Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Am J Drug Alcohol Abuse. 2013 Sep;39(5):291-7. doi: 10.3109/00952990.2013.811513.
Current treatments for addiction are frequently ineffective. Hallucinogenic therapy has been indicated as helpful for a range of substance use disorders, yet this approach remains understudied and publicly unavailable. It is nonetheless a promising treatment, which has significant, long-term beneficial effects with single doses and a profile characterized by general safety, low toxicity, and non-addictiveness. However, pharmacological interventions, such as hallucinogens, should not be offered if the same effects (e.g. psychological insights/mystical experiences) and outcomes (e.g. decreased drug use) could be achieved absent pharmacological intervention. To date, there have been no clinical comparisons of drug-induced altered states with non-drug-induced states for addiction treatment. We propose and then outline a clinical trial to address this gap in knowledge. The proposed design would evaluate abstinence outcomes in a population of prescription opioid abusers after exposure to one of three conditions: a drug-induced altered state using psilocybin, a non-drug-induced altered state via hyperventilation (Holotropic Breathwork), and an active placebo with niacin. The outcomes of such a study would reveal important differences in therapeutic potential by discriminating hallucinogen-dependent effects from those psychological effects resulting from altered states.
目前针对成瘾的治疗方法往往效果不佳。致幻疗法已被证明对多种物质使用障碍有帮助，但这种方法仍研究不足，公众也无法获得。尽管如此，它仍是一种很有前途的治疗方法，单次用药就有显著的、长期的有益效果，且具有总体安全性、低毒性和非成瘾性等特点。然而，如果可以通过非药物干预获得相同的效果（例如心理洞察力/神秘体验）和结果（例如减少药物使用），则不应提供药理学干预，例如致幻剂。迄今为止，还没有关于药物诱导的改变状态与非药物诱导的改变状态对成瘾治疗的临床比较。我们提出并概述了一项临床试验，以填补这一知识空白。拟议的设计将在接受以下三种条件之一的处方类阿片类药物滥用者人群中评估戒断结果：使用裸盖菇素诱导的药物改变状态、通过过度通气诱导的非药物改变状态（Holotropic Breathwork），以及烟酸的活性安慰剂。这样的研究结果将通过区分致幻剂依赖的效果与改变状态产生的心理效果，揭示出治疗潜力的重要差异。
