Using of Psilocybin for Treating Substance Use Disorders

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The World Health Organization has revealed that about 11.8 million people worldwide suffer from illegal drug dependence [1]. It is endemic in the urban and rural populace, while there are question marks about Substance use disorders (SUD). They can be treated through psychotherapy and pharmacotherapy.

However, the effectiveness of these techniques is partial at best. About 50-60% of patients suffer a relapse in 6-12 months [2]. Other methods of treatment are being investigated. The use of hallucinogens to combat SUDs is an avenue that has been a ray of sunshine in limited trials. They can provide the desired results but come with their own issues.

Impact of hallucinogens

Hallucinogens agents like LSD and psilocybin have anti-craving properties and can be used to combat SUDs. Specifically, psilocybin has been used in human studies on alcohol and smoking addiction. Positive results have been witnessed on substance use, especially with respect to low risk of toxicity and dependence [3]. The caveat remains that these trials have been conducted under controlled clinical conditions.

They have been effectively used to alleviate alcohol and nicotine dependence but there are issues concerning their long plasma half-life (14 h), periods where strict medical supervision is necessary. This has medical and financial implications, making it a difficult practical treatment to implement.

The treatment process has to take into consideration the basis of SUDs, which are founded on brain reward, motivation, and memory processes. Any treatment that is presented should tackle the reward system that is of imperative concern [4]. It should also take into examination neurotransmitter systems including but not limited to dopamine (DA), serotonin, and corticotropin-releasing factor (CRF).

The DA system is of chief concern as substance abuse leads to higher levels of DA. While serotonin impacts the reward processing of the brain. Alongside LSD, psilocybin can help counter the neurological impacts of these addictive drugs [5]. They can prove to be anti-SUD but their abuse for recreation led to qualms about their adoption in treatment.

Psilocybin for addiction treatment

While popular stigma continues to haunt LSD, psilocybin has gained popularity. It is naturally found in mushrooms, and a single dose can result in a positive attitude and behavioral changes [6]. It also has significant results with an impact on binge drinking days and tobacco dependence. Studies have shown that 80% of individuals quit smoking within 6-months.

The outcomes recorded have been attributed to changes in attitudes towards the future, and preference of long-term benefits for immediate desires. Individuals also suggested that their exposure to psilocybin also improved strengthened their self-belief to quit [7]. However, this body of research is not definitive and there is a need for follow-up research on relapse rates.

Psilocybin use for emotional impact

For SUDs, psilocybin acts on neural 5-HT2A and 5-HT1A receptors. This impacts the emotional and cognitive processes to alleviate the individual from SUD impact. Psilocybin’s anti-addictive properties along with its positive impact on emotional states and stress make it perfect for patients with SUD [8]. This is also why its low-dosage use in terminal cancer patients has proven to reduce anxiety.

Psilocybin has proven is not a new phenomenon and its use can be dated back several millennia across the globe. It is still ritually used across cultures and can be purchased in its organic form. Truffles are a rich source for psilocybin and can be purchased online.

However, its use as medication was curtailed in 1970, thirteen years after its introduction. In the late 1990s, experimental research was kickstarted given its low toxicity levels. This has allowed for its sale and it can be purchased online.

Side-effects of psilocybin

Research has shown that side-effects of psilocybin use are primarily dependent on personal expectations. The circumstances in which psilocybin is administered also has an impact on the individuals. Test cases in clinical trials proved to be emotionally excitable but did not reveal psychological issues [9].

However, this can result in altered perceptions and subjects are prone to dangerous behaviors in the first 12-14 hours. To combat this, proper discourse on its impact should be given to individuals before administration. [10]It should also be ensured that the subject is given a safe environment to thrive to alleviate excitable side-effects.

Unsupervised high dose use can lead to LSD-overdose-like effects.

Hyperthermia, respiratory failure, or even coma are likely consequences in high plasma levels. There are two reported fatalities from psilocybin overdose[11].


Citation:

Bas T.H. de Veen, Arnt F.A. Schellekens, Michel M.M. Verheij & Judith R. Homberg (2017) Psilocybin for treating substance use disorders?, Expert Review of Neurotherapeutics, 17:2, 203-212, DOI: 10.1080/14737175.2016.1220834
References:

  1. Degenhardt L, Whiteford HA, Ferrari AJ, et al. Global burden of disease attributable to illicit drug use and dependence: findings from the global burden of disease study 2010. Lancet. 2013;382(9904):1564–1574
  2. Cornelius JR, Maisto SA, Pollock NK, et al. Rapid relapse generally follows treatment for substance use disorders among adolescents. Addict Behav. 2003;28(2):381–386.
  3. Nichols DE. Hallucinogens. Pharmacol Ther. 2004;101(2):131–181.
  4. American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders, fifth edition. 5th ed.
  5. Volkow ND, Li T-K. Science and society – Drug addiction: the neurobiology of behaviour gone awry. Nat Rev Neurosci. 2004;5(12):963–970.
  6. MacLean KA, Johnson MW, Griffiths RR. Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness. J Psychopharmacol. 2011;25(11):1453–1461.
  7. You I-J, Wright SR, Garcia-Garcia AL, et al. 5-HT1A autoreceptors in the dorsal raphe nucleus convey vulnerability to compulsive cocaine seeking. Neuropsychopharmacology. 2016;41(5):1210–1222.
  8. Furr A, Lapiz-Bluhm MD, Morilak DA. 5-HT2A receptors in the orbitofrontal cortex facilitate reversal learning and contribute to the beneficial cognitive effects of chronic citalopram treatment in rats. Int J Neuropsychopharmacol. 2012;15(9):1295–1305.
  9. Studerus E, Gamma A, Kometer M, et al. Prediction of psilocy-bin response in healthy volunteers. PLoS One. 2012;7(2):e30800.
  10. Johnson MW, Richards WA, Griffiths RR. Human hallucinogen research: guidelines for safety. J Psychopharmacol. 2008;22(6):603–620.
  11. Lim TH, Wasywich CA, Ruygrok PN. A fatal case of ‘magic mushroom’ ingestion in a heart transplant recipient. Intern Med J. 2012;42(11):1268–1269.

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