance of Psychedelic Research
After decades of prohibition, psychedelics are undergoing a research renaissance. Substances like psilocybin (from "magic mushrooms"), MDMA, and ketamine are being studied for their therapeutic potential in treating addiction, depression, and PTSD. For instance, a recent review of randomized controlled trials found that psilocybin significantly reduced heavy drinking days for individuals with alcohol use disorder. Additionally, a 2017 study has found found that psychedelic use was associated with a 40% reduced risk of past-year opioid misuse and 27% reduced risk of past year opioid dependence among those with opioid use disorder.
How Do Psychedelics Work?
Psychedelic-assisted treatment involves several stages: assessment and preparation, dosing, and integration. During the preparation phase, patients learn about psychedelics and how they can facilitate healing.
Psychedelics are thought to work by:
1. Increasing neuroplasticity (rewiring of the brain).
2. Disrupting entrenched thought patterns.
3. Facilitating emotional breakthroughs.
4. Enhancing mindfulness and self-awareness.
A cautious approach to implementation is essential given the potential for “bad trips” or emotional distress. It’s also vital to ensure informed consent, making clear the benefits and possible challenges associated with psychedelic treatments.
Navigating Legal and Ethical Challenges
While the excitement around psychedelics is palpable, legal hurdles remain. Currently, only Oregon and Colorado have legalized psychedelic therapy for mental health treatment, with a licensing process in place. In other states, treatment facilities may explore partnerships with research organizations to participate in clinical trials.
Ethically, leaders must ensure that all patients feel safe and informed about their treatment options. Considerations around the cultural significance of these substances, particularly within Indigenous communities, also warrant attention. It’s crucial that addiction treatment centers approach the use of psychedelics with respect for their cultural roots and aim to provide equitable access.
Building Diversity and Health Equity Into Psychedelic Treatment
Ensuring that psychedelic treatments are conducted in a DEIB-informed (diversity, equity, inclusion, and belonging) manner is essential. Here are a few strategies to implement:
1. Culturally Competent Care. Train staff in cultural sensitivity to appropriately address the diverse backgrounds of clients seeking psychedelic therapy.
2. Community Engagement. Involve local communities in discussions about introducing psychedelic treatments, ensuring their voices and concerns are heard.
3. Equitable Access. Develop policies to provide these innovative treatments regardless of a client's socioeconomic status, thus avoiding disparities in access.
4. Data Transparency. Regularly assess the demographics of patients accessing psychedelic treatments to ensure equitable representation and adjust practices as needed.
Conclusion
As psychedelics are rediscovered as a potential treatment for addiction, those who administer these medications in therapeutic settings must stay informed and ready to embrace these innovations. By understanding the benefits, navigating the legal landscape, and committing to DEIB principles, addiction treatment centers can be at the forefront of this exciting new era in recovery. Embracing the potential of psychedelic-assisted therapies could transform the lives of countless individuals striving for recovery, making it imperative for all leaders to engage with these evolving treatment modalities.
References
Ezquerra-Romano, I. I., Lawn, W., Krupitsky, E., & Morgan, C. (2018). Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology, 142, 72–82. https://doi.org/10.1016/j.neuropharm.2018.01.017
Gashi, L., Sandberg, S., & Pedersen, W. (2020). Making “bad trips” good: How users of psychedelics narratively transform challenging trips into valuable experiences. International Journal of Drug Policy, 87, 102997. https://doi.org/10.1016/j.drugpo.2020.102997
Koslowski, M., Johnson, M. W., Gründer, G., & Betzler, F. (2021). Novel Treatment approaches for Substance use disorders: therapeutic use of psychedelics and the role of Psychotherapy. Current Addiction Reports, 9(1), 48–58. https://doi.org/10.1007/s40429-021-00401-8
Argento E, et al. (2022) Psychedelic use is associated with reduced daily opioid use among people who use illicit drugs in a Canadian setting. Int J of Drug Policy. Vol 100. https://www.sciencedirect.com/science/article/abs/pii/S0955395921004369…