Testing Advances on Psychedelic Therapies for Substance Use Disorders

The race is on as several bio-pharmaceutical companies and researchers continue testing psychedelic compounds against substance use disorders looking for that unicorn drug or combination of drugs that will become the next billion-dollar blockbuster.
BioSpace reports that there are currently eight psychedelic candidates being tested against alcohol use disorder, opioid use disorder, and other substance use disorders, including nicotine. The projects are being tracked at PsychedelicAlpha, a resource for investors in psychedelics. The site’s Drug Development Tracker shows:
- One Phase III trial of ketamine for alcohol use disorder
- Two Phase III trials of psilocybin for depression
- 34 Phase II trials for psilocybin, MDMA, DMT, LSD, and other psychedelics
- 25 Phase I trials treating everything from headaches to opioid use disorder
BioSpace senior writer, Heather McKenzie, has an elegant discussion with Daniel Karlin, the Chief Medical Officer for MindMed, about how LSD functions to disrupt dwelling on disappointment that is behind so much anxiety and depression:
“We exist as a story we tell ourselves about ourselves, and for some people, that organization leads to neurotic unhappiness,” manifesting in anxiety, depression, or addiction. With LSD treatment, the mind’s organizational structures “come offline. This story you tell about yourself gets disorganized.”
McKenzie interviews Anthony Tennyson, co-founder and CEO of Awakn Life Sciences, which is in a stage three trial of ketamine as an alcohol use disorder treatment. Tennyson reports that Awakn’s Phase II trial “led to an average of 86% abstinence over the six months following treatment versus 2% prior to the trial.” Those are game-changing statistics in the long history of treating alcoholism.
The picture is not as clear as those numbers might appear. Awakn’s Phase II trial of ketamine for alcohol use disorder included “psychological therapy” in the form of “mindfulness-based relapse prevention.” The study showed “a possible beneficial effect of adding psychological therapy alongside ketamine treatment.” In the end, however:
There was no significant difference in relapse rate between the ketamine and placebo groups.
Among other drugs being tested for opioid use disorder, the psychedelic ibogaine has shown anecdotal results in the reduction of withdrawal symptoms and drug cravings. One of the companies in Phase II ibogaine trials is atai Life Sciences, which calls itself “a platform for innovation and accelerating mental healthcare solutions.” Their website lists six current clinical trials for drugs including psilocybin, DMT, and MDMA as well as ibogaine.
More research has been done on psilocybin than any of the other drugs. McKenzie spends considerable time discussing the latest developments in psilocybin research with one of the leading authorities in the field, Albert Garia-Romeu, associate director of the Center for Psychedelic and Consciousness Research at Johns Hopkins University. The Center’s 2006 publication “on the safety and enduring positive effects of a single dose of psilocybin is widely considered the landmark study that sparked a renewal of psychedelic research world-wide,” according to the Center’s website.
The Center’s research focuses largely on mental health disorders, including substance use disorders, eating disorders, and obsessive-compulsive disorders. The website offers dozens of studies, many involving psilocybin, such as:
- Psilocybin and Smoking Cessation
- Psilocybin and Alzheimer’s Disease
- Psilocybin and Buprenorphine for Opioid Use Disorder
- Effects of Psilocybin in Obsessive-Compulsive Disorder
McKenzie also reports on some of the negative results of using psychedelics for mental health disorders. The drugs can induce “feelings of anxiety and fear, existential struggle and social disconnection.” The fact that they are disorienting is both a reason that they work and a reason that they don’t work for some people.
The difficulty of getting approval to do research with psychedelics means we are a long way from understanding exactly how these potent chemical compounds interface with addiction. We look forward to reporting on the results of these trials at AddictionNews.
Written by Steve O’Keefe. First published June 20, 2024.
Sources:
“Psychedelic Therapies Could Soon Break Through Against Addiction,” BioSpace, June 10, 2024.
“Adjunctive Ketamine With Relapse Prevention–Based Psychological Therapy in the Treatment of Alcohol Use Disorder,” American Journal of Psychiatry, January 2022.
Image courtesy rawpixel, used under Public Domain.