Essay on Psychedelics as Treatment for Drug Addiction: History and Implications

Intoduction

The use of psychoactive psychedelic drugs to treat addiction may appear paradoxical, but it is not an entirely new phenomenon. The psychedelic psilocybin (magic mushrooms) and Lysergic acid diethylamide (LSD or acid) have been used to treat alcoholism as early as the 1950s. However, unproven efficacy and public perception of these hallucinogenic drugs have limited research into and the use of psychedelic substances in the treatment of drug addiction. The opinion of the use of experimental drugs to treat addiction is changing due to powerful personal testimonials and scientific research into the field. Certain psychedelic drugs, specifically Ibogaine and Ayahuasca, have been shown to treat addiction. This paper will compare the success rate of the usual standard of care treatment options for addiction to the newer psychedelic treatment options of Ayahuasca and Ibogaine.

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Background

Substance addiction is a chronic mental disorder that leads to a compulsive utilization of a rewarding substance that has harmful side effects. Scientists believe that addiction results from coping mechanisms for early childhood pain, trauma, or emotional rejection (Van Wormer & Davis, 2016). Genetics also plays a role in addiction. Addictive substances are intrinsically rewarding, which reinforces their usage. Traditional treatment for addiction usually involves two steps; detoxification and behavioral counseling.

Detoxification involves the elimination of the addictive substance from the body and the management of withdrawal symptoms. Withdrawal symptoms are typically managed using pharmaceutical drugs such as methadone, naltrexone, and nicotine patches (Wakeman, 2017). Studies have shown that pharmacological interventions occur in 80% of all detoxifications in the U.S. and that nearly all drug users who undergo only rehab go back to drug use (Wakeman, 2017).

Behavioral therapies and counseling are a mainstay in the treatment of substance addiction. Such therapies can either be an individual, group, or family therapy, depending on the opinion of the therapist. Behavioral therapies include cognitive behavioral treatment (most common), multidimensional family therapy, and motivational interviewing. The relapse rate for behavioral therapies ranges between 40-60%.

Psychedelic Therapy

Ibogaine is a psychoactive drug that naturally occurs in a central African shrub called iboga. It is a mild stimulant in small doses and a powerful psychedelic at high doses. Studies have shown that the psychedelic state of the drug can result in diminished withdrawal symptoms and drug cravings (Schep et ap., 2016). The exact mechanism for its effect on addiction has not been established, but several hypotheses exist. It is the only naturally occuring psychoactive substance that binds to receptors inside a cell rather than outside. New Zealand is the only country in which ibogaine can be legally used to treat addiction. Ayahuasca is a South American psychedelic drug that has also been shown to treat addiction (Labate & MacRae, 2016). Peru is one of the few countries where Ayahuasca can be used to treat addiction. While the exact mechanism for treatment is still poorly understood, several hypotheses exist for the same.

Comparison

Several studies have found that the use of the two psychedelics, Ayahuasca, and ibogaine, is as effective as the traditional therapies (Mash et al., 2018). Noller, Frampton, & Yazar-Klosinski (2018) used the Addiction Severity Index-Lite and The Subjective Opioid Withdrawal Scale (SOWS) to assess the efficacy of ibogaine for the treatment of opioid addiction. The study found a significant reduction in both scores, indicating a sharp decrease in withdrawal and craving. The findings were consistent with those of other studies. Noller, Frampton, & Yazar-Klosinski (2018) compared their results to current interventions and found no significant differences. Compared to 28 trials covering 12 psychosocial interventions, the researchers found an advantage for abstinence-only (RR 1.15, 95% CI [1.01-1.32]) but none for detoxification in the short term. In the long time (3 months to one year), ibogaine produced better results on all metrics. The findings are consistent with those of Brown & Alper (2018).

There is limited literature directly comparing the efficacy of Ayahuasca and conventional therapies. However, studies have shown that Ayahuasca is useful in the treatment of addiction. A Canadian study on a treatment plan that utilized both Ayahuasca and conventional behavioral therapies found that the combined therapy was better than both traditional therapy alone and traditional therapy combined with music therapy for cocaine, alcohol, and tobacco but not for cannabis and marijuana and opiates.

Studies have also shown that there are several advantages of using psychedelics over conventional treatments. Psychedelics are less time-intensive compared to traditional therapies, are ideal for people who are not naturally expressive, also treat other mental health disorders, and are less costly. Since there is no difference in efficacy between the newer experimental treatments and traditional therapies, the additional advantages imply that psychedelic treatment may offer better value overall.

Conclusion

Psychedelic therapy appears to be as effective as conventional treatments in the management of substance abuse for some but not all drugs. There is a need for more robust research into the use of psychedelics for the treatment of addiction. One area of focus should be on combination therapy where psychedelics are used together with the conventional therapies to treat addiction.

Works Cited

Brown, Thomas Kingsley, and Kenneth Alper. "Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes." The American journal of drug and alcohol abuse 44.1 (2018): 24-36.

Labate, Beatriz Caiuby, and Edward MacRae. Ayahuasca, ritual and religion in Brazil. Routledge, 2016.

Mash, Deborah Carmen, et al. "Ibogaine detoxification transitions opioid and cocaine abusers between dependence and abstinence: clinical observations and treatment outcomes." Frontiers in pharmacology 9 (2018): 529.

Noller, Geoffrey E., Chris M. Frampton, and Berra Yazar-Klosinski. "Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study." The American journal of drug and alcohol abuse 44.1 (2018): 37-46.

Schep, L. J., et al. "Ibogaine for treating drug dependence. What is a safe dose?." Drug and alcohol dependence 166 (2016): 1-5.

Van Wormer, Katherine, and Diane Rae Davis. Addiction treatment. Cengage Learning, 2016.

Wakeman, Sarah E. "Medications for addiction treatment: changing language to improve care." Journal of addiction medicine 11.1 (2017): 1-2.