Past psychedelic use linked to lower odds of opioid use disorder

Adults who previously used psilocybin, a psychedelic substance, were 30% less likely to have opioid use disorder, according to findings published in Scientific Reports.

“Our study represents an incremental step towards a greater understanding of factors that may prevent or alleviate OUD,” Grant Jones, a PhD student in clinical psychology at Harvard University, and colleagues wrote.

In 2019, the FDA granted psilocybin breakthrough therapy designation for the treatment of depression.

Using data from the National Survey on Drug Use and Health 2015 to 2019, Jones and colleagues evaluated the association between classic psychedelic use and past-year diagnosis of OUD among 214,505 adults. The researchers categorized psilocybin, peyote, mescaline and LSD as classic psychedelics. The survey did not gauge the frequency or amount of psilocybin used.

Participants met the criteria for OUD if they abused or experienced dependence on heroin or prescription pain relievers or if they matched any of the 11-part Diagnostic Manual of Mental Disorders (DSM-IV) criteria.

Jones and colleagues reported that 1% of participants met the criteria for OUD in the past year, 10.4% reported having previously used psilocybin and 46% reported using heroin or prescription pain relievers recreationally at least once in their lifetime. A majority of participants with OUD were men (58.4%), white (72.7%) and had never been married (49.5%). Most participants who did not have OUD were women (51.8%), white (63.8%) and married (51.9%).

Psilocybin was the only substance associated with lowered odds of OUD (adjusted OR [aOR] = 0.7; 95% CI, 0.6-0.83). Moreover, psilocybin use was significantly associated with lowered odds of seven of the 11 criteria for opioid dependence and abuse (aOR range = 0.66-0.83), according to the researchers. All other substances examined were not associated with OUD or were associated with increased odds of OUD. Demographic and pharmacological differences likely contributed to differences between psilocybin and other psychedelics, Jones told Healio.

A number of potential mediators might explain the association between psilocybin use and OUD, according to Jones and colleagues. For example, the effects of psilocybin on the serotonin system might facilitate its protective association with OUD.

“I think that it is likely just a matter of time that psilocybin is used clinically starting with a small handful of disorders,” Jones said. “I think over time, psilocybin will be used more.”