The impact of psychedelics on patients with alcohol use disorder: a systematic review with meta-analysis.
Dakota Sicignano, Adrian V Hernandez, Benjamin Schiff, Nawal Elmahy, C Michael White
Current medical research and opinion February 1, 2024 DOI: 10.1080/03007995.2023.2296968 via PubMed
Summary
AI-generated from the abstractA meta-analysis of randomized controlled trials found that psychedelics, including LSD, increased the odds of patients with alcohol use disorder achieving abstinence or substantially reducing drinking compared to placebo. In double-blind, placebo-controlled trials, LSD (3 trials) produced an odds ratio of 1.99, and any psychedelic (4 trials) produced an odds ratio of 2.16. When including less rigorous controlled trials, the positive effect persisted. However, four of six trials had a high risk of bias and other methodological issues. One trial reported suicidal ideation and transient blood pressure increases, highlighting unresolved safety concerns. The evidence is promising but too weak for definitive conclusions; more rigorous trials are needed.
Study at a glance
| Characteristics | Systematic review and meta-analysis Randomized Placebo-controlled Double-blind Peer reviewed |
|---|---|
| Population | Patients with alcohol use disorder |
| Interventions | LSD any psychedelic |
| Topics | Addiction LSD Psilocybin Psychedelic-assisted therapy |
| Keywords | Meta-analysis |
| Citations | 19 |
| Key finding | Psychedelics, including LSD, significantly increased the odds of abstinence or substantial reduction in alcohol use compared to placebo in randomized controlled trials, but methodological weaknesses and safety concerns prevent definitive conclusions. |
Abstract
Critique the available systematic review and de novo assessment of the role of psychedelics in the treatment of alcohol use disorder. A systematic literature search of PubMed was completed from 1960 to 9/9/2023. We pooled randomized controlled trials comparing psychedelics to control therapy for the treatment of alcohol use disorder. At the first recorded follow-up, LSD [n = 3, Odds Ratio (OR) 1.99 (95% Confidence interval (CI): 1.10 to 3.61)] and any psychedelic [n = 4, OR 2.16 (95%CI: 1.26 to 3.69)] enhanced the odds of patients achieving abstinence or a substantial reduction in drinking alcohol versus placebo in randomized, double-blind, placebo-controlled trials. When the inclusion criteria were relaxed to include controlled trials without double-blinding or placebo control, LSD [n = 5, OR 1.79 (95%CI: 1.36 to 2.34)] and any psychedelic therapy [n = 6, OR 1.89 (95%CI: 1.42 to 2.50)] still enhanced the odds of patients achieving abstinence or a substantial reduction in drinking alcohol. Four of 6 trials had high risk of bias and other methodological issues. One trial found an instance of suicidal ideation as well as transient increases in blood pressure that requires further exploration before the balance of benefits to harms can be determined. The use of psychedelics to treat alcohol use disorder is promising, but the weaknesses in the literature base preclude making definitive statements about its value. Future trials with greater methodological rigor are needed.