Novel Treatment Approaches for Substance Use Disorders: Therapeutic Use of Psychedelics and the Role of Psychotherapy

Abstract Purpose of Review The use of psychedelics in a therapeutical setting has been reported for the treatment of various diagnoses in recent years. However, as psychedelic substances are still commonly known for their (illicit) recreational use, it may seem counterintuitive to use psychedelic therapy to treat substance use disorders. This review aims to discuss how psychedelics can promote and intensify psychotherapeutic key processes, in different approaches like psychodynamic and cognitive behavioral therapy, with a spotlight on the treatment of substance use disorders (SUD). Recent Findings There is promising evidence of feasibility, safety, and efficacy of psychedelic therapy in SUD. In the whole process of former and current psychedelic therapy regimes that have shown to be safe and efficacious, various psychotherapeutic elements, both psychodynamic and behavioral as well as other approaches, can be identified, while a substantial part of the assumed mechanism of action, the individual psychedelic experience, cannot be distinctly classified to just one approach. Summary Psychedelic therapy consists of a complex interaction of pharmacological and psychological processes. When administered in well-defined conditions, psychedelics can serve as augmentation of different psychotherapy interventions in the treatment of SUD and other mental disorders, regardless of their theoretical origin.

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Neuroimmune Mechanisms as Novel Treatment Targets for Substance Use Disorders and Associated Comorbidities

Frontiers in Neuroscience ◽

10.3389/fnins.2021.650785 ◽

2021 ◽

Vol 15 ◽

Author(s):

Mark D. Namba ◽

Jonna M. Leyrer-Jackson ◽

Erin K. Nagy ◽

M. Foster Olive ◽

Janet L. Neisewander

Keyword(s):

Substance Abuse ◽

Substance Use ◽

Nervous System ◽

Synaptic Plasticity ◽

Substance Use Disorders ◽

Immune Signaling ◽

Treatment Targets ◽

Novel Treatment ◽

The Brain

Recent studies examining the neurobiology of substance abuse have revealed a significant role of neuroimmune signaling as a mechanism through which drugs of abuse induce aberrant changes in synaptic plasticity and contribute to substance abuse-related behaviors. Immune signaling within the brain and the periphery critically regulates homeostasis of the nervous system. Perturbations in immune signaling can induce neuroinflammation or immunosuppression, which dysregulate nervous system function including neural processes associated with substance use disorders (SUDs). In this review, we discuss the literature that demonstrates a role of neuroimmune signaling in regulating learning, memory, and synaptic plasticity, emphasizing specific cytokine signaling within the central nervous system. We then highlight recent preclinical studies, within the last 5 years when possible, that have identified immune mechanisms within the brain and the periphery associated with addiction-related behaviors. Findings thus far underscore the need for future investigations into the clinical potential of immunopharmacology as a novel approach toward treating SUDs. Considering the high prevalence rate of comorbidities among those with SUDs, we also discuss neuroimmune mechanisms of common comorbidities associated with SUDs and highlight potentially novel treatment targets for these comorbid conditions. We argue that immunopharmacology represents a novel frontier in the development of new pharmacotherapies that promote long-term abstinence from drug use and minimize the detrimental impact of SUD comorbidities on patient health and treatment outcomes.

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The Role of Different Aspects of Impulsivity as Independent Risk Factors for Substance Use Disorders in Patients with ADHD: A Review

Current Drug Abuse Reviews ◽

10.2174/1874473708666150916112913 ◽

2015 ◽

Vol 8 (2) ◽

pp. 119-133 ◽

Cited By ~ 24

Author(s):

Slobodin Ortal ◽

van de Glind Geurt ◽

Franck Johan ◽

Berger Itai ◽

Yachin Nir ◽

...

Keyword(s):

Risk Factors ◽

Substance Use ◽

Substance Use Disorders ◽

Independent Risk Factors

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The Profound Heterogeneity of Substance Use Disorders: Implications for Treatment Development

Current Directions in Psychological Science ◽

10.1177/09637214211026984 ◽

2021 ◽

pp. 096372142110269

Author(s):

Kathleen M. Carroll

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Behavioral Therapy ◽

Full Range ◽

Treatment Development ◽

Computer Based Training ◽

Tailored Interventions ◽

Effective Interventions ◽

Computer Based ◽

Disorder Type

A single treatment approach will never be sufficient to address the diversity of individuals with substance use disorders (SUDs). SUDs have historically defied definition through simple characterizations or models, and no single characterization has led to the development of broadly effective interventions. The range of dimensions of heterogeneity among individuals with SUDs, including severity of the disorder, type of substance, and issues that frequently co-occur, underscores the need for highly tailored approaches. Personalized medicine for individuals with SUDs will require two major developments. First, given the diversity of individuals with SUDs, multivariate phenotyping is needed to identify the particular features driving addictive processes in a given individual. Second, a wider range of interventions that directly target core mechanisms of addiction and the problems that co-occur with them is needed. As clinicians cannot be expected to master the full range of interventions that may target these core processes, developing interventions that can be delivered easily, flexibly, and systematically via technology will facilitate the ability to truly tailor them to this highly complex and challenging population. One such technology-delivered intervention, Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT), is used as an example to illustrate a vision for the future of highly tailored interventions for individuals with SUDs.

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