Psychedelic-Assisted Therapy

It is a fairly old practice going back at least to the 1950s, but research into this area was stymied for decades due to restrictive legislation.

What Is Psychedelic-Assisted Therapy?

Psychedelic-assisted therapy (PAT) combines the power of psychedelic substances like psilocybin, MDMA, or LSD with psychotherapy. In an editorial published in The Lancet, writers say that this type of therapy is typically used to treat post-traumatic stress disorder and treatment-resistant depression.[7]

Psychedelic-assisted therapy typically moves quickly. People take medications under the supervision of a provider, and they then attend sessions to discuss the experience and what it meant to the person.

A traditional therapy process moves more slowly. Doctors use treatments like cognitive behavioral therapy (CBT) or exposure therapy to help their clients build skills and process difficult emotions. Therapists might use FDA-approved medications to correct imbalances within their patients, but some may not need pharmaceutical help.

Some people stay in traditional therapy for just a few months, but others work with their counselors for years. During that time, people may never take medications in front of their counselors, but they may still use them regularly to help keep their symptoms under control.

Psychedelic-Assisted Therapy: A Timeline

In the 1950s, doctors started using psychedelic medications like LSD within their practices. Researchers estimate that tens of thousands of patients got treatment with medications within the following 15 years.[1]

By the mid-1960s, interest in medications like LSD had cooled. Doctors stopped using these therapies with their patients as they became harder to get due to changing drug rules.[1]

In the mid-1990s, interest in psychedelic therapy began again due to research done in Germany. As clinicians published details about their work, others got interested in replicating their successes.[1]

By the early 2020s, researchers published studies about the safety of studies like psilocybin and LSD. Research continued, and it is driving the interest we see in the field today.[1]

What Drugs Are Used for This Form of Therapy?

A wide variety of drugs are being tested and researched for their potential use in therapy, with some of the most commonly researched drugs being MDMA, psilocybin, LSD, and ketamine.[3] However, research into LSD and ketamine seems to be more limited due to LSD’s long-lasting effects and ketamine’s fairly intense effects. 

Many of these drugs are classified as Schedule I substances by the U.S. Drug Enforcement Agency. That means they’re illegal on the federal level.[10] However, the U.S. Food and Drug Administration released draft guidance to help people perform ethical research on these medications with their patients.[11] Experts believe these medications might be legal within the next few years, depending on the results of these studies.[10]

It’s important to understand that this research is very much in its experimental stages. While human studies are being conducted and these drugs seem to be able to help a variety of mental health symptoms when used in a controlled environment as prescribed by a medical professional, some specifics are still evolving areas of research, such as proper dosing and which drugs work best for which issues.[3] 

How Does the Process Work for Psychedelic-Assisted Therapy?

While the use of psychedelics in therapy is continually evolving as new research emerges, it is pretty firmly established that several elements are important to this type of treatment, including setting the right expectations for a patient, setting the physical environment the patient will be in so that it facilitates therapy and a sense of safety, and developing a healthy clinician-patient relationship.[4] 

This type of treatment also isn’t for everyone. Researchers generally focus on a patient’s resistance to traditional therapy. Treatment-resistant patients with chronic mental illnesses are at least for now the focus of many studies. These people don’t have many alternatives, and it is thus more justifiable to attempt experimental treatments on these patients (with their consent).[4]

This therapy is psychedelic-assisted. A patient doesn’t take psychedelic drugs in the same way one might take an antibiotic. Instead, a patient takes the drug and is then guided in such a way as to help them confront unwanted symptoms. The exact form this guided therapy takes will depend on the specific issues being tackled. 

Psychedelic-assisted therapy sessions are also generally only part of a given treatment plan. Therapy sessions in which no drugs are used are also typically used even when psychedelic-assisted treatment is employed.[4]

How Successful Has This Form of Therapy Been?

Studies into psychedelic-assisted therapy have been promising, often showing an ability to treat mental health symptoms with few adverse outcomes.[5] Some issues psychedelic drugs have shown promise in treating include anxiety, PTSD, and addiction. However, most studies highlighting these promising results will emphasize that this research is still relatively nascent, and more is needed before this type of therapy can ethically be made mainstream. For now, it remains experimental. 

In a study of 27 people using psilocybin-assisted psychotherapy for depression, 71% had a clinically significant response four weeks after a single dose, while 54% achieved remission from depression during the same period.[8]

In a randomized study of 20 people with a history of PTSD lasting about 19 years, people used MDMA along with therapy. They found that PTSD symptoms, as clinically measured, were reduced by 83% in those who got the treatment, while only 25% of people using the placebo drug got the same result.[4]

Overall, it seems very likely that research is going to continue refining what the ideal type of psychedelic-assisted treatment looks like and that we will continue to see patients benefit from this type of treatment with few adverse outcomes. It will not be a “magic bullet” treatment capable of treating all forms of mental illness, but it may help certain people with specific conditions.

What Are the Risks of Psychedelic-Assisted Therapy?

The current risks of psychedelic-assisted therapy are mostly unknowns. We still don’t fully know the best dosing or the ideal drugs to use when it comes to addressing various mental health issues. There may be hidden risks the research hasn’t yet uncovered, especially regarding the long-term use of this therapy.

In research on MDMA safety conducted with healthy volunteers, researchers found that serious issues like high blood pressure, fast heartbeat, and high body temperature occurred in about a third of cases. Researchers say the drug has been administered to more than 100 volunteers in neuroscientific research and to another 100 in clinical studies.[9]

In research on psilocybin, some people develop a moderate increase in blood pressure, and others have headaches.[9]

A study examining survey respondents who reported using LSD, psilocybin, mescaline, and/or peyote did not find any significant association between psychedelic use and negative mental health outcomes. It found some cases where psychedelic use seemed to reduce a person’s rate of mental health problems.[6]

Again, this research is in its early stages. More is needed before experts can definitively conclude that this practice is safe enough for widespread use.

Evidence-Based Care at Boca Recovery Center

Since so much is unknown about psychedelic-assisted therapy, it’s not considered an evidence-based treatment for addiction or mental health issues at this time. At Boca Recovery Center, we employ evidence-based care, including the use of medications and various therapeutic modalities to effectively manage addiction for the long term. Contact us to learn more about our addiction treatment offerings and our tailored treatment plans.