Use of Psychedelics in Therapy for Drug Addiction
The contemporary treatments for addiction often demonstrate moderate effectiveness. In particular, twelve-step programs provide minimal influence on substance dependence. Damage reduction approaches demonstrate more positive effects than addiction treatment. For example, “needle exchanges and supervised injection places” helped to enhance morbidity rates. The methadone programs and naloxone kits also allowed reducing the number of deaths within the drug-addicted population. However, these damage reduction approaches do not address the addiction problem and only prevent negative outcomes of substance abuse. The possible solution of this issue is introducing psychedelics into therapy. Although this treatment option is understudied, it has already been indicated as useful for various substance addictions. Thus, the psychedelics therapy proved its effectiveness in treating patients with dependence on crack, cocaine, heroin and cannabis. Even small doses of psychedelics lead to outstanding long-term effects. Furthermore, the distinctive feature of the psychedelics therapy is that it is safe and non-addictive.
The theories about effects of psychedelics vary. Early studies of psychedelics were generally focused on their spiritual effects. For example, it was found that LSD is helpful for treating addictions because it can create “high spiritual experiences” in patients. However, the current investigations indicate that psychedelics have the “therapeutic mechanisms of action”. These mechanisms have both biological and psychological character. Bogenschuts and Pommy offered a hierarchical model for analyzing therapeutic influences of psychedelics. This model included acute and persisting influences. All these effects were followed by final change impacts of therapy. Acute influences were subdivided into biological and psychological groups while persisting influences involved some alterations in mood, personality, and cognition. However, the most outstanding outcome of psychedelics therapy is that it does reduce cravings and enhances the well-being of a patient. Even one-nine sessions with psychedelics allow reaching abstinence rate of 61% within the next six months after completing the treatment. Introducing of psychedelics into therapy of drug addiction would significantly improve the quality of such treatment due to numerous biological and psychological effects of the drugs, including activation of glutamate receptors and changes in perception, cognition and mood.
Biological and Psychological Effects of Psychedelics
According to the model of Bogenschut and Pommy, all therapeutic effects can be divided into acute and persisting ones. Acute influences also have two categories, such as biological and psychological groups. Persisting influences involve some alterations in “personality, cognition, mood, anxiety, and neuroplasticity. Acute and persisting influences are followed by reduced craving and self-efficacy. Acute influences are the most important in the therapy of action because they serve the beginning of recovery. The biological category of acute effects is characterized by the influence of hallucinogens on human brains. Although there are three classes of hallucinogens, they all have similar effects on human body. They operate by “agonist action of 5-HT2A receptors”. Besides, the studies found that 5-HT2A stops the subjective influences of psilocybin in people. Phenylethylamies are selective for 5-HT2 and 5-H2T1 receptors, while indoleamines are quite non-selective for these receptors. When the postsynaptic 5-HT2A receptions are affected, it causes the release of glutamate in cells of the deeps layers of the prefrontal cortex. Then these processes lead to the activation of AMPA and NMDA glutamate receptors, what results in the changed perception and mood.
The psychological influences of psychedelics therapy include alterations in perception. For example, individuals start to see hallucinogens. Patients also experience changes in body sensation; particularly they can suffer from headache or nausea. Another typical effect is specific cognition. For example, patients demonstrate metaphysical thinking or distance from the real world. Besides, some individuals face such changes of mood as euphoria or lability. All these psychological effects of the drugs can be also subdivided into psychological insight and mystical experience. Psychedelic therapy requires high doses of the drugs to reach a mystical experience. Such approach differs from the principles of psycholytic therapy, which normally uses small doses of drugs because therapists believe that unconscious powers of the psyche can result in functional deficits, while insight in the following powers decreases their ruinous influences. The possible benefit from using hallucinogens in therapy is their ability to improve recollection. For example, a functional magnetic resonance imaging research found that taking psilocybin causes “cortical activations from memory cues”. The memory was also brighter after using psilocybin. The trauma model has another viewpoint on the psychological insight. In particular, the model claims that trauma develops from improper analysis of the occasion. Therefore, exposure therapy for post-traumatic stress disorder concentrates on having the patient return to the traumatic situation. In addition, health providers keep the necessary degree of “emotional involvement and sympathetic activation”. Patients taking psychedelics have reduced fear level and increased cognitive processing. Thus, models that apply drugs aim to solve some psychological conflicts.
“Mystical experience” is also helpful in therapy for drug addiction. The term “mystical experience” means that the person reaches transcendence, meaningfulness and vivid spiritual experiences. The study of patients with cancer revealed that hallucinogens helped them deal with existential anxiety. Such effect of drugs is achieved due to their specific influence on human consciousness. According to MRI scans, these drugs make changes in the work of the brains so that people can see dreamlike hallucinations. Thus, the data is processed not only at the back of the head (visual cortex) but also in many other brain centers. Individuals start viewing images from their imagination rather from the external environment. Another specific feature of hallucinations caused by psychedelics is they are more complex than hallucinations without any drugs. People taking drugs also experience change in the quality of the consciousness. This is explained by different way of performing functions in the human brains. In particular, the brain normally has networks, which work separately. For example, there are networks, which are responsible for vision, movement, hearing or attention. Under psychedelics, these networks begin to work together, so people have a more unified perception of reality. Moreover, they experience the deep modified state of consciousness, which is often called “ego-dissolution”. During this state, the common sense of self is destroyed. Instead, the person experiences the sense of connecting with himself/herself, others human beings and nature. These new perceptions are typically called thinking in a religious/spiritual way. They seem to lead to enhancing of well-being after taking psychedelics.
Mystical experience is important in addiction treatment because spirituality plays one of major roles. Thus, religiosity prevents drug addictions formation. Overall, there are three typical reasons, which encourage a person to fight his/her addiction, such as reaching rock bottom, facing a traumatic situation and experiencing a spiritual awakening. Although a spiritual link is an evident reason, other two situations are also connected with the meaningfulness element of spirituality. The thing is that the addiction is often a result of a person to escape the reality. When the person reaches the rock bottom or experiences some traumatic situation, he/she cannot deny the truth anymore. At last, focus on spirituality is a type of treatment that allows increasing the duration of abstinence. In fact, psychedelics do help addicted people to change, since they make a person face the acute moment of insight. Patients taking drugs during their therapy return to their suppressed memories and detect experiences, which can modify their behavior and treat the addiction.
In addition, brains become less restricted and stereotypical. They start to resemble the brains of infants that are free and unrestricted. The mind becomes more emotional and imaginative. These alterations are also probably connected with destroying “ego-dissolution” and common work of networks in the human brains. In the early age, the person does not set many limits between own ego and the outside world. Therefore, cooperative work of different brains centers leads to more emotional, flexible and imaginative mind as well as improving relationships with others. The person after taking psychedelics becomes like a child.
In conclusion, psychedelics involve acute and persisting therapeutic effects in addiction treatment, which are followed by reducing of patients’ dependence on drugs and self-efficacy. Acute effects include biological and psychological components. Thus, psychedelics provoke the activation of AMPA and NMDA glutamate receptors, what results in the changed perception and mood. Besides, the substances cause psychological insight and mystical experience. Patients’ memory enhances due to cortical activation from memory cues so that individuals improve their ability of recollection. Psychedelics are also applied for returning patients to past traumatic events, which allow addressing some causes of addictions. In addition, patients are characterized by the deep alteration of their consciousness. This happens because psychedelics change the work of networks in the brain. Normally, there are networks that are responsible for specific functions, such attention or vision. Under drugs, the networks work together, so humans obtain a more unified perception of reality. While the deep modified state of consciousness (or “ego-dissolution”), the person feels reconnecting with self, other people and nature.