High hopes? Precision psychedelic addiction medicine.
Frontiers in psychiatry January 1, 2025 Rayyan Raja Zafar, Patrick Kleine, Danielle Kurtin et al.
Only 1.8% of people with substance use disorders receive effective treatment, revealing a gap between neuroscience research and clinical care. This paper argues that addiction neuroscience should shift from a diagnostic focus to a theragnostic framework that uses biomarkers to guide treatment decisions. Integrating fMRI, EEG, and PET biomarkers within psychedelic addiction research offers an opportunity for this change. Psychedelics like psilocybin engage neuroplasticity and reward networks central to addiction. The authors review neuroimaging paradigms for indexing drug effects and propose a roadmap for embedding biomarkers in clinical trials. They outline ongoing work at Imperial College London co-developing biomarkers for gambling and opioid use disorders to identify biotype-specific responses, aiming for regulatory-grade tools similar to those in oncology.