Psilocybin and MDMA in Couples Therapy: Investigating Treatment for Substance Use Disorders and Codependency

Substance use disorders harm not only the user but also their romantic partner, who may develop negative codependent traits. This narrative review examines how psilocybin-assisted therapy can treat substance use disorders and how MDMA, already used for PTSD, might also address codependency in a spouse affected by their partner's addiction. Combining both substances with couples therapy could reduce addictive behaviors in one partner while shifting codependent behaviors in the other. The review discusses clinical implications, limitations of current research, and suggests further study of psychedelic-assisted couples therapy.

Study at a glance

Abstract

Abstract Substance use disorders (SUDs) are increasingly common in the United States, and while this may be a dilemma for those using, it also inflicts problems for those around the user. In couples where drug abuse is present, negative codependent characteristics can arise independently in the non-user, having a damaging effect on the couple dynamic. This is a narrative review to identify how psilocybin-assisted therapy (PAT) has been used to treat SUDs and 3,4-methylenedioxymethamphetamine (MDMA) for disorders like PTSD, examining how MDMA may also be able to treat codependency in a spouse uniquely afflicted by their counterpart’s addiction. When utilizing the combination of these two substances with couples therapy, a reduction of addictive characteristics in one client with a SUD may occur while also shifting codependent behaviors in the romantic partner. Clinical implications as well as limitations on current research are discussed along with further suggestions for psychedelic-assisted couples therapy [149].