Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review
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REVIEW
Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review Alec J. DiVito1 · Robert F. Leger2 Received: 29 July 2020 / Revised: 9 November 2020 / Accepted: 16 November 2020 © Springer Nature B.V. 2020
Abstract Classical psychedelics are a group of drugs characterized by their activation of the serotonin-2A (5-hydroxytryptamine-2A; 5-HT2A) receptor and the unique hallucinogenic and mystical-type experiences that result. After a substantial period of restrictions limiting investigations into the therapeutic potential of psychedelics, a relatively recent recommencement of interest has sparked the burgeoning possibility for these drugs to play a part in the treatment of a wide array of psychopathologies. One of the most promising is in the study of addiction. Evidence has emerged that psychedelic agents may provide a novel avenue for the clinical treatment of patients dealing with substance use disorders (SUD). These serotonergic hallucinogens have displayed remarkable and enduring positive outcomes in this area, even when administered as one or two doses. The neural targets for these psychedelics are varied and underlie a complex mechanism of action—modulating multiple neural networks. It is believed that these agents allow for the reorganization of disordered neural pathways in the default mode network and attenuate maladaptive signaling in mesolimbic reward circuitry. The aim of this review is to examine the current standing of evidence regarding psychedelic psychopharmacology and to provide an overview of the use and effectiveness of these drugs in the treatment of SUD, alcohol use disorder, and for smoking cessation. Keywords 5-HT2A receptor (serotonin-2A receptor) · Addiction · Substance use disorder (SUD) · Alcohol use disorder (AUD) · Smoking cessation · Psychedelics · Serotonergic hallucinogen
Introduction Psychedelics are a group of drugs that alter perception, cognition, and consciousness [1, 2], and often elicit mystical or awe-inspiring personal experiences [3–5]. Although many of these substances—such as ayahuasca, psilocybin, and peyote—have been utilized in various cultural and spiritual practices for centuries [1, 6–9], psychedelics largely entered Western culture following the discovery of the effects of lysergic acid diethylamide (LSD) by Albert Hofmann in 1943 [1, 10]. In spite of initial, intense interest in their potential therapeutic applications, these drugs suffered from * Robert F. Leger [email protected]; [email protected] Alec J. DiVito [email protected] 1
Lewis Katz School of Medicine at Temple University, 1505 South Juniper St., Philadelphia, PA 19147, USA
Lewis Katz School of Medicine at Temple University, 42 South 15th St., No 501, Philadelphia, PA 19102, USA
2
wide-spread restrictions as a result of cultural perceptions regarding their recreational usage outside of the clinical setting and were classified as schedule I controlled substances by the Comprehensive Drug Abuse Prevention and Control Act of 1970 [11–14].
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