Q&A: Hallucinogen-based treatments resurge after multi-decade halt
Researchers from NYU Langone Health recently reported psilocybin-assisted psychotherapy reduced the number of heavy drinking days in those with alcohol use disorders.
The study, published in JAMA Psychiatry, was accompanied with an editorial from Henry R. Kranzler, MD, and Emily E. Hartwell, PhD, both of the Center for Studies of Addiction at the University of Pennsylvania Perelman School of Medicine. Kranzler and Hartwell discussed the history of hallucinogen-based treatments and the renewed interest in the practice after several decades of no relevant attention.
Healio spoke with Kranzler to gain a better understanding of why the study of hallucinogen-based therapy ceased for roughly 50 years and what the future of hallucinogen use as therapy may look like.
Healio: Is there a reason why so few studies were conducted on hallucinogen use for the treatment of alcohol use disorder in the 1960s, given that promising results were reported?
Kranzler: Psychedelics were increasingly being used recreationally and largely by counterculture individuals. This political/legal issue, combined with some adverse events associated with their unsupervised use, led to LSD being made illegal in 1966, which made it hard to access, and it has taken about 50 years for the pendulum to swing back and for the drugs to be accessible for use in research.
Healio: Can we infer why there is a resurfacing of hallucinogen use for the treatment of many psychological disorders?
Kranzler: The drugs have been shown in initial studies to be of therapeutic value for depression, including that associated with cancer and in treating smoking and alcohol use disorder. This has created a considerable amount of interest because the drugs have a novel mechanism of action and could augment current treatments.
Healio: The studies you mentioned from the 1960s involved LSD, while current studies involve psilocybin. Is there a big difference in treatment when using different hallucinogens?
Kranzler: There are some differences in the physiological effects and in the dosage required. LSD is more potent, so it has psychedelic effects at a much lower dosage than psilocybin. LSD also has a lot more historical baggage than psilocybin, so efforts to study it may encounter greater regulatory obstacles.
Healio: Do you see a legitimate future for hallucinogen-based treatments?
Kranzler: I do, because the therapeutic effects — including those shown by Bogenschutz and colleagues in their recent study in alcohol use disorder — are impressive. Although not miraculous, they appear to be as good or better than the effects of any of the medications currently approved or used off label to treat alcohol use disorder.
Reference:
Bogenschutz MP, et al. JAMA Psychiatry. 2022;doi:10.1001/jamanetworkopen.2022.2096.