Psychedelic therapy is a technique that involves the use of psychedelic substances to aid the therapeutic process. Hallucinogenic substances have been used in holistic medicine and for spiritual practices by various cultures for thousands of years.
Research on the use of psychedelics flourished during the 1950s and 1960s until such substances were made illegal in the U.S. While psychedelic drugs such as LSD and psilocybin are still illegal in the U.S., they are believed to have the potential for the treatment of a range of conditions including anxiety, depression, and addiction.
Over the last two decades, researchers have gotten approval from authorities to conduct trials on the use of these substances to treat various conditions. What researchers have found is that psychedelic substances can have beneficial therapeutic effects.
When utilized under supervision in a carefully controlled setting, these substances can produce lasting and significant psychological and behavioral changes.
History of Psychedelic Therapy
Throughout human history, people have used various plants and seeds containing psychedelic substances to induce spiritual experiences. Scientific explorations into the therapeutic uses of psychedelics did not emerge until the discovery of the hallucinogenic properties of LSD.
After this discovery in the 1940s, researchers began exploring the potential of such substances to have therapeutic effects. During the 1950s and 1960s, psychedelic compounds, particularly lysergic acid diethylamide LSD and psilocybin (also known as “magic mushrooms”), were studied for their therapeutic potential including the treatment of alcoholism.
Such substances were given to thousands of patients and researchers published numerous findings detailing the effects and possible uses for these drugs.1
This work was halted when the U.S. passed the Controlled Substances Act (CSA) in 1970. The act classified LSD and similar substances as Schedule I substances. Schedule I substances are those that possess “significant potential for abuse and dependence” and have “no recognized medicinal value.”2 By classifying these Schedule I substances, the federal government made them illegal for all purposes.
Despite this, some people continue to explore the therapeutic potential of psychedelics and there has been an increased interest in recent years.
Interest and further research were rekindled in 2006 when scientists received approval to give psilocybin to participants and found that not only was the substance safe, it could produce significant positive effects on well-being.3
The Effects of Psychedelics
While psychedelics have the potential to help treat a number of mental health conditions, it is important to remember that these are powerful substances that can produce profound mind-altering effects.
These drugs are believed to work by affecting the neural circuits that use the neurotransmitter serotonin. Some of the effects of psychedelics include:
- Seeing, hearing, or sensing things that one would otherwise not experience
- Feelings of relaxation
- Distortions of reality
- Spiritual experiences
- Distorted perceptual experiences
- Altered sense of time
- Intense perceptions or emotions
According to the National Institute on Drug Abuse, these effects are a type of drug-induced psychosis that affects a person’s ability to communicate with others, think rationally, and interpret reality.4
After taking psychedelic substances, people often have mystical or spiritual experiences. They often describe having feelings of peace, joy, unity, and empathy.
Psychedelics can also produce physiological effects such as increased heart rate, sweating, nausea, agitation, increased blood pressure, and other various effects that may differ depending on the substance that is ingested.
The effects that a person experiences can be unpredictable and can vary depending on the amount of the substance that is used as well as the individual’s personality, mood, and surroundings.4
The use of psychedelics can also result in what is known as a “bad trip.” These experiences are marked by intense and terrifying feelings of anxiety and the fear of losing control.
Substances Used in Psychedelic Therapy
There are a number of different types of substances that can have psychedelic effects. Some common psychedelic substance and their uses include:
This brew originating in South America is purported to help with addiction, anxiety, and depression. Possible side effects of Ayahuasca include serotonin syndrome and medication interactions.
This substance can lead to altered mood, perception, and consciousness. Potential uses include the treatment of addiction and anxiety.
Like LSD, psilocybin alters consciousness, mood, and perceptions. It is being studied for its use in the treatment of addiction, anxiety, and depression.
While not a classic psychedelic substance, MDMA (ecstasy) is a drug that produces “psychedelic effects” including feelings of euphoria, altered perceptions, increased arousal, and increased sociability. Research suggests it has therapeutic potential in the treatment of post-traumatic stress disorder (PTSD).5
What Can It Treat?
Researchers have uncovered a number of potential applications for psychedelic therapy. Studies have found that anxiety, depression, substance use, alcohol use, and PTSD may all respond positively to psychedelic-assisted treatments.
Anxiety and Mood Disorders
Psychedelics appear to have potential mood benefits that may be helpful in the treatment of depression. A 2016 randomized double-blind controlled trial found that psilocybin treatment led to significant reductions in anxiety and depression in patients undergoing cancer treatment.6
Psilocybin-assisted therapy was also associated with increased quality of life, improved optimism, and reduced anxiety over mortality. About 80% of participants continued to show improvements six months later.
“When administered under psychologically supportive, double-blind conditions, a single dose of psilocybin produced substantial and enduring decreases in depressed mood and anxiety along with increases in quality of life and decreases in death anxiety in patients with a life-threatening cancer diagnosis,” the authors of the study concluded.6
Another study looked at the effects of real-world psychedelic use by surveying music festival attendees. The participants reported that taking LSD and psilocybin helped improve mood and feel more socially connected. They also reported that these effects continued even after the drugs had worn off.7
Alcohol and Substance Use Disorders
Early research showed strong evidence that LSD could help in the recovery from substance use conditions.8 Some more recent evidence also supports the idea that psychedelic therapy holds promise as an addiction treatment. A 2015 study found that psilocybin-assisted therapy was associated with decreased drinking, reduced alcohol cravings, and increased abstinence.9
One 2019 study involved surveying people who had already quit using alcohol with the use of psychedelics. While only 10% of the respondents used psychedelics intentionally as a way to reduce alcohol use, more than 25% reported that the hallucinogenic experience played a role in changing their alcohol use.10
It is important to note, however, that studies such as this are based on self-reports by people who have taken psychedelics in the past. In order to determine if psychedelic therapy is truly effective in the treatment of alcohol and substance use disorders, more research using randomized clinical trials is needed.
It is important to note that the effects on alcohol and substance use have not yet been proven or disproven. One 2012 study found that a single dose of LSD had a beneficial effect on alcohol misuse up to six months after treatment, the effects were not significant at the 12-month mark.11
Post-Traumatic Stress Disorder (PTSD)
Research also suggests that MDMA-assisted psychotherapy may be useful in the treatment of post-traumatic stress disorder (PTSD). MDMA is best known as the main ingredient in the club drugs ecstasy (or molly), but it also has psychedelic effects that have been shown to be useful for severe forms of PTSD that have not responded to other forms of treatment.
Clinical trials have demonstrated the treatment’s long-term efficacy in the treatment of PTSD. One study found that 54% of participants no longer met the criteria for diagnosis following treatment.12 Only 23% of participants in the control group no longer met the diagnostic criteria upon follow up.
The benefits also appear to be long-lasting—68% of those in the MDMA-assisted therapy treatment did not meet the diagnostic criteria for PTSD a year after treatment.
How Psychedelic Therapy Works
Because there is no standardized method of administration and practice, individual practitioners have their own methods for administering psychedelic therapy. However, there are often a few common elements:
- Administration of a low to moderate dose of a psychedelic drug.
- Supervision by a professional during the psychedelic experience.
- Repeating the psychedelic dose with one to two weeks between sessions.
During a psychedelic session, factors known as set and setting are critical. Set refers to things such as mood and expectations. Setting refers to the environment where the session takes place and the relationship with the therapist. The goal is to be comfortable with the therapist and the room where the session will take place. It is also important to go into the experience feeling calm and attentive.
After the psychedelic experience, the focus at the next step is a process known as integration. These psychotherapy sessions are designed to help the individual process, make sense of, and find meaning in the psychedelic experience.
One variation of psychedelic therapy is known as microdosing, which involves taking very small, sub-hallucinogenic doses of psychedelic substances. Proponents of microdosing suggest that even these very low doses can have beneficial health effects such as enhancing performance, increasing energy, and decreasing depression.
While there is some evidence that microdosing may have some beneficial effects, more research is needed.
While psychedelic therapy is generally considered safe and well-tolerated, there are some potential risks and adverse effects to consider. The classic psychedelics such as LSD and psilocybin pose few risks in terms of physical or psychological dependence. Some possible risks include:
Negative psychological reactions
The potential for psychological risks such as the possibility of a “bad trip” and symptoms of anxiety, panic, and paranoia is something to consider.
Possible personality changes
Some have suggested that these drugs have the potential to produce long-term mind-altering, personality-changing effects.
For example, one study found that psilocybin therapy was associated with increases in extraversion and openness.13 This suggests that people may become more outgoing and willing to try new things after being treated with psilocybin-assisted therapy.
Dangers of self-treatment
Another potential concern is the possibility of people using psychedelic substances to self-treat. This can pose a number of risks including the psychological dangers of experiencing a bad trip, the possibility of drug interactions, and the fact that many street-drugs are mixed with unknown substances.
Never try to self-treat with psychedelics. In clinical settings, people are given a specified, pure dose, are supervised during the psychedelic experience, and receive professional help from a therapist to integrate the experience.
The Future of Psychedelic Therapy
In 2019, John Hopkins University launched a center dedicated to researching the effects of psychedelics. The Center for Psychedelic and Consciousness research is exploring how psychedelics such as psilocybin can be used to treat conditions such as addiction and Alzheimer’s disease.
Also in 2019, the U.S. Food and Drug Administration (FDA) named psilocybin-assisted therapy as a “breakthrough therapy.” This designation is designed to speed up the development and review of drugs that preliminary clinical trials have indicated treat serious conditions.14
Currently, clinical trials into the use of LSD and psilocybin as treatments for alcohol dependence,9 anxiety, and depression are underway.
Some of these studies are currently in phase II and set to move on to phase III in the near future. Phase II of a clinical trial focuses on determining if a treatment works, while phase III focuses on determining if a treatment works better than what is already currently available.15
A Word From Verywell
Psychedelic therapy shows a great deal of promise in the treatment of a wide variety of mental health conditions including addiction and depression. While further research is needed, current trials are underway to better determine the applications and effectiveness of using different psychedelic drugs to treat specific conditions.
It is also important to note that while psychedelic therapy has demonstrated that it can be helpful in the treatment of a number of conditions, researchers are still exploring the exact mechanisms of action. Further research will allow scientists to figure out which drugs are most helpful for specific conditions, what doses should be used, and when such treatments should be avoided.
If you are interested in trying psychedelic therapy, signing up for a research trial is an option. You can search for clinical trials that are recruiting participants at clinicaltrials.gov. The Multidisciplinary Association for Psychedelic Studies (MAPS) and the John Hopkins Center for Psychedelic and Consciousness Research may also sponsor research and trials that are accepting participants.