Using data from the 2023 U.S. National Survey on Drug Use and Health, lifetime use of mescaline or peyote was associated with lower opioid use disorder severity, while lifetime use of LSD, psilocybin, MDMA, or DMT was associated with higher severity. The link between mescaline/peyote use and lower severity appeared only among adults with high mental health impairment. The findings suggest that different types of psychedelic use have divergent relationships with opioid use disorder severity, and that mental health status may influence these associations.
Classic psychedelics like psilocybin show promise for treating substance use disorders, and if larger trials confirm efficacy, psychedelic-assisted psychotherapy might be integrated into existing treatments such as cognitive behavioral therapy and twelve-step facilitation programs like Alcoholics Anonymous. Although AA has historically rejected medication-assisted treatments, the authors argue that classic psychedelics and their subjective experiences may be more compatible than conventional medications. They describe Bill Wilson's, the founder of AA, little-known experiences with psychedelics, suggesting aspects of psychedelic treatments could complement AA. A review of clinical trials evaluating psychedelics for substance use disorders is provided, along with discussion of potential large-scale impact if integrated into AA.