Experience with psychedelic drugs is associated with decreased risk of opioid abuse and dependence. Conversely, other illicit drug use history is largely associated with increased risk of opioid abuse and dependence. These findings suggest that psychedelics are associated with positive psychological characteristics and are consistent with prior reports suggesting efficacy in treatment of substance use disorders.

Among respondents with a history of illicit opioid use, psychedelic drug use is associated with 27% reduced risk of past year opioid dependence (weighted risk ratio = 0.73 (0.60–0.89) p = 0.002) and 40% reduced risk of past year opioid abuse (weighted risk ratio = 0.60 (0.41–0.86) p = 0.006). Other than marijuana use, which was associated with 55% reduced risk of past year opioid abuse (weighted risk ratio = 0.45 (0.30–0.66) p < 0.001), no other illicit drug was associated with reduced risk of past year opioid dependence or abuse.

While controlling for socio-demographic covariates and the use of other substances, the relationship between classic psychedelic use and past year opioid use disorders was analyzed within 44,000 illicit opioid users who completed the National Survey on Drug Use and Health from 2008 to 2013.

Preliminary studies show psychedelic compounds administered with psychotherapy are potentially effective and durable substance misuse interventions. However, little is known about the association between psychedelic use and substance misuse in the general population. This study investigated the association between psychedelic use and past year opioid use disorders within illicit opioid users.

References

Abrams, DI, Couey, P, Shade, SB. ( 2011 ) Cannabinoid-opioid interaction in chronic pain . Clin Pharmacol Ther 90: 844 – 851 .

Google Scholar Crossref | Medline | ISI

Abuzzahab, FS, Anderson, BJ ( 1971 ) A review of LSD treatment in alcoholism . Int Pharmacopsychiatry 6: 223 – 235 .

Google Scholar Crossref | Medline

Amato, L, Minozzi, S, Davoli, M. ( 2011 ) Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification . Cochrane Database Syst Rev: CD005031.

Google Scholar Crossref

Bachhuber, MA, Saloner, B, Cunningham, CO. ( 2014 ) Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999–2010 . JAMA Intern Med 174: 1668 – 1673 .

Google Scholar Crossref | Medline | ISI

Ballantyne, JC, Mao, J ( 2003 ) Opioid therapy for chronic pain . N Engl J Med 349: 1943 – 1953 .

Google Scholar Crossref | Medline | ISI

Berger, M, Gray, JA, Roth, BL ( 2009 ) The expanded biology of serotonin . Annu Rev Med 60: 355 – 366 .

Google Scholar Crossref | Medline | ISI

Bogenschutz, MP, Forcehimes, AA, Pommy, JA. ( 2015 ) Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study . J Psychopharmacol 29: 289 – 299 .

Google Scholar SAGE Journals | ISI

Buckholtz, N, Freedman, D, Middaugh, L ( 1985 ) Daily LSD administration selectively decreases serotonin 2 receptor binding in rat brain . Eur J Pharmacol 109: 421 – 425 .

Google Scholar Crossref | Medline | ISI

Buckholtz, N, Zhou, D, Freedman, D. ( 1990 ) Lysergic acid diethylamide (LSD) administration selectively downregulates serotonin2 receptors in rat brain . Neuropsychopharmacology 3: 137 – 148 .

Google Scholar Medline | ISI

Dart, RC, Surratt, HL, Cicero, TJ. ( 2015 ) Trends in opioid analgesic abuse and mortality in the United States . N Engl J Med 372: 241 – 248 .

Google Scholar Crossref | Medline | ISI

Frokjaer, VG, Mortensen, EL, Nielsen, FA. ( 2008 ) Frontolimbic serotonin 2A receptor binding in healthy subjects is associated with personality risk factors for affective disorder . Biol Psychiatry 63: 569 – 576 .

Google Scholar Crossref | Medline | ISI

Gasser, P, Kirchner, K, Passie, T ( 2015 ) LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects . J Psychopharmacol 29: 57 – 68 .

Google Scholar SAGE Journals | ISI

Grob, CS, Danforth, AL, Chopra, GS. ( 2011 ) Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer . Arch Gen Psychiatry 68: 71 – 78 .

Google Scholar Crossref | Medline

Grof, S, Soskin, RA, Richards, WA. ( 1973 ) DPT as an adjunct in psychotherapy of alcoholics . Int Pharmacopsychiatry 8: 104 – 115 .

Google Scholar Crossref | Medline

Halpern, JH ( 1996 ) The use of hallucinogens in the treatment of addiction . Addict Res 4: 177 – 189 .

Google Scholar Crossref | ISI

Halpern, J, Sherwood, A, Passie, T. ( 2008 ) Evidence of health and safety in American members of a religion who use a hallucinogenic sacrament . Med Sci Monit 14: SR15 – 22 .

Google Scholar Medline | ISI

Haug, NA, Sorensen, JL, Lollo, ND. ( 2005 ) Gender differences among HIV-positive methadone maintenance patients enrolled in a medication adherence trial . AIDS Care 17: 1022 – 1029 .

Google Scholar Crossref | Medline

Hendricks, PS, Clark, CB, Johnson, MW. ( 2014 ) Hallucinogen use predicts reduced recidivism among substance-involved offenders under community corrections supervision . J Psychopharmacol 28: 62 – 66 .

Google Scholar SAGE Journals | ISI

Hendricks, PS, Thorne, CB, Clark, CB. ( 2015 ) Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population . J Psychopharmacol 29: 280 – 288 .

Google Scholar SAGE Journals | ISI

Hser, YI, Evans, E, Huang, D. ( 2016 ) Long-term outcomes after randomization to buprenorphine/naloxone versus methadone in a multi-site trial . Addiction 111: 695 – 705 .

Google Scholar Crossref | Medline

Jann, M, Slade, J ( 2007 ) Antidepressant agents for the treatment of chronic pain and depression . Pharmacotherapy 27: 1571 – 1587 .

Google Scholar Crossref | Medline

Johnson, M, Richards, W, Griffiths, R ( 2008 ) Human hallucinogen research: Guidelines for safety . J Psychopharmacol 22: 603 – 620 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Garcia-Romeu, A, Cosimano, MP. ( 2014 ) Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction . J Psychopharmacol 28: 983 – 992 .

Google Scholar SAGE Journals | ISI

Johnston, LD, O’Malley, PM, Bachman, JG. ( 2008 ) Monitoring the Future National Survey Results on Drug Use, 1975–2007: Volume II, College Students and Adults Ages 19–45. Bethesda : National Institute on Drug Abuse .

Google Scholar

Lerner, M, Lyvers, M ( 2006 ) Values and beliefs of psychedelic drug users: A cross-cultural study . J Psychoactive Drugs 38: 143 – 147 .

Google Scholar Crossref | Medline | ISI

Leysen, J, Janssen, P, Niemegreers, C ( 1989 ) Rapid desensitization and down-regulation of 5-HT2 receptors by DOM treatment . Eur J Pharmacol 163: 145 – 149 .

Google Scholar Crossref | Medline | ISI

Li, JX, Koek, W, Rice, KC. ( 2011 ) Effects of direct- and indirect-acting serotonin receptor agonists on the antinociceptive and discriminative stimulus effects of morphine in rhesus monkeys . Neuropsychopharmacology 36: 940 – 949 .

Google Scholar Crossref | Medline

Lu, L, Su, W, Yue, W. ( 2001 ) Attenuation of morphine dependence and withdrawal in rats by venlafaxine, a serotonin and noradrenaline reuptake inhibitor . Lifesciences 69: 37 – 46 .

Google Scholar Crossref

McCabe, SE, Cranford, JA, West, BT ( 2008 ) Trends in prescription drug abuse and dependence, co-occurrence with other substance use disorders, and treatment utilization: Results from two national surveys . Addict Behav 33: 1297 – 1305 .

Google Scholar Crossref | Medline | ISI

Mattick, RP, Breen, C, Kimber, J. ( 2009 ) Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence . Cochrane Database Syst Rev: CD002209.

Google Scholar Crossref | Medline

Mattick, RP, Breen, C, Kimber, J. ( 2014 ) Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence . Cochrane Database Syst Rev: CD002207.

Google Scholar Crossref | Medline

Minozzi, S, Amato, L, Vecchi, S. ( 2011 ) Oral naltrexone maintenance treatment for opioid dependence . Cochrane Database Syst Rev: CD001333.

Google Scholar Crossref

Mithoefer, MC, Wagner, MT, Mithoefer, AT. ( 2011 ) The safety and efficacy of {+/-}3, 4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: The first randomized controlled pilot study . J Psychopharmacol 25: 439 – 452 .

Google Scholar SAGE Journals

Muller, CP, Homberg, JR ( 2015 ) The role of serotonin in drug use and addiction . Behav Brain Res 277: 146 – 192 .

Google Scholar Crossref | Medline | ISI

Nichols, DE ( 2004 ) Hallucinogens . Pharmacol Ther 101: 131 – 181 .

Google Scholar Crossref | Medline | ISI

Nour, MM, Evans, L, Nutt, D. ( 2016 ) Ego-dissolution and psychedelics: Validation of the Ego-Dissolution Inventory (EDI) . Front Hum Neurosci 10: 269 .

Google Scholar Crossref | Medline | ISI

Obata, H, Saito, S, Sasaki, M. ( 2001 ) Antiallodynic effect of intrathecally administered 5-HT2 agonists in rats with nerve ligation . Pain 90: 173 – 179 .

Google Scholar Crossref | Medline

Oehen, P, Traber, R, Widmer, V. ( 2013 ) A randomized, controlled pilot study of MDMA (+/- 3, 4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD) . J Psychopharmacol 27: 40 – 52 .

Google Scholar SAGE Journals

Palamar, JJ, Salomone, A, Vincenti, M. ( 2016 ) Detection of “bath salts” and other novel psychoactive substances in hair samples of ecstasy/MDMA/“Molly” users . Drug and Alcohol Dependence 161: 200 – 205 .

Google Scholar Crossref | Medline

Pugh, G, Smith, PB, Dombrowski, DS. ( 1996 ) The role of endogenous opioids in enhancing the antinociception produced by the combination of delta 9-tetrahydrocannabinol and morphine in the spinal cord . J Pharmacol Exp Ther 279: 606 – 616 .

Google Scholar

Rasic, D, Robinson, JA, Bolton, J. ( 2011 ) Longitudinal relationships of religious worship attendance and spirituality with major depression, anxiety disorders, and suicidal ideation and attempts: Findings from the Baltimore epidemiologic catchment area study . J Psychiatr Res 45: 848 – 854 .

Google Scholar Crossref | Medline

Ross, S ( 2012 ) Serotonergic hallucinogens and emerging targets for addiction pharmacotherapies . Psychiatr Clin North Am 35: 357 – 374 .

Google Scholar Crossref | Medline | ISI

Savage, C, McCabe, OL ( 1973 ) Residential psychedelic (LSD) therapy for the narcotic addict . Arch Gen Psychiatry 28: 808 – 814 .

Google Scholar Crossref | Medline

Savage, C, Savage, E, Fadiman, J. ( 1964 ) LSD: Therapeutic effects of the psychedelic experience . Psychol Reports 14: 111 – 120 .

Google Scholar SAGE Journals

Sinha, R, Li, CS ( 2007 ) Imaging stress- and cue-induced drug and alcohol craving: association with relapse and clinical implications . Drug Alcohol Rev 26: 25 – 31 .

Google Scholar Crossref | Medline | ISI

Thomas, G, Lucas, P, Capler, NR. ( 2013 ) Ayahuasca-assiSted therapy for addiction: Results from a preliminary observational study in Canada . Curr Drug Abuse Rev 6: 1 – 13 .

Google Scholar Crossref | Medline

United States Department of Health and Human Services ( 2014 ) Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. Rockville : Substance Abuse and Mental Health Services Administration .

Google Scholar

United States Department of Health and Human Services ( 2009 ) National Survey of Drug Use and Health, 2008. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. Ann Arbor : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services ( 2010 ) National Survey of Drug Use and Health, 2009. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. Ann Arbor : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services ( 2011 ) National Survey of Drug Use and Health, 2010. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. Ann Arbor : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services ( 2012 ) National Survey of Drug Use and Health, 2011. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. Ann Arbor : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services ( 2013 ) National Survey of Drug Use and Health, 2012. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. Ann Arbor : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services ( 2014 ) National Survey of Drug Use and Health, 2013. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. Ann Arbor : Inter-university Consortium for Political and Social Research .

Google Scholar

Van den Brink, W, Haasen, C ( 2006 ) Evidenced-based treatment of opioid-dependent patients . Can J Psychiatry 51: 635 – 646 .

Google Scholar SAGE Journals | ISI

Wedham, EF, Bigelow, GE, Johnson, RE. ( 2007 ) QT-interval effects of methadone, levomethadyl and buprenorphine in a randomized trial . Arch Intern Med 167: 2469 – 2475 .

Google Scholar Crossref | Medline