Dr Mary Hornick – Dr Ashley Stefanski | Exploring the Potential of Hallucinogens for Treating Opioid Use Disorder

However, prohibition and stigma surrounding these substances have hampered scientific research into their therapeutic use. In a recent article, Drs. Mary Hornick and Ashley Stefanski at Roosevelt University appraised the current evidence for hallucinogen use in opioid use disorder, and discussed future perspectives.

The researchers began by discussing the multifaceted nature of opioid use disorder, which involves a host of socioeconomic and psychological factors, from legal and financial troubles to severe mental health issues and relationship problems.

Given this complex pathology, a treatment encompassing a range of effects may have significant potential. Hallucinogens may represent such a treatment, as they can rapidly induce neuroplasticity that may lead to long-term changes in a patient’s behavior and outlook. The personal insights that occur during treatment with hallucinogens also contribute to positive psychological effects.

The researchers discuss a variety of hallucinogenic substances, their mechanisms of action, evidence for efficacy and safety issues. For instance, ibogaine is a compound derived from the root bark of an African shrub, which induces a dream-like state. As discovered by recreational users in the 1960s, ibogaine can reduce opioid withdrawals and enable long-term abstinence.

Another drug they discuss is ketamine, an anesthetic primarily used in veterinary medicine. Multiple doses of ketamine alongside psychotherapy resulted in 50% of patients remaining opioid-free after 1 year.

Classic psychedelic drugs, including LSD, ayahuasca and psilocybin, are also covered in the article. These compounds produce altered states of consciousness and rapid neuroplasticity, with subsequent brain changes that can reduce the tendency for addictive behaviors.

Hornick and Stefanski suggest that hallucinogens have significant promise in treating opioid use disorder, even in patients with treatment-resistant addiction issues. However, prohibition and stigma are key stumbling blocks to progress. There is a clear need for further robust research to establish the potential and safety of these drugs, and a change in their legal status may be required to achieve this.