Improving Outcomes in Psychedelic-Assisted Therapy for Opioid Addiction through Herbal Medicine

Psychedelic therapies show promise for conditions like PTSD, depression, and substance use disorders, but their success heavily depends on the facilitator and the setting. The field remains outside mainstream medicine and faces stigma from historical prohibition, despite positive trial results. For addiction medicine, facilitators often lack skills to manage substance abstinence. This review offers a clinical guide for managing opioid withdrawal symptoms after psychedelic use, aiming to provide a safer transition for people with opioid use disorder. Several herbal substances—corydalis, saffron, berberine, and nigella sativa—may help ease opioid withdrawal and contribute to addressing the opioid crisis.

Study at a glance

Abstract

Psychedelic therapies have emerged as a modality of treatment for several treatment resistant diseases, including post-traumatic stress disorder (PTSD), treatment resistant depression, substance use disorders, anxiety, and obsessive-compulsive disorders. Arguably more than with other therapies, their success is dependent on the facilitator and the context of the administration. Several programs have emerged to provide facilitators education, but the field is not an acknowledged part of medicine, and suffers from stigma due to historical legal prohibition, despite positive results in trials as well as patient testimony. Medicine has been wary to advocate for psychedelic medicine, given its seeming overturning of several implicit assumptions, such as the primacy of the experience, as opposed to the action of the pharmacological agent itself, on the therapeutic action. For the case of addiction medicine, facilitators are often not well poised to navigate the challenges of substance abstinence with their clients. This review presents a guide to the clinical management of opioid addiction symptoms following psychedelic use, to provide a more secure offramp for individuals with opioid use disorder. Several herbal substances, including corydalis, saffron, berberine, and nigella sativa, may help to alleviate symptoms of opioid withdrawal and may be helpful for drawing down the opioid crisis.