Addiction
January 30, 2025
Theodore Piper, Francesca Small, Michael Kelleher et al.
27 citations
This first systematic review of psychedelic-assisted treatments for alcohol, tobacco, and other substance use disorders examined 37 studies involving 2,035 participants. The best evidence of efficacy came from a phase 2 randomized controlled trial of psilocybin for alcohol use disorder and a phase 2 trial of ketamine for alcohol use disorder. Psilocybin-assisted treatment for alcohol use disorder appears to have the strongest evidence among all major psychedelic-assisted treatments. No serious adverse events were reported across any study. The review recommends that future research report all safety events, identify contraindications, mitigate participant blinding, use factorial designs, and develop a core outcome set.
Addiction
March 19, 2021
Amanda Roxburgh, Bülent Şam, Pirkko Kriikku et al.
27 citations
Between 2011 and 2017, MDMA-related death rates increased in Australia, Finland, Portugal, and Turkey, coinciding with higher MDMA purity and availability. Across 1,400 deaths in Turkey, 507 in Australia, 100 in Finland, and 45 in Portugal, most decedents were young males (81–94% male; median age 24–27.5 years). Drug toxicity was the primary cause in Australia (61%), Finland (70%), and Turkey (60%), while other causes dominated in Portugal (56%). Only 13–25% of deaths were due to MDMA alone; these had significantly higher blood MDMA concentrations than multiple-drug toxicity deaths. Other drugs commonly detected included stimulants and alcohol in Australia and Finland, benzodiazepines and opioids in Finland, and synthetic cannabinoids and cannabis in Turkey.
Addiction
January 11, 2024
Nicolas Garel, Steven Tate, Kristin Nash et al.
23 citations
Hallucinogen-related emergency department visits in California rose 54% from 2016 to 2022 (2260 to 3476 visits), while alcohol-related visits fell 20% and cannabis-related visits rose 15%. Hallucinogen-related hospitalizations increased 55% (2556 to 3965), compared with a 1% increase for both alcohol and cannabis. These trends were statistically different from those for alcohol and cannabis. The absolute numbers remain small, but the relative increase is large.
Addiction
July 24, 2025
Amandine Luquiens, Dahbia Belahda, Carine Graux et al.
22 citations
A pilot randomized controlled trial tested psilocybin-assisted psychotherapy in 30 adults with severe alcohol use disorder and depression who had recently completed detoxification. Participants received either 25 mg or 1 mg of psilocybin in two sessions three weeks apart, alongside standard care. At 12 weeks, the 25 mg group had a significantly higher abstinence rate (55% vs 11%), greater reductions in drinking days and craving frequency, and a lower relapse rate (35% vs 50%), though the latter difference was not statistically significant. Blinding was imperfect, and one serious adverse event (myocardial infarction) occurred in the 25 mg group, deemed unrelated. The treatment appears feasible, acceptable, and safe in this population.
Addiction
June 6, 2024
Wayne Hall, Keith Humphreys, John Marsden et al.
18 citations
The current push to broaden the production, sale, and use of psychedelics parallels the movement to legalize cannabis in the United States and other nations, notably through poorly-evidenced therapeutic claims that create a de facto recreational market via the health care system. Experience with cannabis highlights the value of debating legalization for nonmedical use directly rather than misrepresenting it as a medical issue. Lessons from cannabis policy suggest a need to challenge hype of psychedelic research findings, promote rigorous clinical research on dosing and potency, minimize for-profit industry influence, and coordinate federal, state, and local governments to regulate manufacture, sale, and distribution of psychedelic drugs.
Addiction
June 1, 2022
Beth Han, Carlos Blanco, Emily B. Einstein et al.
16 citations
Young adults who used illicit LSD in the past year have a higher risk of suicidal ideation, serious psychological distress, major depressive episode, and any or serious mental illness compared with those who never used illicit LSD. They also miss more days of work or normal activities due to mental health conditions. Despite this greater need, past-year LSD users are less likely to receive prescription medications for mental health care or any mental health care. Lifetime use without past-year use showed similar but less consistent associations. The findings suggest that young adults with any lifetime illicit LSD use may benefit from mental illness prevention and interventions.
Addiction
May 21, 2024
Shane Darke, Johan Duflou, Amy Peacock et al.
14 citations
From 2000 to 2023 in Australia, 43 deaths involving LSD (33 cases) or psilocybin (10 cases) were identified. Most deaths were from traumatic accidents (36.4% for LSD, 40.0% for psilocybin) or self-harm by physical means (12 cases, all involving LSD). Multiple drug toxicity accounted for about a fifth of deaths. Only one death was attributed solely to LSD toxicity, and two followed a cardiovascular event after LSD use. In four psilocybin cases the cause was undetermined. Severe agitation was the most common clinical presentation. Median blood concentrations were 0.8 μg/l for LSD and 20 μg/l for psilocin. Pre-existing organ pathology was uncommon.
Addiction
April 22, 2005
B Mirken, Mitch Earleywine
10 citations
A critique of a New Zealand cohort study on cannabis and psychosis argues that the study's use of ten items from the Symptom Checklist 90 to assess psychosis is flawed because the items focus heavily on paranoid ideation, which is a known acute effect of marijuana intoxication. The authors did not ask respondents to distinguish feelings while intoxicated from those at other times, nor did they consider that paranoid feelings may be a rational reaction for people using an illegal, socially frowned-upon substance. The daily user group reported an average of less than two symptoms each, raising questions about whether the findings reflect mental illness or normal reactions to intoxication and social context.
Addiction
August 12, 2021
Wayne Hall, Michael Farrell
8 citations
Research from the 1950s and 1960s on using LSD to treat alcohol dependence offers cautionary lessons for the current revival of psychedelic therapy. Early uncontrolled studies by Osmond and Hoffer reported that high doses of LSD induced mystical experiences that helped alcoholics embrace abstinence, with some reports claiming a 50% success rate. However, later controlled trials found no better outcomes in LSD-treated patients at 12–18 months follow-up, though a meta-analysis showed benefits up to 6 months. The history warns against irrational exuberance and emphasizes that psychedelics are not standalone cures; they require combination with aftercare and rigorous clinical trials before widespread use.
Addiction
September 20, 2025
Elizabeth Knock, Krista J. Siefried, Gillinder Bedi et al.
4 citations
A single 25 mg dose of psilocybin combined with psychotherapy was safely delivered in an outpatient setting to 15 people seeking treatment for methamphetamine use disorder. No serious adverse events occurred; mild side effects included headache, nausea, and noise sensitivity. Methamphetamine use dropped from a median of 12 days in the prior month at screening to 0 days at 28 days and 2 days at 90 days after dosing. Craving decreased while quality of life, depression, anxiety, and stress scores improved at follow-ups. A larger randomized trial is needed to confirm efficacy.
Addiction
August 13, 2024
Beau Kilmer
3 citations
As more U.S. states and localities consider alternatives to prohibiting psychedelics for non-clinical use, policy debates will likely differ from cannabis legalization. While parallels exist—over two dozen jurisdictions have deprioritized enforcement, and Oregon and Colorado passed initiatives legalizing supervised psilocybin use—psychedelics produce different effects and have distinct market dynamics. Unlike cannabis, where frequent users drive consumption, about 60 percent of psychedelic use days come from those using five or fewer days per month. The author endorses the point that effective regulation of cannabis was hampered by limited federal-state coordination and warns that without federal action, psychedelics may follow a similar for-profit commercial model.
Addiction
December 10, 2025
John Marsden, Michael Kelleher, Fiona Dunbar et al.
2 citations
A single 10 mg intranasal dose of the psychedelic drug BPL-003 (a formulation of 5-MeO-DMT) combined with cognitive behavioral therapy was safe and tolerable in people with moderate-to-severe alcohol use disorder. Over 12 weeks, the average percentage of abstinent days increased from 33.2% at baseline to 80.8%, and heavy drinking days dropped from 56.2% to 13.2%. Half of the 12 participants who completed the study were continuously abstinent, a quarter had meaningful reductions in drinking, and a quarter showed little change. Measures of craving, well-being, and quality of life also improved. The findings support larger controlled trials.
Addiction
March 8, 2026
Michelle Priest, Beau Kilmer, Rajeev Ramchand et al.
1 citation
At least 8.4 million U.S. adults have microdosed psilocybin in their lifetime. People who used psilocybin within the past year are more likely to report microdosing the last time they used compared to those whose use was more than a year ago. However, about 15% of lifetime psilocybin users were unsure whether they microdosed the last time they used. The top motivations for self-reported microdosing are improving physical and mental health.
Addiction
February 16, 2026
Cassie Bloy, Ananya Sarma, Bethan Marsh et al.
1 citation
People with alcohol use disorder experience changes in consciousness from 0.8 mg/kg intravenous ketamine administration. Ketamine's effects remain broadly consistent across three repeated infusions. Reductions in alcohol consumption linked to ketamine do not appear to be caused by the acute psychoactive effects of the drug.
Addiction
August 12, 2024
Michael P. Bogenschutz
1 citation
The author agrees with Andrews et al. that biased media and market forces have distorted public views of psychedelics, blurring medical and non-medical use. If psychedelics follow cannabis's path, increased harms from poor regulation and impeded clinical research may result. Three psychedelic NMDA receptor antagonists (racemic ketamine, esketamine, dextromethorphan) are already approved, but off-label ketamine prescribing often lacks empirical support. The author urges comprehensive risk evaluation and mitigation strategies for psilocybin and MDMA if approved, emphasizing careful screening, preparation, and monitoring. Methodological challenges like unblinding and expectancy effects must be addressed; correlations between drug experiences and clinical improvement need causal clarification.
Addiction
June 17, 2024
P. Todd Korthuis, Adrianne R. Wilson‐poe, Joshua C. Black et al.
1 citation
As psychedelic use expands, adverse effects will increase proportionally. Darke et al. characterized 33 LSD and 10 psilocybin-related deaths in Australia between 2000 and 2023, finding that traumatic accidents and physical self-harm in private settings accounted for most deaths. The 43 deaths over 24 years are rare compared to the more than 325,000 Australians who reported using hallucinogens in 2019 alone. Co-use of other substances was common: 75% of LSD cases and 80% of psilocybin cases involved other substances. The findings suggest regulated services must consider harm reduction, including skilled supervision, screening for comorbidities, and counseling against other drug use. Better population-level monitoring frameworks are urgently needed as legal frameworks for psychedelic services expand.
Addiction
November 2, 2023
Celia J. A. Morgan
1 citation
A near doubling in non-LSD hallucinogen use among 19-30 year olds from 2018 to 2021, driven largely by psilocybin and possibly ketamine, occurred primarily in white, educated, higher socio-economic status males who used hallucinogens infrequently (two to three times per year). The authors of the original study interpret this rise as a health concern, but this conclusion is not supported by the data; infrequent hallucinogen use is associated with greater well-being and lower psychopathology in both cross-sectional and longitudinal surveys, and the demographic group showing increased use is relatively protected from drug-related harms. The commentary argues for abandoning negative narratives about these drugs in favor of conclusions aligned with evidence of modest mental health benefits.
Addiction
March 11, 2026
Christina Mcanulty, Nicolas Garel
A commentary on the KARE trial argues that the study's conclusion—that ketamine's dissociative and perceptual effects do not mediate abstinence outcomes in alcohol use disorder—may be premature due to measurement issues. The authors note that subjective effects were assessed repeatedly during infusions, which could alter the experience, and that non-validated Likert scales were used instead of validated instruments like the Mystical Experience Questionnaire or Emotional Breakthrough Inventory. They highlight that mystical-type experiences, not dissociation, have been linked to therapeutic benefits in other studies of ketamine and psilocybin for addiction and depression. The commentary calls for future trials to minimize in-session interruptions, use validated psychedelic-specific scales after the acute phase, and distinguish dissociation from mystical or transformative experiences before concluding that the altered state is mechanistically irrelevant.
Addiction
December 22, 2025
Jonathan Brett, Toby Lea, Elizabeth Knock et al.
People with methamphetamine use disorder who took part in psilocybin-assisted psychotherapy reported that the treatment was acceptable and often transformative. Before treatment, participants held tempered hopes for positive outcomes. During the psychedelic sessions, many confronted challenging emotional or psychic obstacles by deliberately 'leaning into' them, a process that led to new understandings of themselves, their personal histories, and their relationships. Resolving these obstacles was associated with a reduced importance of methamphetamine in their lives. The therapeutic relationship—characterized by concentrated attention and deep interpersonal intimacy between participant and therapist—was seen as critical to these positive changes.
Addiction
December 8, 2025
María Rita Concepción García, Nelson G. M. Gomes, Diana Dias Da Silva
MDMA (ecstasy), commonly used for its stimulant and empathogenic effects especially among young adults in recreational settings, can cause hyponatraemia—a low blood sodium concentration that alters mental state and is life-threatening if untreated. Although hyponatraemia is a common electrolyte disorder in clinical care, acute MDMA-induced hyponatraemia was first reported in 1993. Women face higher incidence rates and greater odds of severe effects. This review describes the clinical manifestations, prevalence, pathophysiological mechanisms, and therapeutic approaches for correcting this electrolyte imbalance.
Addiction
July 29, 2024
Peder Clark
A review of Erika Dyck and Chris Elcock's edited collection 'Expanding Mindscapes: A Global History of Psychedelics' describes how the volume expands the historiography of psychedelics both temporally and geographically beyond the familiar North American narrative. Across 20 chapters, contributors explore topics including LSD in clinical theology among medical missionaries in India, African plants voacanga africana and tabernanthe iboga, Korean artist Nam June Paik's video work as a technology of consciousness, and psychedelic use in Israel, Britain, France, and Pakistan. The collection maintains a unified critical perspective while covering Europe, Asia, Africa, the Middle East, and South America, though scholars from the Global South are heavily outnumbered.