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Levin AW, Lancelotta R, Sepeda ND, Gukasyan N, Nayak S, Wagener TL, Barrett FS, Griffiths RR, Davis AK. The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial for major depressive disorder. PLoS One 2024; 19:e0300501. [PMID: 38483940 PMCID: PMC10939230 DOI: 10.1371/journal.pone.0300501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
We examined if the therapeutic alliance between study participants and intervention facilitators in a psilocybin-assisted therapy (PAT) trial changed over time and whether there were relationships between alliance, acute psilocybin experiences, and depression outcomes. In a randomized, waiting list-controlled clinical trial for major depressive disorder in adults (N = 24), participants were randomized to an immediate (N = 13) or delayed (N = 11) condition with two oral doses of psilocybin (20mg/70kg and 30mg/70kg). Ratings of therapeutic alliance significantly increased from the final preparation session to one-week post-intervention (p = .03, d = .43). A stronger total alliance at the final preparation session predicted depression scores at 4 weeks (r = -.65, p = .002), 6 months (r = -.47, p = .036), and 12 months (r = -.54, p = .014) post-intervention. A stronger total alliance in the final preparation session was correlated with higher peak ratings of mystical experiences (r = .49, p = .027) and psychological insight (r = .52, p = .040), and peak ratings of mystical experience and psychological insight were correlated with depression scores at 4 weeks (r = -.45, p = .030 for mystical; r = -.75, p < .001 for insight). Stronger total alliance one week after the final psilocybin session predicted depression scores at 4 weeks (r = -.85, p < .001), 3 months (r = -.52, p = .010), 6 months (r = -.77, p < .001), and 12 months (r = -.61, p = .001) post-intervention. These findings highlight the importance of the therapeutic relationship in PAT. Future research should explore therapist and participant characteristics which maximize the therapeutic alliance and evaluate its relationship to treatment outcomes. Trial registration: Registration: Clinicaltrials.gov NCT03181529. https://classic.clinicaltrials.gov/ct2/show/NCT03181529.
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Affiliation(s)
- Adam W. Levin
- The Ohio State University, Center for Psychedelic Drug Research and Education, Columbus, Ohio, United States of America
- Department of Psychiatry, The Ohio State University, Columbus, Ohio, United States of America
| | - Rafaelle Lancelotta
- The Ohio State University, Center for Psychedelic Drug Research and Education, Columbus, Ohio, United States of America
| | - Nathan D. Sepeda
- The Ohio State University, Center for Psychedelic Drug Research and Education, Columbus, Ohio, United States of America
- Johns Hopkins University, Center for Psychedelic and Consciousness Research, Baltimore, Maryland, United States of America
| | - Natalie Gukasyan
- Johns Hopkins University, Center for Psychedelic and Consciousness Research, Baltimore, Maryland, United States of America
| | - Sandeep Nayak
- Johns Hopkins University, Center for Psychedelic and Consciousness Research, Baltimore, Maryland, United States of America
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Department of Internal Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Frederick S. Barrett
- Johns Hopkins University, Center for Psychedelic and Consciousness Research, Baltimore, Maryland, United States of America
| | - Roland R. Griffiths
- Johns Hopkins University, Center for Psychedelic and Consciousness Research, Baltimore, Maryland, United States of America
| | - Alan K. Davis
- The Ohio State University, Center for Psychedelic Drug Research and Education, Columbus, Ohio, United States of America
- Johns Hopkins University, Center for Psychedelic and Consciousness Research, Baltimore, Maryland, United States of America
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Armstrong SB, Xin Y, Sepeda ND, Polanco M, Averill LA, Davis AK. Prospective associations of psychedelic treatment for co-occurring alcohol misuse and posttraumatic stress symptoms among United States Special Operations Forces Veterans. Mil Psychol 2024; 36:184-191. [PMID: 38377244 PMCID: PMC10880491 DOI: 10.1080/08995605.2022.2156200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/30/2022] [Indexed: 02/05/2023]
Abstract
This study evaluated prospective associations of ibogaine and 5-MeO-DMT treatment for risky alcohol use and post-traumatic stress disorder (PTSD) symptoms among United States (US) Special Operations Forces Veterans (SOFV). Data were collected during standard clinical operations at pre-treatment and 1-month (1 m), 3-months (3 m), and 6-months (6 m) post-treatment in an ibogaine and 5-MeO-DMT treatment program in Mexico. Of the 86 SOFV that completed treatment, 45 met criteria for risky alcohol use at pre-treatment (mean age = 44; male = 100%; White = 91%). There was a significant reduction in alcohol use from pre-treatment (M = 7.2, SD = 2.3) to 1 m (M = 3.6; SD = 3.5) post-treatment, which remained reduced through 6 m (M = 4.0; SD = 2.9; p < .001, partial eta squared = .617). At 1 m, 24% were abstinent, 33% were non-risky drinking, and 42% were risky drinkers. At 6 m, 16% were abstinent, 31% were non-risky drinking, and 53% were risky drinkers. There were no differences between responders (abstinent/non-risky drinkers) and non-responders (risky drinkers) in demographics/clinical characteristics. However, there were significant and very large differences between responders and non-responders in PTSD symptom (p < .01, d = -3.26) and cognitive functioning change (p < .01, d = -0.99). Given these findings, future clinical trials should determine whether psychedelic-assisted therapy holds promise for individuals with complex trauma and alcohol misuse who have not been successfully treated with traditional interventions.
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Affiliation(s)
- Stacey B. Armstrong
- Center for Psychedelic Drug Research and Education, The Ohio State University, Columbus, Ohio
| | - Yitong Xin
- Center for Psychedelic Drug Research and Education, The Ohio State University, Columbus, Ohio
| | - Nathan D. Sepeda
- Center for Psychedelic Drug Research and Education, The Ohio State University, Columbus, Ohio
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, Maryland
| | | | - Lynnette A. Averill
- US Department of Veterans Affairs, Michael E. DeBakey Veterans Administration Medical Center, Houston, TX, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alan K. Davis
- Center for Psychedelic Drug Research and Education, The Ohio State University, Columbus, Ohio
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, Maryland
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Aday JS, Bloesch EK, Davis AK, Domoff SE, Scherr K, Woolley JD, Davoli CC. Effects of Ayahuasca on Gratitude and Relationships with Nature: A Prospective, Naturalistic Study. J Psychoactive Drugs 2024:1-10. [PMID: 38310541 DOI: 10.1080/02791072.2024.2312980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024]
Abstract
Qualitative studies and anecdotal reports suggest that experiences with ayahuasca, a psychedelic brew found in Central and South America, may be followed by individuals enduringly feeling more grateful and connected to nature. Yet, to date, these changes have been understudied. Here, participants (N = 54) completed validated surveys related to gratitude, nature relatedness, and nature appreciation one-week before, one-week after, and one-month after attending an ayahuasca retreat center. Compared to baseline, there was a significant increase in gratitude, nature relatedness, and nature appreciation at the one-week and one-month follow-ups. Ratings of mystical-type experiences and awe, but not ego dissolution, during participants' ayahuasca sessions were weakly-to-moderately correlated with these increases. The number of ayahuasca ceremonies attended at the retreat was not related to change in outcomes, underscoring the importance of the quality rather than the quantity of the experiences in post-acute change. Lastly, participant age was negatively related to the occurrence of mystical-type experiences and awe, supporting literature indicating blunted psychedelic effects with increased age. In the context of study limitations, the results suggest that mystical-type experiences and awe occasioned by ayahuasca may be linked to prosocial changes in gratitude and relationships with nature that may be beneficial to mental health.
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Affiliation(s)
- Jacob S Aday
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
- Translational Psychedelic Research (TrPR) Program, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Michigan Psychedelic Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Emily K Bloesch
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, US
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah E Domoff
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Kyle Scherr
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Josh D Woolley
- Translational Psychedelic Research (TrPR) Program, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
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Davis AK, Arterberry BJ, Xin Y, Hubbard SM, Schwarting CM, Bonar EE. Incremental Predictive Validity of the Dualistic Model of Passion for Cannabis Use Among College Undergraduate Students With and Without a Cannabis Use Disorder. Cannabis 2023; 6:105-126. [PMID: 38035170 PMCID: PMC10683744 DOI: 10.26828/cannabis/2023/000180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Introduction We examined whether the Dualistic Model of Passion (DMP; i.e., obsessive passion [OP] and harmonious passion [HP]) for cannabis use was prospectively associated with cannabis use and use-related outcomes, and with academic performance, relationship attachment style, and social connectedness among college students. We also explored whether the DMP was associated with outcomes when included in a model using established constructs (e.g., coping motives, refusal self-efficacy, cannabis use disorder [CUD] symptoms) as predictors of cannabis use and outcomes. Methods Using a longitudinal cohort design (baseline, 5-month, 10-month [timepoints chosen to better correspond to 9-month academic year]), 513 undergraduate students from two universities who reported using cannabis at least four times in the past month completed a baseline survey (308 meeting criteria for CUD). We used Generalized Estimating Equations to assess longitudinal associations between OP/HP and cannabis use and academic/social outcomes at 5-month and 10-month. Results At baseline, participants were young adults (Mean age = 20.57, SD = 2.51), 78.8% non-Hispanic, 83.8% White, 55.0% female, and 72.3% heterosexual. Greater HP was not associated with greater past month cannabis use or cannabis-related problems. Greater OP was associated with greater past month cannabis use and more cannabis-related problems. There were no significant passion by time interactions. Greater HP was associated with more anxious attachment. OP was associated with less social connection. Conclusion This research suggests that the DMP provides novel information about factors associated with cannabis use and use-related consequences, which can aid in our understanding of cannabis use, misuse, and CUD among college students.
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Affiliation(s)
- Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University. Columbus, OH USA
- Institute for Population Research, University of Michigan, Ann Arbor, MI USA
| | - Brooke J Arterberry
- Institute for Population Research, University of Michigan, Ann Arbor, MI USA
- Department of Psychology, Iowa State University, Ames, IA USA
| | - Yitong Xin
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University. Columbus, OH USA
| | | | | | - Erin E Bonar
- University of Michigan - Department of Psychiatry; Ann Arbor, MI, USA
- University of Michigan - Addiction Center; Ann Arbor, MI, USA
- University of Michigan - Injury Prevention Center; Ann Arbor, MI, USA
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Simonsson O, Carlbring P, Carhart-Harris R, Davis AK, Nutt DJ, Griffiths RR, Erritzoe D, Goldberg SB. Assessing the risk of symptom worsening in psilocybin-assisted therapy for depression: A systematic review and individual participant data meta-analysis. Psychiatry Res 2023; 327:115349. [PMID: 37523886 PMCID: PMC10528683 DOI: 10.1016/j.psychres.2023.115349] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/09/2023] [Accepted: 07/16/2023] [Indexed: 08/02/2023]
Abstract
We conducted a meta-analysis using individual participant data from three, two-dose psilocybin trials for depression (N = 102) with the aim of assessing the risk of symptom worsening. Clinically significant symptom worsening occurred for a minority of participants in the psilocybin and escitalopram conditions (∼10%) and for a majority of participants in the waitlist condition (63.6%). Using data from the two trials with control arms, the psilocybin arm showed a lower likelihood of symptom worsening versus waitlist, and no difference in the likelihood of symptom worsening versus escitalopram. The limitation of a relatively small sample size should be addressed in future studies.
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Affiliation(s)
- Otto Simonsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Norra Stationsgatan 69, Stockholm 113 64, Sweden; Department of Sociology, University of Oxford, Oxford, United Kingdom.
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Robin Carhart-Harris
- Neuroscape Psychedelics Division, Department of Neurology, University of California San Francisco, San Francisco, CA, United States; Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, United States; Department of Psychiatry, The Ohio State University, Columbus, OH, United States; Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - David J Nutt
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
| | - David Erritzoe
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin, Madison, WI, United States
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Hyzak KA, Bunger AC, Bogner J, Davis AK, Corrigan JD. Implementing traumatic brain injury screening in behavioral health treatment settings: results of an explanatory sequential mixed-methods investigation. Implement Sci 2023; 18:35. [PMID: 37587532 PMCID: PMC10428542 DOI: 10.1186/s13012-023-01289-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a complex condition common among individuals treated in behavioral healthcare, but TBI screening has not been adopted in these settings which can affect optimal clinical decision-making. Integrating evidence-based practices that address complex health comorbidities into behavioral healthcare settings remains understudied in implementation science, limited by few studies using theory-driven hypotheses to disentangle relationships between proximal and medial indicators on distal implementation outcomes. Grounded in the Theory of Planned Behavior, we examined providers' attitudes, perceived behavioral control (PBC), subjective norms, and intentions to adopt The Ohio State University TBI Identification Method (OSU TBI-ID) in behavioral healthcare settings. METHODS We used an explanatory sequential mixed-methods design. In Phase I, 215 providers from 25 organizations in the USA completed training introducing the OSU TBI-ID, followed by a survey assessing attitudes, PBC, norms, and intentions to screen for TBI. After 1 month, providers completed another survey assessing the number of TBI screens conducted. Data were analyzed using structural equation modeling (SEM) with logistic regressions. In Phase II, 20 providers were purposively selected for semi-structured interviews to expand on SEM results. Qualitative data were analyzed using thematic analysis, integrated with quantitative results, and combined into joint displays. RESULTS Only 25% (55/215) of providers adopted TBI screening, which was driven by motivations to trial the intervention. Providers who reported more favorable attitudes (OR: 0.67, p < .001) and greater subjective norms (OR: 0.12, p < .001) toward TBI screening demonstrated increased odds of intention to screen, which resulted in greater TBI screening adoption (OR: 0.30; p < .01). PBC did not affect intentions or adoption. Providers explained that although TBI screening can improve diagnostic and clinical decision-making, they discussed that additional training, leadership engagement, and state-level mandates are needed to increase the widespread, systematic uptake of TBI screening. CONCLUSIONS This study advances implementation science by using theory-driven hypothesis testing to disentangle proximal and medial indicators at the provider level on TBI screening adoption. Our mixed-methods approach added in-depth contextualization and illuminated additional multilevel determinants affecting intervention adoption, which guides a more precise selection of implementation strategies.
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Affiliation(s)
- Kathryn A Hyzak
- Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus, OH, 43210-1234, USA.
| | - Alicia C Bunger
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Jennifer Bogner
- Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus, OH, 43210-1234, USA
| | - Alan K Davis
- College of Social Work, The Ohio State University, Columbus, OH, USA
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University Baltimore, Baltimore, MD, USA
- Department of Psychiatry, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - John D Corrigan
- Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus, OH, 43210-1234, USA
- Ohio Valley Center for Brain Injury Prevention and Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Philyaw-Kotov ML, Walton MA, Brenneman B, Gleckman-Krut M, Davis AK, Bonar EE. What undergraduates want in campus sexual assault prevention programming: Findings from a formative research study. J Am Coll Health 2023; 71:1879-1886. [PMID: 34292853 PMCID: PMC8788217 DOI: 10.1080/07448481.2021.1950161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 05/03/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Campus sexual assault (SA) prevention programs are widely implemented, despite few having strong empirical support. To inform the development and refinement of prevention programs, we collected pilot qualitative data to capture undergraduates' perspectives regarding desirable program characteristics. PARTICIPANTS Undergraduates completed an audio-taped interview (n = 19) or a focus group (n = 16) in June - November 2016. METHODS We double-coded transcripts for a priori and emerging themes using NVivo 11. A third coder resolved disagreements; we assessed intercoder reliability using Cohen's Kappa. RESULTS Participants preferred SA prevention programming to be delivered in-person to small, coed groups of unfamiliar students. Students preferred programming with peer-facilitated, candid conversation about SA outcomes and prevention strategies. Participants also preferred for the tone of these training sessions to match the serious subject matter. CONCLUSIONS Students' perceptions of desirable program characteristics differ somewhat from current evidence-based programs in several ways, highlighting important future directions for SA prevention research.
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Affiliation(s)
- Meredith L. Philyaw-Kotov
- University of Michigan Addiction Center and Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
| | - Maureen A. Walton
- University of Michigan Addiction Center and Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, Michigan, 48109
| | - Brianne Brenneman
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, Michigan, 48109
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan 48109
| | - Miriam Gleckman-Krut
- University of Michigan Department of Sociology, 3115 LSA Building, 500 S. State Street, Ann Arbor, Michigan, 48109
| | - Alan K. Davis
- University of Michigan Addiction Center and Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, Maryland, 21224
| | - Erin E. Bonar
- University of Michigan Addiction Center and Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, Michigan, 48109
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Davis AK, Timmermann C, Ortiz Bernal AM, Lancelotta R, Nayak S, Sepeda ND, Nikolaidis A, Griffiths RR. Translation and Initial Psychometric Evaluation of Spanish Versions of Three Psychedelic Acute Effects Measures: Mystical, Challenging, and Insight Experiences. J Psychoactive Drugs 2023:1-11. [PMID: 37449499 DOI: 10.1080/02791072.2023.2232379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/10/2023] [Accepted: 05/04/2023] [Indexed: 07/18/2023]
Abstract
This study translated and tested the psychometric properties of acute psychedelic effects measures among Spanish-speaking people. The Psychological Insight Questionnaire (PIQ), Challenging Experiences Questionnaire (CEQ), and Mystical Experiences Questionnaire (MEQ) were translated before being incorporated into a web-based survey. We recruited native Spanish-speakers (N = 442; Mage = 30.8, SD = 10.9; Latino/Latina = 62%; Hispanic = 91.4%; male = 71.5%) to assess their previous experience with one of two psychedelics (LSD = 58.4%; Psilocybin = 41.6%) and their acute and enduring effects. Confirmatory factor analysis (confirming factor structure based on the English version) revealed a good fit for the MEQ, PIQ and the CEQ. Repeating our analysis in each drug subsample revealed consistency in factor structure for each assessment tool. Construct validity was supported by significant positive associations between the PIQ and MEQ, and between the PIQ and MEQ and changes in cognitive fusion and negative associations between changes in prosocial behaviors. As a signal of predictive validity, persisting effects (PEQ) were strongly related to scores on the MEQ and PIQ. Findings demonstrate that the Spanish versions of these measures can be reliably employed in studies of psychedelic use or administration in Spanish-speaking populations.
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Affiliation(s)
- Alan K Davis
- College of Social Work, The Ohio State University - Center for Psychedelic Drug Research and Education, Columbus, Ohio, USA
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
| | | | - Ana Maria Ortiz Bernal
- Department of Human Development and Family Studies, University of Wisconsin-Madison - School of Human Ecology, Madison, Wisconsin, USA
| | - Rafaelle Lancelotta
- College of Social Work, The Ohio State University - Center for Psychedelic Drug Research and Education, Columbus, Ohio, USA
| | - Sandeep Nayak
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
| | - Nathan D Sepeda
- College of Social Work, The Ohio State University - Center for Psychedelic Drug Research and Education, Columbus, Ohio, USA
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
| | - Aki Nikolaidis
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Roland R Griffiths
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
- Johns Hopkins University - Department of Neuroscience
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Haeny AM, Lopez JA, Colón Grigas PA, Crouch MC, Davis AK, Williams M. Investigating the associations of acute psychedelic experiences and changes in racial trauma symptoms, psychological flexibility, and substance use among People with Racial and Ethnic Minoritized Identities in the United States and Canada. J Subst Use Addict Treat 2023; 149:209035. [PMID: 37019336 DOI: 10.1016/j.josat.2023.209035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/03/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Evidence suggests that psychedelics may serve as a therapeutic approach to reduce substance use; however, people with racial and ethnic minoritized (REM) identities are often excluded from this research. We investigated whether psychedelic use affects other substance use among REM people and whether perceived changes in psychological flexibility and racial trauma mediates this association. METHODS REM people in the United States and Canada (N = 211; 32 % Black, 29 % Asian, 18 % American Indian/Indigenous Canadian, 21 % Native Hawaiian/Pacific Islander; 57 % female; mean age = 33.1, SD = 11.2) completed an online survey retrospectively reporting their substance use, psychological flexibility, and racial trauma symptoms 30 days before and after their most memorable psychedelic experience. RESULTS Analyses showed a significant perceived reduction in alcohol (p < .0001, d = 0.54) and drug use (p = .0001, d = 0.23) from before to after the psychedelic experience. Preliminary associations found perceived reductions in racial trauma symptoms were associated with perceived reductions in alcohol use and this association varied by race, dose, ethnic identity, and change in depressive symptoms. Specifically, Indigenous participants experienced greater perceived reductions in alcohol use relative to participants who identified as Asian, Black, or other. Those who took a high dose of psychedelics experienced greater perceived reductions in alcohol use relative to those who took a low dose. Participants with a stronger ethnic identity and those with a perceived reduction in depressive symptoms experienced a perceived reduction in alcohol use. Serial mediation indicated a perceived increase in psychological flexibility and reduction in racial trauma symptoms mediated the association between acute psychedelic effects and perceived reductions in alcohol and drug use. CONCLUSION These findings suggest that psychedelic experiences may contribute to an increase in psychological flexibility and reduction in racial trauma symptoms and alcohol and drug use among REM people. REM people have been largely excluded from psychedelic treatment research even though psychedelic use is considered a traditional healing practice in many communities of color. Longitudinal studies of REM people should replicate our findings.
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Affiliation(s)
- Angela M Haeny
- Yale School of Medicine, 34 Park St, New Haven, CT 06519, USA.
| | - Joel A Lopez
- University of Connecticut, Department of Psychological Sciences, 406 Unit 1020, Babbidge Rd., Storrs, CT 06269, USA
| | - Pamela A Colón Grigas
- University of Connecticut, Department of Psychological Sciences, 406 Unit 1020, Babbidge Rd., Storrs, CT 06269, USA
| | - Maria C Crouch
- Yale School of Medicine, 34 Park St, New Haven, CT 06519, USA
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, The Ohio State University, College of Social Work, 1947 College Rd N., Columbus, OH 43210, USA; The Ohio State University, Department of Psychiatry, 370 W. 9th Avenue, Columbus, OH 43210, USA; Center for Psychedelic and Consciousness Research, Johns Hopkins University, 5510 Nathan Shock Rd., Baltimore, MD, USA
| | - Monnica Williams
- University of Ottawa, Faculty of Social Sciences, 120 University Private Social Sciences Building, Ottawa, Ontario K1N 6N5, Canada
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Davis AK, Levin AW, Nagib PB, Armstrong SB, Lancelotta RL. Study protocol of an open-label proof-of-concept trial examining the safety and clinical efficacy of psilocybin-assisted therapy for veterans with PTSD. BMJ Open 2023; 13:e068884. [PMID: 37142308 PMCID: PMC10163450 DOI: 10.1136/bmjopen-2022-068884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Psilocybin-assisted therapy has shown significant promise in treating the cluster of mood and anxiety symptoms that comprise post-traumatic stress disorder (PTSD) but has yet to be tested specifically in this condition. Furthermore, current pharmacological and psychotherapeutic treatments for PTSD are difficult to tolerate and limited in efficacy, especially in the US Military Veteran (USMV) population. This open-label pilot study will examine the safety and efficacy of two psilocybin administration sessions (15 mg and 25 mg), combined with psychotherapy, among USMVs with severe, treatment resistant PTSD. METHODS AND ANALYSIS We will recruit 15 USMVs with severe, treatment resistant PTSD. Participants will receive one low dose (15 mg) and one moderate/high dose (25 mg) of psilocybin in conjunction with preparatory and post-psilocybin therapy sessions. The primary safety outcome will be the type, severity and frequency of adverse events and suicidal ideation/behaviour, as measured by the Columbia Suicide Severity Rating Scale. The primary outcome measure for PTSD will be the Clinician Administered PTSD Scale-5. The primary endpoint will be 1 month following the second psilocybin administration session, and the total follow-up time will be 6 months. ETHICS AND DISSEMINATION All participants will be required to provide written informed consent. The trial has been authorised by the Ohio State University Institutional Review Board (study number: 2022H0280). Dissemination of results will occur via a peer-reviewed publication and other relevant media. TRIAL REGISTRATION NUMBER NCT05554094.
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Affiliation(s)
- Alan K Davis
- Center for Psychedelic Drug Research and Education, The Ohio State University College of Social Work, Columbus, Ohio, USA
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Adam W Levin
- Center for Psychedelic Drug Research and Education, The Ohio State University College of Social Work, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Paul B Nagib
- Center for Psychedelic Drug Research and Education, The Ohio State University College of Social Work, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Stacey B Armstrong
- Center for Psychedelic Drug Research and Education, The Ohio State University College of Social Work, Columbus, Ohio, USA
| | - Rafaelle L Lancelotta
- Center for Psychedelic Drug Research and Education, The Ohio State University College of Social Work, Columbus, Ohio, USA
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11
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Nikolaidis A, Lancelotta R, Gukasyan N, Griffiths RR, Barrett FS, Davis AK. Subtypes of the psychedelic experience have reproducible and predictable effects on depression and anxiety symptoms. J Affect Disord 2023; 324:239-249. [PMID: 36584715 PMCID: PMC9887654 DOI: 10.1016/j.jad.2022.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/24/2022] [Accepted: 12/10/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Subjective experiences seem to play an important role in the enduring effects of psychedelic experiences. Although the importance of the subjective experience on the impact of psychedelics is frequently discussed, a more detailed understanding of the subtypes of psychedelic experiences and their associated impacts on mental health has not been well documented. METHODS In the current study, machine learning cluster analysis was used to derive three subtypes of psychedelic experience in a large (n = 985) cross sectional sample. RESULTS These subtypes are not only associated with reductions in anxiety and depression symptoms and other markers of psychological wellbeing, but the structure of these subtypes and their subsequent impact on mental health are highly reproducible across multiple psychedelic substances. LIMITATIONS Data were obtained via retrospective self-report, which does not allow for definitive conclusions about the direction of causation between baseline characteristics of respondents, qualities of subjective experience, and outcomes. CONCLUSIONS The present analysis suggests that psychedelic experiences, in particular those that are associated with enduring improvements in mental health, may be characterized by reproducible and predictable subtypes of the subjective psychedelic effects. These subtypes appear to be significantly different with respect to the baseline demographic characteristics, baseline measures of mental health, and drug type and dose. These findings also suggest that efforts to increase psychedelic associated personal and mystical insight experiences may be key to maximizing beneficial impact of clinical approaches using this treatment in their patients.
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Affiliation(s)
- Aki Nikolaidis
- Child Mind Institute, Center for the Developing Brain, United States of America
| | - Rafaelle Lancelotta
- College of Social Work, The Ohio State University, Columbus, United States of America
| | - Natalie Gukasyan
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Frederick S Barrett
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Alan K Davis
- College of Social Work, The Ohio State University, Columbus, United States of America; Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
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12
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Ching THW, Davis AK, Xin Y, Williams MT. Effects of Psychedelic Use on Racial Trauma Symptoms and Ethnic Identity among Asians in North America. J Psychoactive Drugs 2023; 55:19-29. [PMID: 35012425 DOI: 10.1080/02791072.2022.2025960] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is a need to understand ways in which Asians in North America attempt to heal from racial trauma, given their well-documented high risk of exposure and associated adverse mental health outcomes. We conducted a secondary analysis of Asians from a survey of people of color in North America who have consumed psychedelics in response to racial discrimination. Ninety-two Asian participants (Mage = 30.25, SD = 6.83) completed online questions assessing demographics, racial discrimination frequency, characteristics and acute effects of their most meaningful psychedelic experience, change in racial trauma symptoms 30 days before and after their psychedelic experience, and current ethnic identity. Participants reported improvements in racial trauma symptoms (d = 0.52). Bootstrapped mediation analyses controlling for racial discrimination frequency and psychedelic dose and duration indicated complete mediation of the link between higher intensity of insightful experiences and stronger ethnic identity, via improvements in racial trauma symptoms (indirect effect = .08, 95% CI = [.004, .19]). There was partial mediation for the independent variable of lower intensity of challenging experiences (indirect effect = -.08, 95% CI = [-.18, -.005]). This study highlights the central role of higher-intensity insightful experiences and both higher- and lower-intensity challenging experiences in alleviating racial trauma symptoms and promoting ethnic identity among Asians in North America who have experienced racial discrimination. Future research should attune to culturally relevant outcomes of psychedelic use in response to racial discrimination among Asians.
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Affiliation(s)
- Terence H W Ching
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Alan K Davis
- College of Social Work, the Ohio State University, Columbus, OH, USA.,Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yitong Xin
- College of Social Work, the Ohio State University, Columbus, OH, USA
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13
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Xin Y, Schwarting CM, Wasef MR, Davis AK. Exploring the intersectionality of stigma and substance use help-seeking behaviours among lesbian, gay, bisexual, transgender, queer, questioning or otherwise gender or sexuality minority (LGBTQ+) individuals in the United States: A scoping review. Glob Public Health 2023; 18:2277854. [PMID: 37939481 DOI: 10.1080/17441692.2023.2277854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
Problematic substance use (SU) is a significant issue among LGBTQ+ individuals, but rates of treatment/help-seeking in this population remain low. This review aimed to investigate literature about intersectional stigma of SU and LGBTQ+ identity and its impact on SU help-seeking behaviours in the U.S. Eligible studies from eight-database were included if peer-reviewed, in English, from the U.S., published between 2000 and 2022, focused on SU, stigma, SU help-seeking behaviours, among LGBTQ+ adults. Of 458 search results, 50 underwent full-text review, 12 were included in the final sample. Minority Stress Theory emerged as a relevant theoretical framework. Findings revealed that increased SU as a coping strategy was associated with minority stress. Intersectional stigma negatively impacted SU treatment experience among LGBTQ+ individuals, leading to avoidance of help-seeking or poor treatment outcomes. Patterns of SU and impact of stigma among LGBTQ+ individuals differ, wherein bisexual and transgender individuals reported significantly more treatment barriers and unique stressors. LGBTQ+ individuals reported earlier age of SU onset and were more likely to encounter opportunities for SU. This review highlights the impact of intersectional stigma on SU help-seeking behaviour among LGBTQ+ individuals in the U.S. Recommendations are provided for future clinical practice, research, and policy to better support LGBTQ+ individuals.
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Affiliation(s)
- Yitong Xin
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Corrine M Schwarting
- Department of Psychology, Psychology Department, Iowa State University, Ames, IA, USA
| | - Mary R Wasef
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
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14
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Abstract
Fibromyalgia (FM) is a difficult to treat chronic pain condition for which there is strong interest in alternative treatments. There is growing interest in the potential of psychedelic substances (e.g., psilocybin) in conjunction with psychotherapy to treat chronic pain. Via a cross-sectional, anonymous, online survey, we aimed to characterize knowledge, perceptions, and past use of serotonergic ("classic") and non-serotonergic psychedelics among a population of individuals with FM, and to investigate interest in psychedelic-based FM treatments. Among a North American population of 354 participants with FM, 29.9% reported past use of a psychedelic, with lysergic acid diethylamide (LSD) and psilocybin mushrooms being most commonly used. Perceptions of benefit from psychedelic use were generally neutral (59.4%) or positive (36.8%), with <3% reporting negative impacts on overall health or pain symptoms. Among 12 participants who used psychedelics with intentions of treating chronic pain, 11 reported improved symptoms. Regardless of past use, the majority of participants believed that psychedelics have potential for chronic pain treatments and would be willing to participate in a psychedelic-based clinical trial for their pain. These findings support the need for additional studies to understand the potential and effectiveness of psychedelic substances in managing FM symptoms.
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Affiliation(s)
- Nicolas G Glynos
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA.,Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer Pierce
- Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Alan K Davis
- College of Social Work and Department of Psychiatry, Ohio State University, Columbus, OH, USA.,Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
| | - Jenna McAfee
- Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Kevin F Boehnke
- Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, USA
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15
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Davis AK, Agin-Liebes G, España M, Pilecki B, Luoma J. Attitudes and Beliefs about the Therapeutic Use of Psychedelic Drugs among Psychologists in the United States. J Psychoactive Drugs 2022; 54:309-318. [PMID: 34468293 DOI: 10.1080/02791072.2021.1971343] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Psychologists are a vital component of mental health treatment and their perceptions of psychedelic-assisted therapy are critical for future implementation. This cross-sectional quasi-experimental electronic survey study explored the attitudes about psychedelics used in treatment among 366 clinical psychologists in the United States. Participants expressed cautiously favorable attitudes toward therapeutic psychedelic experiences but indicated concern about possible psychiatric and neurocognitive risks. Most participants indicated that they lack an understanding of the full range of effects of psychedelics, would need to seek out additional consultation, and endorsed positive beliefs in the potential of psychedelic treatment and the need for further research. Overall, this research identified the need to increase education and training about psychedelics for psychologists in order to help increase knowledge and reduce stigma about psychedelic therapies.
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Affiliation(s)
- Alan K Davis
- College of Social Work, The Ohio State University, Columbus, Ohio, USA.,Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Gabrielle Agin-Liebes
- Department of Psychiatry, University of California, San Francisco, California, USA.,Zuckerberg San Francisco General Hospital, San Francisco, USA
| | - Megan España
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
| | - Brian Pilecki
- Portland Psychotherapy Clinic, Research, & Training Center, Portland, USA
| | - Jason Luoma
- Portland Psychotherapy Clinic, Research, & Training Center, Portland, USA
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16
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Abstract
Depression is highly prevalent and represents the leading cause of global disability and primary contributor to overall global burden of disease. Several lines of evidence from early-phase experimental trials suggest that serotonergic psychedelics, particularly psilocybin, with therapeutic support show great promise in the treatment of depression with large effect sizes. Neuroimaging data have also revealed the dynamic effects of psilocybin on functional activity within and between neural regions. This chapter reviews the methods and findings from three small human laboratory clinical trials examining the effects of psilocybin therapy for patients with major depressive disorder and treatment-resistant depression. Insights from functional magnetic resonance imaging and qualitative analyses are also presented, as well as a discussion of study limitations and future directions for the research.
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Affiliation(s)
- Gabrielle Agin-Liebes
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA. .,Neuroscape, Sandler Neurosciences Center, San Francisco, CA, USA.
| | - Alan K Davis
- Department of Psychiatry, College of Social Work, The Ohio State University, Columbus, OH, USA.,Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
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17
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Levin A, Nagib PB, Deiparine S, Gao T, Mitchell J, Davis AK. Inconsistencies between national drug policy and professional beliefs about psychoactive drugs among psychiatrists in the United States. Int J Drug Policy 2022; 108:103816. [PMID: 35964449 DOI: 10.1016/j.drugpo.2022.103816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence points to an incongruence between international drug policy and expert opinion about safety, abuse potential, and therapeutic potential of specific drugs. However, no prior studies have directly explored psychiatrists' attitudes about the current drug schedule. Therefore, we examined whether American psychiatrists' perceptions of four psychoactive drugs differed from those indicated by their schedules. METHODS A quasi-experimental online survey of a convenience sample of psychiatrists in the United States (N=181; Mean age=48.7; Female=35%). Participants were randomized to receive 1-of-4 vignettes, each depicting a depressed patient reporting relief from symptoms after non-prescribed psychoactive drug use (i.e., psilocybin [Schedule I], methamphetamine [SchedII], ketamine [SchedIII], or alprazolam [SchedIV]). Participants responded to questions related to this clinical scenario and then rated the safety, therapeutic, and abuse potentials of these four drugs and alcohol. RESULTS There were significant differences by vignette condition in mean likelihood ratings of: warning against engaging in drug use again (p<.01), being concerned about developing a new psychiatric problem (p<.001), being concerned about increased suicide risk (p<.01) and being supportive of further use of this drug as part of the treatment plan (p<.001). Overall, non-prescribed use of methamphetamine and alprazolam was rated more concerning and less acceptable than non-prescribed use of psilocybin and ketamine. Compared to psilocybin and ketamine, participants rated methamphetamine and alprazolam as less safe (p<.001), having less therapeutic potential (p<.001), and having more abuse potential (p<.001). Mean ratings of safety and abuse/therapeutic potential of alprazolam and methamphetamine were equivalent to that of alcohol, and all three were rated more harmful than psilocybin and ketamine. CONCLUSION American psychiatrists' perceptions about safety and abuse/therapeutic potentials associated with certain psychoactive drugs were inconsistent with those indicated by their placement in drug schedules. These findings add to a growing consensus amongst experts that the current drug policy is not scientifically coherent.
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Affiliation(s)
- Adam Levin
- College of Medicine, The Ohio State University, Columbus, OH 43210, United States; Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH 43210, United States
| | - Paul B Nagib
- College of Medicine, The Ohio State University, Columbus, OH 43210, United States; Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH 43210, United States
| | - Selina Deiparine
- College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Thomas Gao
- College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Justin Mitchell
- College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH 43210, United States; Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD 21224, United States; College of Medicine, The Ohio State University, Columbus, OH 43210, United States.
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18
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Bonar EE, Bauermeister JA, Blow FC, Bohnert ASB, Bourque C, Coughlin LN, Davis AK, Florimbio AR, Goldstick JE, Wisnieski DM, Young SD, Walton MA. A randomized controlled trial of social media interventions for risky drinking among adolescents and emerging adults. Drug Alcohol Depend 2022; 237:109532. [PMID: 35759874 PMCID: PMC9745675 DOI: 10.1016/j.drugalcdep.2022.109532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Alcohol use among adolescents and emerging adults is an important public health issue requiring prevention approaches. Herein, we describe outcomes from a randomized controlled trial testing the efficacy of group-based social media interventions targeting risky drinking among youth. PROCEDURES Using social media advertisements to screen potential participants, we recruited 955 youth (ages 16-24) reporting recent risky drinking. After completing a baseline assessment, participants were randomized to 8-week secret Facebook group conditions: Social Media Intervention + Incentives for engagement, Social Media Intervention only, and attention-placebo control. Electronic coaches trained in motivational interviewing facilitated interaction in intervention groups. Primary outcomes include past 3-month alcohol use and consequences over 3-, 6-, and 12-month follow-ups. Secondary outcomes include other drug use, consequences, and impaired driving. We also measured intervention engagement and acceptability. RESULTS The interventions were well-received, with significantly greater acceptability ratings and engagement in the SMI+I condition relative to other groups. In adjusted analyses, there were no significant differences between interventions and control on alcohol-related outcomes, with all groups showing reductions. Regarding secondary outcomes (70.4% used other drugs), compared to control, the incentivized group reduced other drug use, consequences, and cannabis-impaired driving; the non-incentivized group did not significantly differ from the control condition. CONCLUSIONS Among this predominantly poly-substance using sample, findings were mixed, with significant effects of the incentivized social media intervention on drug (but not alcohol) outcomes. Future studies are needed to further refine social media-delivered interventions to reduce alcohol and other drug use. TRIAL REGISTRATION ClinicalTrials.gov NCT02809586; University of Michigan HUM#00102242.
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Affiliation(s)
- Erin E. Bonar
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
| | - José A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104
| | - Frederic C. Blow
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Veterans Health Administration, Center for Clinical Management Research, North Campus Research Complex, 2800 Plymouth Rd Bldg 16, Ann Arbor, MI 48109, USA
| | - Amy S. B. Bohnert
- Veterans Health Administration, Center for Clinical Management Research, North Campus Research Complex, 2800 Plymouth Rd Bldg 16, Ann Arbor, MI 48109, USA,Department of Anesthesiology, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Carrie Bourque
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Lara N. Coughlin
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
| | - Alan K. Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, 1947 College Rd, Columbus, OH 43210 USA,Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Autumn Rae Florimbio
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Jason E. Goldstick
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA,Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd Bldg 10-G080, Ann Arbor, MI 48109, USA,Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48105
| | - Diane M. Wisnieski
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Sean D. Young
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA 92697,Department of Emergency Medicine, University of California Irvine, Irvine, CA 92697
| | - Maureen A. Walton
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
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Affiliation(s)
- Kevin F. Boehnke
- Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor
| | - Alan K. Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jenna McAfee
- Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor
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20
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Davis AK, Arterberry BJ, Xin Y, Agin-Liebes G, Schwarting C, Williams MT. Race, Ethnic, and Sex Differences in Prevalence of and Trends in Hallucinogen Consumption Among Lifetime Users in the United States Between 2015 and 2019. Front Epidemiol 2022; 2:876706. [PMID: 38455323 PMCID: PMC10910982 DOI: 10.3389/fepid.2022.876706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/28/2022] [Indexed: 03/09/2024]
Abstract
Background The current study is one of the first to examine race, ethnic, and sex differences in the prevalence of and trends in hallucinogen use among lifetime users in the United States. Methods Data came from the 2015-2019 National Survey on Drug Use and Health and included respondent's reporting ever-using hallucinogens (n = 41,060; female = 40.4%). Descriptive and multinomial logistic regression analyses were conducted in Stata. Results Highest prevalence of past year hallucinogen use was among Asian females (35.06%), which was two-or-more times larger than prevalence of past year use among White males/females and Native American males. More than half of White males/females, Multiracial males, and Hispanic males reported had ever-used psilocybin or LSD, whereas less than one-quarter of Black males/females reported lifetime psilocybin use, and less than a third of Black females reported lifetime LSD use. Native American males had the lowest prevalence of lifetime MDMA use (17.62-33.30%) but had the highest lifetime prevalence of peyote use (40.37-53.24%). Pacific Islander males had the highest prevalence of lifetime mescaline use (28.27%), and lifetime DMT use was highest among Pacific Islander males/females (15.68-38.58%). Black, Asian, and Multiracial people had greater odds of past-year (ORs = 1.20-2.02; ps < 0.05) and past-month (ORs = 1.39-2.06; ps < 0.05) hallucinogen use compared to White people. Females had lower odds of past-year (OR = 0.79; ps < 0.05), past-month (OR = 0.78; ps < 0.05) hallucinogen use compared to males, except for lifetime use of MDMA (OR = 1.29; ps < 0.05). Conclusions These findings should inform public health initiatives regarding potential benefits and risks of hallucinogen use among racial/ethnic groups and women.
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Affiliation(s)
- Alan K. Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, United States
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, United States
| | - Brooke J. Arterberry
- Center for Studies of Drugs, Alcohol, Smoking, and Health (DASH Center), University of Michigan, Ann Arbor, MI, United States
| | - Yitong Xin
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, United States
| | - Gabrielle Agin-Liebes
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
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21
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Uthaug MV, Davis AK, Haas TF, Davis D, Dolan SB, Lancelotta R, Timmermann C, Ramaekers JG. The epidemiology of mescaline use: Pattern of use, motivations for consumption, and perceived consequences, benefits, and acute and enduring subjective effects. J Psychopharmacol 2022; 36:309-320. [PMID: 33949246 PMCID: PMC8902264 DOI: 10.1177/02698811211013583] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mescaline is a naturally occurring psychoactive phenethylamine found in several cacti and historically used ceremonially by Indigenous and Latin American populations. Broader recognition of its possible therapeutic value in Western science began in the 1950s; however, knowledge of the safety profile of mescaline and the extent of its use remains limited. The primary aim of this study is to examine the epidemiology of mescaline use among English-speaking adults. METHODS About 452 respondents completed a web-based survey designed to assess their previous experience with mescaline (subjective effects, outcome measures, and mescaline type used). RESULTS Most respondents reported that they had consumed mescaline infrequently (⩽once/year), for spiritual exploration or to connect with nature (74%). A small number of respondents reported drug craving/desire (9%), whereas very few reported legal (1%), or psychological problems (1%) related to its use, and none reported seeking any medical attention. Overall, respondents rated the acute mystical-type effects as "moderate," ego-dissolution and psychological insight effects as "slight," and challenging effects as "very slight." Most respondents reported that they used Peyote and San Pedro in their most memorable mescaline experience. Overall, the intensity of acute mescaline effects did not differ between mescaline types. About 50% of the sample reported having a psychiatric condition (i.e. depression, anxiety, etc.), and most (>67%) reported improvements in these conditions following their most memorable experience with mescaline. CONCLUSION Findings indicate that the mescaline in any form may produce a psychedelic experience that is associated with the spiritual significance and improvements in the mental health with low potential for abuse.
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Affiliation(s)
- Malin Vedøy Uthaug
- Department of Neuropsychology and
Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University,
Maastricht, The Netherlands,Dr. Malin Vedøy Uthaug, Department of
Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience,
Maastricht University, Universiteitssingel 40, Maastricht 6200 MD, The
Netherlands.
| | - Alan K Davis
- College of Social Work, The Ohio State
University, Columbus, OH, USA,Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Dawn Davis
- Department of Natural Resources,
University of Idaho, Moscow, ID, USA
| | - Sean B Dolan
- Behavioral Pharmacology Research Unit,
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | | | - Christopher Timmermann
- Centre for Psychedelic Research,
Department of Brain Sciences, Imperial College London, London, UK
| | - Johannes G Ramaekers
- Department of Neuropsychology and
Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University,
Maastricht, The Netherlands
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22
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Coxe-Hyzak KA, Bunger AC, Bogner J, Davis AK, Corrigan JD. Implementing traumatic brain injury screening in behavioral healthcare: protocol for a prospective mixed methods study. Implement Sci Commun 2022; 3:17. [PMID: 35164885 PMCID: PMC8842803 DOI: 10.1186/s43058-022-00261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background Characteristics of both individuals and innovations are foundational determinants to the adoption of evidenced-based practices (EBPs). However, our understanding about what drives EBP adoption is limited by few studies examining relationships among implementation determinants and implementation outcomes through theory-driven hypothesis testing. Therefore, drawing on the Theory of Planned Behavior and Diffusion of Innovations Theory, this study will disentangle relationships between provider characteristics and innovation factors on the early adoption of the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) in behavioral health settings. Methods This study will utilize an explanatory sequential mixed methods design. In Phase I (quantitative), Time 1, we will investigate behavioral health providers (N = 200) attitudes, perceived behavioral control, subjective norms, and intentions to screen for TBI upon completion of a video module introducing the OSU TBI-ID. At Time 2, we will examine the number of TBI screens conducted over the previous month, as well as the feasibility, appropriateness, and acceptability of using the OSU TBI-ID in practice. Structural equation modeling will be used to determine whether provider characteristics predict TBI screening intentions, and whether intentions mediate actual TBI screening behaviors. We will then test whether feasibility, appropriateness, and acceptability of the OSU TBI-ID moderates the relationship between intentions and TBI screening behaviors. In Phase II (qualitative), we will develop an interview guide using results from Phase I and will conduct semi-structured interviews with providers (N = 20) to assess contextual determinants of TBI screening adoption. Qualitative data will be thematically analyzed using sensitizing concepts from the Consolidated Framework for Implementation Research and integrated with the quantitative results using a joint display. Discussion This mixed methods study capitalizes on two theory-driven hypotheses bridging proximal (e.g., screening intent) to distal (actual behaviors) implementation outcomes and will contextualize these results qualitatively to advance our understanding about why TBI screening adoption has failed to translate to the behavioral healthcare context. Results of this study will offer insights into what is driving TBI screening adoption so that implementation strategies can be selected with greater precision to improve the adoption, sustainment, and scale-up of TBI screening in behavioral healthcare. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-022-00261-x.
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23
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Reckweg JT, Uthaug MV, Szabo A, Davis AK, Lancelotta R, Mason NL, Ramaekers JG. The clinical pharmacology and potential therapeutic applications of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT). J Neurochem 2022; 162:128-146. [PMID: 35149998 PMCID: PMC9314805 DOI: 10.1111/jnc.15587] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Abstract
5‐methoxy‐N,N‐dimethyltryptamine (5‐MeO‐DMT) is a naturally occurring tryptamine that primarily acts as an agonist at the 5‐HT1A and 5‐HT2A receptors, whereby affinity for the 5‐HT1A subtype is highest. Subjective effects following 5‐MeO‐DMT administration include distortions in auditory and time perception, amplification of emotional states, and feelings of ego dissolution that usually are short‐lasting, depending on the route of administration. Individual dose escalation of 5‐MeO‐DMT reliably induces a “peak” experience, a state thought to be a core predictor of the therapeutic efficacy of psychedelics. Observational studies and surveys have suggested that single exposure to 5‐MeO‐DMT can cause rapid and sustained reductions in symptoms of depression, anxiety, and stress. 5‐MeO‐DMT also stimulates neuroendocrine function, immunoregulation, and anti‐inflammatory processes, which may contribute to changes in mental health outcomes. To date, only one clinical trial has been published on 5‐MeO‐DMT, demonstrating the safety of vaporized dosing up to 18 mg. Importantly, the rapid onset and short duration of the 5‐MeO‐DMT experience may render it more suitable for individual dose‐finding strategies compared with longer‐acting psychedelics. A range of biotech companies has shown an interest in the development of 5‐MeO‐DMT formulations for a range of medical indications, most notably depression. Commercial development will therefore be the most important resource for bringing 5‐MeO‐DMT to the clinic. However, fundamental research will also be needed to increase understanding of the neurophysiological and neural mechanisms that contribute to the potential clinical effects of 5‐MeO‐DMT and its sustainability and dissemination over time. Such studies are less likely to be conducted as part of drug development programs and are more likely to rely on independent, academic initiatives.
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Affiliation(s)
- J T Reckweg
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
| | - M V Uthaug
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
| | - A Szabo
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - A K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA.,Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - R Lancelotta
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - N L Mason
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
| | - J G Ramaekers
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
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24
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Davis AK, Mangini P, Xin Y. Corrigendum: Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study. JPS 2022. [DOI: 10.1556/2054.2021.30000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Alan K. Davis
- College of Social Work, Ohio State University, Columbus, OH, USA
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
| | - Pratheek Mangini
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Yitong Xin
- College of Social Work, Ohio State University, Columbus, OH, USA
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25
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Mangini P, Averill LA, Davis AK. Psychedelic treatment for co-occurring alcohol misuse and post-traumatic stress symptoms among United States Special Operations Forces Veterans. JPS 2022. [DOI: 10.1556/2054.2021.00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Background & aims
Special Operations Forces Veterans (SOFV) have unique treatment needs stemming from multiple repeated forms of combat exposure resulting in a complex sequela of problems including alcohol misuse and post-traumatic stress symptoms. Current approved pharmacologic treatments for alcohol misuse and PTSD are lacking in adherence and efficacy, warranting novel treatment development. The current study examined the correlations between psychedelic treatment and changes in alcohol misuse among trauma exposed United States SOFV.
Method
An anonymous internet-based survey was conducted among SOFV who completed a specific psychedelic clinical program in Mexico. Retrospective questions probed alcohol use and post-traumatic stress symptoms during the 30-days before and 30-days after the psychedelic treatment. A total of 65 SOFV completed treatment and were eligible for contact. Of these, 51 (78%) completed the survey, and 27 (42%) reported alcohol misuse (≥4 on the AUDIT-C) in the 30 days prior to treatment and were included in analyses (Mean Age = 40; male = 96%; Caucasian/White = 96%).
Results
There were significant and very large reductions in retrospective reports of alcohol use (P < 0.001; d = –2.4) and post-traumatic stress symptoms (P < 0.001; d = –2.8) and a significant and large increase in psychological flexibility (P < 0.001; d = –1.8), from before-to-after the psychedelic treatment. In the 30 days after treatment, 85% reduced their alcohol consumption to non-risky levels (33% abstinent; 52% non-risky drinking). Increases in psychological flexibility were strongly associated with reductions in alcohol use and post-traumatic stress symptoms (rs range 0.38–0.90; ps < 0.05).
Conclusion
Rigorous longitudinal studies should be conducted to determine whether psychedelic-assisted therapy holds promise as an intervention in this population.
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Affiliation(s)
- Pratheek Mangini
- Rutgers Robert Wood Johnson Medical School, Department of Psychiatry, New Brunswick, NJ, USA
| | - Lynnette A. Averill
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, TX, USA
- Clinical Neurosciences Division, National Center for PTSD, West Haven, CT, USA
| | - Alan K. Davis
- The Ohio State University, College of Social Work, Columbus, OH, USA
- Johns Hopkins University, Center for Psychedelic and Consciousness Research, Baltimore, MD, USA
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26
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Gukasyan N, Davis AK, Barrett FS, Cosimano MP, Sepeda ND, Johnson MW, Griffiths RR. Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up. J Psychopharmacol 2022; 36:151-158. [PMID: 35166158 PMCID: PMC8864328 DOI: 10.1177/02698811211073759] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Preliminary data suggest that psilocybin-assisted treatment produces substantial and rapid antidepressant effects in patients with major depressive disorder (MDD), but little is known about long-term outcomes. AIMS This study sought to examine the efficacy and safety of psilocybin through 12 months in participants with moderate to severe MDD who received psilocybin. METHODS This randomized, waiting-list controlled study enrolled 27 patients aged 21-75 with moderate to severe unipolar depression (GRID-Hamilton Depression Rating Scale (GRID-HAMD) ⩾ 17). Participants were randomized to an immediate or delayed (8 weeks) treatment condition in which they received two doses of psilocybin with supportive psychotherapy. Twenty-four participants completed both psilocybin sessions and were followed through 12 months following their second dose. RESULTS All 24 participants attended all follow-up visits through the 12-month timepoint. Large decreases from baseline in GRID-HAMD scores were observed at 1-, 3-, 6-, and 12-month follow-up (Cohen d = 2.3, 2.0, 2.6, and 2.4, respectively). Treatment response (⩾50% reduction in GRID-HAMD score from baseline) and remission were 75% and 58%, respectively, at 12 months. There were no serious adverse events judged to be related to psilocybin in the long-term follow-up period, and no participants reported psilocybin use outside of the context of the study. Participant ratings of personal meaning, spiritual experience, and mystical experience after sessions predicted increased well-being at 12 months, but did not predict improvement in depression. CONCLUSIONS These findings demonstrate that the substantial antidepressant effects of psilocybin-assisted therapy may be durable at least through 12 months following acute intervention in some patients.
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Affiliation(s)
- Natalie Gukasyan
- Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, MD, USA,Natalie Gukasyan, Center for Psychedelic
and Consciousness Research, Department of Psychiatry and Behavioral Sciences,
Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore,
MD 21224, USA.
| | - Alan K Davis
- Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, MD, USA,College of Social Work, The Ohio State
University, Columbus, OH, USA
| | - Frederick S Barrett
- Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary P Cosimano
- Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nathan D Sepeda
- Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew W Johnson
- Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, MD, USA
| | - Roland R Griffiths
- Center for Psychedelic and
Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, MD, USA,Department of Neuroscience, Johns
Hopkins University School of Medicine, Baltimore, MD, USA,Roland R Griffiths, Center for Psychedelic
and Consciousness Research, Department of Psychiatry and Behavioral Sciences,
Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore,
MD 21224, USA.
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27
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Ortiz Bernal AM, Raison CL, Lancelotta RL, Davis AK. Reactivations after 5-methoxy-N,N-dimethyltryptamine use in naturalistic settings: An initial exploratory analysis of the phenomenon's predictors and its emotional valence. Front Psychiatry 2022; 13:1049643. [PMID: 36523876 PMCID: PMC9745201 DOI: 10.3389/fpsyt.2022.1049643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The psychedelic 5-MeO-DMT has shown clinical potential due to its short duration and ability to induce mystical experiences. However, a phenomenon known as "reactivations" (similar to "flashbacks") is a poorly understood and frequently reported phenomenon which appears associated with 5-MeO-DMT use and warranted further investigation. AIMS This study examined whether differences in age, gender, education, lifetime use, use location, and preparation strategies predict reactivations (primary outcome). Additionally, we explored how reactivations were perceived by survey respondents and whether demographic data predicted emotional valence (secondary outcome) of reported reactivations. MATERIALS AND METHODS This study used secondary quantitative data from a survey assessing epidemiological and behavioral associations of 5-MeO-DMT use in non-clinical settings (N = 513). Descriptive statistics, chi-square tests, t-tests, and logistic regressions were utilized to explore aims. RESULTS Being female, older at the time of first 5-MeO-DMT dose, having higher educational attainment, and dosing in a structured group setting were associated with increased odds of reporting a reactivation event. Higher mystical experience scores, greater personal wellbeing and having had a non-dual awareness experience that was not substance-induced were associated with higher likelihood of reporting a neutral or positive emotional valence of a reactivation event. CONCLUSION These findings suggest that reactivation phenomena, in this particular sample may most often represent a neutral or positive byproduct of the acute 5-MeO-DMT experience. More information is needed to best identify individuals most likely to experience a reactivation as a negative event to prevent such potential challenging outcomes.
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Affiliation(s)
- Ana María Ortiz Bernal
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, WI, United States
| | - Charles L Raison
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, WI, United States
| | - Rafael L Lancelotta
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, United States
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, United States.,Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, United States
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28
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Davis AK, Mangini P, Xin Y. Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study. JPS 2021. [DOI: 10.1556/2054.2021.00179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
Trauma exposure across the lifespan produces risks for posttraumatic stress disorder (PTSD), depression, anxiety, as well as global disability in functioning. This retrospective clinical chart review is the first of its kind to assess the utility of sublingual ketamine-assisted body-centered psychotherapy in trauma-exposed patients in a real world clinic setting. De-identified clinical records data on self-reported symptom measures were retrospectively analyzed for patients (N = 18; M
age = 45.22, SD = 12.90) entering ketamine-assisted psychotherapy treatment in an outpatient clinic between 2018 and 2020. Patients who completed six sessions of ketamine therapy reported meaningful (e.g., medium effect size) improvements in PTSD symptoms (P = 0.058; d = −0.48) and global disability in functioning (P = 0.050; d = −0.52) and statistically significant and meaningful improvements in depression (P = 0.019; d = −0.53). There were no improvements in anxiety symptoms. Sublingual ketamine-assisted psychotherapy was associated with heterogenous clinical utility among patients with trauma-exposure in an outpatient setting. This study was underpowered and unrepresentative of the population of ketamine patients in the United States. Replication of these findings is needed with larger and more diverse patient samples.
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Affiliation(s)
- Alan K. Davis
- 1 College of Social Work, Ohio State University, Columbus, OH, USA
- 2 Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
| | - Pratheek Mangini
- 3 Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Yitong Xin
- 1 College of Social Work, Ohio State University, Columbus, OH, USA
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29
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Clark DA, Arterberry BJ, Walton MA, Cunningham RM, Goldstick JE, Zimmerman MA, Davis AK, Bonar EE. Examining Same-Day Associations Between Cannabis Use Motives and Condom Use in Urban Emerging Adults: A Brief Report. J Stud Alcohol Drugs 2021. [DOI: 10.15288/jsad.2021.82.516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- D. Angus Clark
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Brooke J. Arterberry
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan
- Department of Psychology, Iowa State University, Ames, Iowa
| | - Maureen A. Walton
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Rebecca M. Cunningham
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, Ann Arbor, Michigan
- Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
- Hurley Medical Center, Flint, Michigan
| | - Jason E. Goldstick
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, Ann Arbor, Michigan
- Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Marc A. Zimmerman
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, Ann Arbor, Michigan
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Alan K. Davis
- College of Social Work, The Ohio State University, Columbus, Ohio
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Erin E. Bonar
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, Ann Arbor, Michigan
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, Michigan
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30
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Affiliation(s)
- Alan K Davis
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.,College of Social Work, The Ohio State University, Columbus
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland
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31
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Davis AK, Barrett FS, May DG, Cosimano MP, Sepeda ND, Johnson MW, Finan PH, Griffiths RR. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2021; 78:481-489. [PMID: 33146667 PMCID: PMC7643046 DOI: 10.1001/jamapsychiatry.2020.3285] [Citation(s) in RCA: 496] [Impact Index Per Article: 165.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Major depressive disorder (MDD) is a substantial public health burden, but current treatments have limited effectiveness and adherence. Recent evidence suggests that 1 or 2 administrations of psilocybin with psychological support produces antidepressant effects in patients with cancer and in those with treatment-resistant depression. OBJECTIVE To investigate the effect of psilocybin therapy in patients with MDD. DESIGN, SETTING, AND PARTICIPANTS This randomized, waiting list-controlled clinical trial was conducted at the Center for Psychedelic and Consciousness Research at Johns Hopkins Bayview Medical Center in Baltimore, Maryland. Adults aged 21 to 75 years with an MDD diagnosis, not currently using antidepressant medications, and without histories of psychotic disorder, serious suicide attempt, or hospitalization were eligible to participate. Enrollment occurred between August 2017 and April 2019, and the 4-week primary outcome assessments were completed in July 2019. A total of 27 participants were randomized to an immediate treatment condition group (n = 15) or delayed treatment condition group (waiting list control condition; n = 12). Data analysis was conducted from July 1, 2019, to July 31, 2020, and included participants who completed the intervention (evaluable population). INTERVENTIONS Two psilocybin sessions (session 1: 20 mg/70 kg; session 2: 30 mg/70 kg) were given (administered in opaque gelatin capsules with approximately 100 mL of water) in the context of supportive psychotherapy (approximately 11 hours). Participants were randomized to begin treatment immediately or after an 8-week delay. MAIN OUTCOMES AND MEASURES The primary outcome, depression severity was assessed with the GRID-Hamilton Depression Rating Scale (GRID-HAMD) scores at baseline (score of ≥17 required for enrollment) and weeks 5 and 8 after enrollment for the delayed treatment group, which corresponded to weeks 1 and 4 after the intervention for the immediate treatment group. Secondary outcomes included the Quick Inventory of Depressive Symptomatology-Self Rated (QIDS-SR). RESULTS Of the randomized participants, 24 of 27 (89%) completed the intervention and the week 1 and week 4 postsession assessments. This population had a mean (SD) age of 39.8 (12.2) years, was composed of 16 women (67%), and had a mean (SD) baseline GRID-HAMD score of 22.8 (3.9). The mean (SD) GRID-HAMD scores at weeks 1 and 4 (8.0 [7.1] and 8.5 [5.7]) in the immediate treatment group were statistically significantly lower than the scores at the comparable time points of weeks 5 and 8 (23.8 [5.4] and 23.5 [6.0]) in the delayed treatment group. The effect sizes were large at week 5 (Cohen d = 2.5; 95% CI, 1.4-3.5; P < .001) and week 8 (Cohen d = 2.6; 95% CI, 1.5-3.7; P < .001). The QIDS-SR documented a rapid decrease in mean (SD) depression score from baseline to day 1 after session 1 (16.7 [3.5] vs 6.3 [4.4]; Cohen d = 2.6; 95% CI, 1.8-3.5; P < .001), which remained statistically significantly reduced through the week 4 follow-up (6.0 [5.7]; Cohen d = 2.3; 95% CI, 1.5-3.0; P < .001). In the overall sample, 17 participants (71%) at week 1 and 17 (71%) at week 4 had a clinically significant response to the intervention (≥50% reduction in GRID-HAMD score), and 14 participants (58%) at week 1 and 13 participants (54%) at week 4 were in remission (≤7 GRID-HAMD score). CONCLUSIONS AND RELEVANCE Findings suggest that psilocybin with therapy is efficacious in treating MDD, thus extending the results of previous studies of this intervention in patients with cancer and depression and of a nonrandomized study in patients with treatment-resistant depression. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03181529.
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Affiliation(s)
- Alan K. Davis
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland,College of Social Work, The Ohio State University, Columbus
| | - Frederick S. Barrett
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Darrick G. May
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mary P. Cosimano
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nathan D. Sepeda
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Matthew W. Johnson
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Patrick H. Finan
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Roland R. Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland,Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland
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Aday JS, Davis AK, Mitzkovitz CM, Bloesch EK, Davoli CC. Predicting Reactions to Psychedelic Drugs: A Systematic Review of States and Traits Related to Acute Drug Effects. ACS Pharmacol Transl Sci 2021; 4:424-435. [PMID: 33860172 PMCID: PMC8033773 DOI: 10.1021/acsptsci.1c00014] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Indexed: 12/21/2022]
Abstract
Psychedelic drugs are increasingly being incorporated into therapeutic contexts for the purposes of promoting mental health. However, they can also induce adverse reactions in some individuals, and it is difficult to predict before treatment who is likely to experience positive or adverse acute effects. Although consideration of setting and dosage as well as excluding individuals with psychotic predispositions has thus far led to a high degree of safety, it is imperative that researchers develop a more nuanced understanding of how to predict individual reactions. To this end, the current systematic review coalesced the results of 14 studies that included baseline states or traits predictive of the acute effects of psychedelics. Individuals high in the traits of absorption, openness, and acceptance as well as a state of surrender were more likely to have positive and mystical-type experiences, whereas those low in openness and surrender or in preoccupied, apprehensive, or confused psychological states were more likely to experience acute adverse reactions. Participant sex was not a robust predictor of drug effects, but 5-HT2AR binding potential, executive network node diversity, and rACC volume may be potential baseline biomarkers related to acute reactions. Finally, increased age and experience with psychedelics were individual differences related to generally less intense effects, indicating that users may become slightly less sensitive to the effects of the drugs after repeated usage. Although future well-powered, placebo-controlled trials directly comparing the relative importance of these predictors is needed, this review synthesizes the field's current understanding of how to predict acute reactions to psychedelic drugs.
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Affiliation(s)
- Jacob S. Aday
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
| | - Alan K. Davis
- College
of Social Work, The Ohio State University, 1947 College Road, Columbus, Ohio 43210, United States
- Center
for Psychedelic and Consciousness Research, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, Maryland 21224, United
States
| | - Cayla M. Mitzkovitz
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
| | - Emily K. Bloesch
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
| | - Christopher C. Davoli
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
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Davis AK, Barrett FS, So S, Gukasyan N, Swift TC, Griffiths RR. Development of the Psychological Insight Questionnaire among a sample of people who have consumed psilocybin or LSD. J Psychopharmacol 2021; 35:437-446. [PMID: 33427007 PMCID: PMC8056708 DOI: 10.1177/0269881120967878] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Several measures have been developed to examine acute psychedelic effects (e.g. mystical-type and challenging experiences), but no measure assesses acute psychologically insightful experiences that may occur during psychedelic experiences. AIM The purpose of this study was to develop and examine the psychometric properties of the Psychological Insight Questionnaire. METHOD A cross-sectional survey study among psilocybin and LSD users. Respondents (n=1661; Mage=22.9, standard deviation=8.5; Caucasian/White=83%; non-Hispanic=91%; men=72%; United States resident=66%) completed an Internet-based survey. RESULTS The Psychological Insight Questionnaire consists of 23 items with two subscales: (a) Avoidance and Maladaptive Patterns Insights and (b) Goals and Adaptive Patterns Insights. Construct validity of the Psychological Insight Questionnaire was supported by strong correlations of the Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores with the insight subscale of the Session Impacts Scale, and weak-to-moderate correlations with the Mystical Experiences and Challenging Experiences Questionnaires. Furthermore, Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores were moderately-to-strongly correlated with retrospectively reported increases in psychological flexibility, and well-being/life satisfaction that were attributed to a memorable psychedelic experience. Lastly, incremental validity was established showing that the Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights subscale) scores predict unique variance in changes in psychological flexibility, and Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores predict changes in well-being and life satisfaction, beyond measures of acute mystical-type and challenging effects. CONCLUSIONS The Psychological Insight Questionnaire has the potential to extend the understanding of the acute and enduring effects of psychedelics. Further longitudinal research is necessary to determine the long-term predictive validity of the Psychological Insight Questionnaire and to examine the role of psychological insight in predicting therapeutic outcomes.
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Affiliation(s)
- Alan K Davis
- College of Social Work, The Ohio State University, Columbus, USA
- Center for Psychedelic and Conscioussness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - Frederick S Barrett
- Center for Psychedelic and Conscioussness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - Sara So
- Center for Psychedelic and Conscioussness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - Natalie Gukasyan
- Center for Psychedelic and Conscioussness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - Thomas C Swift
- Center for Psychedelic and Conscioussness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
- RiverStyx Foundation, Kirkland, USA
| | - Roland R Griffiths
- Center for Psychedelic and Conscioussness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, USA
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Agin-Liebes G, Haas TF, Lancelotta R, Uthaug MV, Ramaekers JG, Davis AK. Naturalistic Use of Mescaline Is Associated with Self-Reported Psychiatric Improvements and Enduring Positive Life Changes. ACS Pharmacol Transl Sci 2021; 4:543-552. [PMID: 33860184 PMCID: PMC8033766 DOI: 10.1021/acsptsci.1c00018] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Indexed: 12/20/2022]
Abstract
Mescaline is a naturally occurring psychoactive alkaloid that has been used as a sacrament by Indigenous populations in spiritual ritual and healing ceremonies for millennia. Despite promising early preliminary research and favorable anecdotal reports, there is limited research investigating mescaline's psychotherapeutic potential. We administered an anonymous online questionnaire to adults (N = 452) reporting use of mescaline in naturalistic settings about mental health benefits attributed to mescaline. We assessed respondents' self-reported improvements in depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol and drug use disorders (AUD and DUD). Of the respondents reporting histories of these clinical conditions, most (68-86%) reported subjective improvement following their most memorable mescaline experience. Respondents who reported an improvement in their psychiatric conditions reported significantly higher ratings of acute psychological factors including mystical-type, psychological insight, and ego dissolution effects compared to those who did not report improvements (Cohen's d range 0.7 - 1.5). Many respondents (35-50%) rated the mescaline experience as the single or top five most spiritually significant or meaningful experience(s) of their lives. Acute experiences of psychological insight during their mescaline experience were associated with increased odds of reporting improvement in depression, anxiety, AUD and DUD. Additional research is needed to corroborate these preliminary findings and to rigorously examine the efficacy of mescaline for psychiatric treatment in controlled, longitudinal clinical trials.
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Affiliation(s)
- Gabrielle Agin-Liebes
- Department
of Psychiatry, University of California,
San Francisco, 1001 Potrero
Ave., San Francisco, California 94110, United States,Zuckerberg
San Francisco General Hospital, 1001 Potrero Ave., Bldg. 80, San Francisco, California 94110, United States,Tel.: 646-641-2000.
| | - Trevor F. Haas
- University
of California, Davis, School of Medicine, 4610 X Street, Sacramento, California 95817, United States,Department
of Psychiatry and Behavioral Sciences, University
of Southern California, 3620 McClintock Ave., Los Angeles, California 90089-0001, United States
| | - Rafael Lancelotta
- Habituating
to Wholeness, LLC, 6500 W 13th Ave, Lakewood, Colorado 80214, United States
| | - Malin V. Uthaug
- Department
of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229, Maastricht, Limburg 6200
MD, The Netherlands
| | - Johannes G. Ramaekers
- Department
of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229, Maastricht, Limburg 6200
MD, The Netherlands
| | - Alan K. Davis
- College
of Social Work, The Ohio State University, 1947 College Road, Columbus, Ohio 43210, United States,Center
for Psychedelic and Consciousness Research, Johns Hopkins University, 5510 Nathan Shock Drive, Baltimore, Maryland 21224, United
States,Tel.: 614-292-5251.
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Davis AK, Xin Y, Sepeda ND, Garcia-Romeu A, Williams MT. Increases in Psychological Flexibility Mediate Relationship Between Acute Psychedelic Effects and Decreases in Racial Trauma Symptoms Among People of Color. Chronic Stress (Thousand Oaks) 2021; 5:24705470211035607. [PMID: 34377878 PMCID: PMC8342866 DOI: 10.1177/24705470211035607] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/12/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Previous research showed acute psychedelic effects were associated with decreases in racial trauma (RT) symptoms among black, indigenous, and people of color (BIPOC). Among samples comprised primarily of white participants, positive outcomes of psychedelic experiences have been mediated by increases in psychological flexibility. Therefore, we examined whether changes in psychological flexibility from before to after a psychedelic experience mediated the relationship between acute psychedelic effects and changes in RT symptoms among BIPOC. METHODS This cross-sectional online survey study included 313 BIPOC (mean age = 33.1; SD = 11.2; female = 57%). A multiple linear regression analysis was used to examine the association between acute psychedelic effects and decreases in RT symptoms in a nonclinical setting; a path analysis was used to explore whether changes in psychological flexibility mediated this relationship. RESULTS Acute insight and challenging effects were significantly (p < .001) associated with decreases in RT symptoms following a psychedelic experience. Increases in psychological flexibility partially mediated relationships between greater intensity of psychological insight and less intensity of challenging experiences and decreases in RT symptoms (ps<.001). CONCLUSION This research suggests psychedelics confer potential benefits in decreasing RT symptoms among BIPOC and psychological flexibility may be an important mediator of these effects. Future research should test this hypothesis in a longitudinal clinical trial among BIPOC.
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Affiliation(s)
- Alan K. Davis
- The Ohio State University, Columbus, OH, USA
- Johns Hopkins School of
Medicine, Baltimore, MD, USA
| | - Yitong Xin
- The Ohio State University, Columbus, OH, USA
| | | | | | - Monnica T. Williams
- University of Ottawa, Ottawa, Ontario, Canada
- University of Connecticut, Storrs, Connecticut, USA
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Williams MT, Davis AK, Xin Y, Sepeda ND, Grigas PC, Sinnott S, Haeny AM. People of color in North America report improvements in racial trauma and mental health symptoms following psychedelic experiences. Drugs (Abingdon Engl) 2020; 28:215-226. [PMID: 34349358 PMCID: PMC8330400 DOI: 10.1080/09687637.2020.1854688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study examined how psychedelics reduced symptoms of racial trauma among black, indigenous, and people of color (BIPOC) subsequent to an experience of racism. A cross-sectional internet-based survey included questions about experiences with racism, mental health symptoms, and acute and enduring psychedelic effects. Changes in mental health were assessed by retrospective report of symptoms in the 30 days before and 30 days after an experience with psilocybin, Lysergic acid diethylamide (LSD), or 3,4-Methylenedioxymethamphetamine (MDMA). We recruited 313 diverse BIPOC in the US and Canada. Results revealed a significant (p < .001) and moderate (d = −.45) reduction in traumatic stress symptoms from before-to-after the psychedelic experience. Similarly, participants reported decreases in depression (p < .001; d = −.52), anxiety (p < .001; d = −.53), and stress (p < .001; d = −.32). There was also a significant relationship (Rc = 0.52, p < .001) between the dimension of acute psychedelic effects (mystical-type, insight, and challenging experiences) and decreases in a cluster of subsequent psychopathology (traumatic stress, depression, anxiety, and stress), while controlling for the frequency of prior discrimination and the time since the psychedelic experience. BIPOC have been underrepresented in psychedelic studies. Psychedelics may decrease the negative impact of racial trauma. Future studies should examine the efficacy of psychedelic-assisted therapy for individuals with a history of race-based trauma.
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Affiliation(s)
- Monnica T Williams
- School of Psychology, University of Ottawa, Ottawa, Canada.,Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Alan K Davis
- College of Social Work, The Ohio State University, Columbus, OH, USA.,Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yitong Xin
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Nathan D Sepeda
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Pamela Colόn Grigas
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Sinead Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Davis AK, Clifton JM, Weaver EG, Hurwitz ES, Johnson MW, Griffiths RR. Survey of entity encounter experiences occasioned by inhaled N,N-dimethyltryptamine: Phenomenology, interpretation, and enduring effects. J Psychopharmacol 2020; 34:1008-1020. [PMID: 32345112 DOI: 10.1177/0269881120916143] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Experiences of having an encounter with seemingly autonomous entities are sometimes reported after inhaling N,N-dimethyltryptamine. AIM The study characterized the subjective phenomena, interpretation, and persisting changes that people attribute to N,N-dimethyltryptamine-occasioned entity encounter experiences. METHODS Two thousand, five hundred and sixty-one individuals (mean age 32 years; 77% male) completed an online survey about their single most memorable entity encounter after taking N,N-dimethyltryptamine. RESULTS Respondents reported the primary senses involved in the encounter were visual and extrasensory (e.g. telepathic). The most common descriptive labels for the entity were being, guide, spirit, alien, and helper. Although 41% of respondents reported fear during the encounter, the most prominent emotions both in the respondent and attributed to the entity were love, kindness, and joy. Most respondents endorsed that the entity had the attributes of being conscious, intelligent, and benevolent, existed in some real but different dimension of reality, and continued to exist after the encounter. Respondents endorsed receiving a message (69%) or a prediction about the future (19%) from the experience. More than half of those who identified as atheist before the experience no longer identified as atheist afterwards. The experiences were rated as among the most meaningful, spiritual, and psychologically insightful lifetime experiences, with persisting positive changes in life satisfaction, purpose, and meaning attributed to the experiences. CONCLUSION N,N-dimethyltryptamine-occasioned entity encounter experiences have many similarities to non-drug entity encounter experiences such as those described in religious, alien abduction, and near-death contexts. Aspects of the experience and its interpretation produced profound and enduring ontological changes in worldview.
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Affiliation(s)
- Alan K Davis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA.,College of Social Work, The Ohio State University, Columbus, USA
| | - John M Clifton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA.,University of Maryland School of Medicine, Baltimore, USA
| | - Eric G Weaver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - Ethan S Hurwitz
- Department of Psychology, University of California San Diego, La Jolla, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - Roland R Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA.,Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, USA
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Rosenberg H, Grant J, Davis AK. Acceptance of Non-Abstinence as an Outcome Goal for Individuals Diagnosed With Substance Use Disorders: A Narrative Review of Published Research. J Stud Alcohol Drugs 2020; 81:405-415. [PMID: 32800076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVE Natural recovery and treatment outcome studies published over the past four decades indicate that some individuals with substance use problems moderate their consumption of alcohol and other drugs. Concurrently, a growing number of investigations have assessed service providers' attitudes regarding non-abstinence goals. METHOD To provide a summary of that research, we identified 25 articles published between 1981 and 2019 that reported agency and/ or clinician acceptance of non-abstinence treatment goals, often as a function of severity of the client condition, finality of the outcome goal, type of substance consumed, and/or treatment setting. RESULTS Although acceptance rates varied considerably across studies, respondents more often endorsed non-abstinence as an outcome goal (a) for less severely impaired rather than for more severely impaired clients; (b) as an intermediate goal on the way to achieving abstinence rather than as the final outcome goal; and (c) when the target substance is alcohol or cannabis rather than drugs such as cocaine, heroin/opioids, hallucinogens, amphetamines, and MDMA/Ecstasy (3,4-methylenedioxymethamphetamine). Acceptance also varied by treatment setting, with more acceptance of non-abstinence goals in outpatient settings than residential settings, and by geographic location, with larger proportions of service providers in Australia and European countries endorsing non-abstinence goals than those working in the United States and Canada. CONCLUSIONS We anticipate that acceptance will increase or remain high as research continues to demonstrate improved functioning by those who achieve non-abstinence outcomes, and we recommend further evaluation of other client and clinician characteristics that might influence acceptance and rejection of non-abstinence outcome goals.
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Affiliation(s)
- Harold Rosenberg
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio
| | - Jennifer Grant
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio
| | - Alan K Davis
- College of Social Work, The Ohio State University, Columbus, Ohio
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
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Rosenberg H, Grant J, Davis AK. Acceptance of Non-Abstinence as an Outcome Goal for Individuals Diagnosed With Substance Use Disorders: A Narrative Review of Published Research. J Stud Alcohol Drugs 2020. [DOI: 10.15288/jsad.2020.81.405] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Harold Rosenberg
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio
| | - Jennifer Grant
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio
| | - Alan K. Davis
- College of Social Work, The Ohio State University, Columbus, Ohio
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
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Abstract
After a two-decade hiatus in which research on psychedelics was essentially halted, placebo-controlled clinical trials of psychedelic-assisted therapy for mental health conditions have begun to be published. We identified nine randomized, placebo-controlled clinical trials of psychedelic-assisted therapy published since 1994. Studies examined psilocybin, LSD (lysergic acid diethylamide), ayahuasca (which contains a combination of N,N-dimethyltryptamine and harmala monoamine oxidase inhibitor alkaloids), and MDMA (3,4-methylenedioxymethamphetamine). We compared the standardized mean difference between the experimental and placebo control group at the primary endpoint. Results indicated a significant mean between-groups effect size of 1.21 (Hedges g), which is larger than the typical effect size found in trials of psychopharmacological or psychotherapy interventions. For the three studies that maintained a placebo control through a follow-up assessment, effects were generally maintained at follow-up. Overall, analyses support the efficacy of psychedelic-assisted therapy across four mental health conditions - post-traumatic stress disorder, anxiety/depression associated with a life-threatening illness, unipolar depression, and social anxiety among autistic adults. While study quality was high, we identify several areas for improvement regarding the conduct and reporting of trials. Larger trials with more diverse samples are needed to examine possible moderators and mediators of effects, and to establish whether effects are maintained over time.
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Affiliation(s)
- Jason B Luoma
- Portland Psychotherapy Clinic, Research, & Training Center , Portland, OR, USA
| | - Christina Chwyl
- Portland Psychotherapy Clinic, Research, & Training Center , Portland, OR, USA
| | - Geoff J Bathje
- Department of Clinical Mental Health Counseling, Adler University , Chicago, IL, USA
| | - Alan K Davis
- College of Social Work, The Ohio State University , Columbus, OH, USA.,Behavioral Pharmacology Research Unit, Department of Psychiatry, Johns Hopkins School of Medicine , Baltimore, MD, USA
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Sepeda ND, Clifton JM, Doyle LY, Lancelotta R, Griffiths RR, Davis AK. Inhaled 5-methoxy-N,N-dimethyltryptamine: Supportive context associated with positive acute and enduring effects. JPS 2020. [DOI: 10.1556/2054.2019.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background and aims 5-Methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a potent, short-acting psychedelic that produces strong hallucinogenic effects. The association between the context (i.e., set and setting) of 5-MeO-DMT use and the acute and enduring effects of the substance is unknown. Therefore, this study examined these associations using secondary data from two cross-sectional survey studies. Methods The acute and enduring effects of inhaled synthetic 5-MeO-DMT were compared between individuals who used 5-MeO-DMT in a non-structured context (NSC; n = 216, female = 10%, Mage = 35.5, SD = 11.8) and those who used in a structured context (SC; n = 362, female = 45%, Mage = 47.7, SD = 13.3). Questionnaires were administered online and responses were anonymized for privacy purposes. Respondents were asked to retrospectively rate their first experience with synthesized 5-MeO-DMT on measures of mystical experience, challenging experience, and enduring effects. Results Both groups endorsed high ratings on the Mystical Experience Questionnaire; however, mean scores were significantly higher in the SC group compared to the NSC group. Similarly, the proportion of respondents who had a complete mystical experience was significantly larger in the SC group (83%) compared to the NSC group (54%). Ratings of enduring effects (i.e., meaningfulness, spirituality, and well-being) were also significantly higher, and the intensity of challenging experiences was significantly lower, in the SC group compared to the NSC group. Conclusions 5-MeO-DMT appears to occasion mystical-type experiences with enduring positive effects, which are more intense when 5-MeO-DMT is administered in a safe and supportive context. Future prospective experimental studies should examine the effects of 5-MeO-DMT and its interactive relationship with supportive contextual factors.
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Affiliation(s)
- Nathan D. Sepeda
- 1 Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - John M. Clifton
- 1 Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Laura Y. Doyle
- 1 Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Rafael Lancelotta
- 2 School of Counseling, Leadership, Advocacy, and Design, University of Wyoming, Laramie, WY, USA
| | - Roland R. Griffiths
- 1 Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- 3 Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Alan K. Davis
- 1 Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- 4 College of Social Work, The Ohio State University, Columbus, OH, USA
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42
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Lancelotta RL, Davis AK. Use of Benefit Enhancement Strategies among 5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT) Users: Associations with Mystical, Challenging, and Enduring Effects. J Psychoactive Drugs 2020; 52:273-281. [PMID: 32148190 DOI: 10.1080/02791072.2020.1737763] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT) is a potent, fast-acting psychedelic. Anecdotal reports from 5-MeO-DMT users suggest that they employ a variety of benefit enhancement (BE) strategies aimed to increase positive effects and decrease any potential challenging effects of the substance, but no empirical study has investigated this claim. We examined the prevalence of BE strategy use using secondary data from a survey of 5-MeO-DMT users (n = 515; Mage = 35.4, SD = 11.7; Male = 79%; White/Caucasian = 86%). Results indicated that BE strategy use was common in this sample. As a secondary aim, we assessed whether the use of BE strategies was associated with acute subjective (i.e., mystical-type, challenging) and persisting effects of 5-MeO-DMT among a subset of respondents who reported using 5-MeO-DMT once in their lifetime (n = 116). Results showed that the use of several BE strategies were associated with significantly more intense mystical-type effects and enduring beliefs about the personal meaning and spiritual significance of their experience, and some BE strategies were associated with less intense or challenging experiences. Data suggests that BE strategies are commonly used, and that the use of BE strategies may be associated with increases in positive mystical-type and enduring effects. The causal influence of BE strategies on acute/persisting effects of 5-MeO-DMT should be examined in longitudinal research.
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Affiliation(s)
- Rafael L Lancelotta
- School of Counseling, Leadership, Advocacy, and Design, University of Wyoming , Laramie, WY, USA.,Innate Path Psychotherapy Clinic , Lakewood, CO, USA
| | - Alan K Davis
- College of Social Work, The Ohio State University , Columbus, OH, USA.,Behavioral Pharmacology Research Unit, Department of Psychiatry, Johns Hopkins School of Medicine , Baltimore, MD, USA
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Uthaug MV, Lancelotta R, Szabo A, Davis AK, Riba J, Ramaekers JG. Prospective examination of synthetic 5-methoxy-N,N-dimethyltryptamine inhalation: effects on salivary IL-6, cortisol levels, affect, and non-judgment. Psychopharmacology (Berl) 2020; 237:773-785. [PMID: 31822925 PMCID: PMC7036074 DOI: 10.1007/s00213-019-05414-w] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Abstract
RATIONALE 5-methoxy-N,N-dimethyltryptamine is a psychotropic substance found in various plant and animal species and is synthetically produced. 5-methoxy-N,N-dimethyltryptamine is used in naturalistic settings for spiritual exploration, recreation, or to address negative affect and mood problems. However, scientific knowledge on the effects of 5-methoxy-N,N-dimethyltryptamine in humans is scarce. OBJECTIVES The first objective was to assess the effects of inhalation of vaporized synthetic 5-methoxy-N,N-dimethyltryptamine on neuroendocrine markers. The second objective was to assess effects of the substance on affect and mindfulness. In addition, we assessed whether ratings of subjective measures were associated with changes in stress biomarkers (i.e., cortisol) and immune response (i.e., IL-6, CRP, IL-1β), as well as the acute psychedelic experience. METHODS Assessments (baseline, immediately post-session, and 7-day follow-up) were made in 11 participants. Salivary samples were collected at baseline and post-session and analyzed by high-sensitivity enzyme-linked immunosorbent assay (ELISA). RESULTS 5-methoxy-N,N-dimethyltryptamine significantly increased cortisol levels and decreased IL-6 concentrations in saliva immediately post-session. These changes were not correlated to ratings of mental health or the psychedelic experience. Relative to baseline, ratings of non-judgment significantly increased, and ratings of depression decreased immediately post-session and at follow-up. Ratings of anxiety and stress decreased from baseline to 7-day follow-up. Participant ratings of the psychedelic experience correlated negatively with ratings of affect and positively with ratings of non-judgment. CONCLUSION Inhalation of vaporized synthetic 5-methoxy-N,N-dimethyltryptamine produced significant changes in inflammatory markers, improved affect, and non-judgment in volunteers. Future research should examine the effect of 5-methoxy-N,N-dimethyltryptamineamine with healthy volunteers in a controlled laboratory setting.
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Affiliation(s)
- Malin V Uthaug
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, Maastricht, 6229 ER, The Netherlands.
| | | | - Attila Szabo
- NORMENT, Institute of Clinical Medicine, University of Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Alan K Davis
- College of Social Work, The Ohio State University, Columbus, OH, 43210, USA
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 21224, USA
| | - Jordi Riba
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, Maastricht, 6229 ER, The Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, Maastricht, 6229 ER, The Netherlands.
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Garcia-Romeu A, Davis AK, Erowid E, Erowid F, Griffiths RR, Johnson MW. Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey. Front Psychiatry 2020; 10:955. [PMID: 32038317 PMCID: PMC6987443 DOI: 10.3389/fpsyt.2019.00955] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/03/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Observational data and preliminary studies suggest serotonin 2A agonist psychedelics may hold potential in treating a variety of substance use disorders (SUDs), including opioid use disorder (OUD). AIMS The study aim was to describe and analyze self-reported cases in which naturalistic psychedelic use was followed by cessation or reduction in other substance use. METHODS An anonymous online survey of individuals reporting cessation or reduction in cannabis, opioid, or stimulant use following psychedelic use in non-clinical settings. RESULTS Four hundred forty-four respondents, mostly in the USA (67%) completed the survey. Participants reported 4.5 years of problematic substance use on average before the psychedelic experience to which they attributed a reduction in drug consumption, with 79% meeting retrospective criteria for severe SUD. Most reported taking a moderate or high dose of LSD (43%) or psilocybin-containing mushrooms (29%), followed by significant reduction in drug consumption. Before the psychedelic experience 96% met SUD criteria, whereas only 27% met SUD criteria afterward. Participants rated their psychedelic experience as highly meaningful and insightful, with 28% endorsing psychedelic-associated changes in life priorities or values as facilitating reduced substance misuse. Greater psychedelic dose, insight, mystical-type effects, and personal meaning of experiences were associated with greater reduction in drug consumption. CONCLUSIONS While these cross-sectional and self-report methods cannot determine whether psychedelics caused changes in drug use, results suggest the potential that psychedelics cause reductions in problematic substance use, and support additional clinical research on psychedelic-assisted treatment for SUD.
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Affiliation(s)
- Albert Garcia-Romeu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alan K. Davis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- College of Social Work, The Ohio State University, Columbus, OH, United States
| | | | - Fire Erowid
- Erowid Center, Grass Valley, CA, United States
| | - Roland R. Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Bonar EE, Goldstick JE, Cunningham RM, Fernandez AC, Davis AK, Ilgen MA, Walton MA. Individual and Social Factors Related to Trajectories of Blackouts among Underage Drinkers in the Emergency Department. Alcohol Alcohol 2020; 54:370-377. [PMID: 30608570 DOI: 10.1093/alcalc/agy087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 11/19/2018] [Accepted: 11/23/2018] [Indexed: 12/19/2022] Open
Abstract
AIMS Alcohol-related blackouts can result in acute injuries and other negative outcomes. Among underage risky drinkers, we examined longitudinal trajectories of blackout frequency following an emergency department (ED) visit, and identified baseline characteristics associated with blackout trajectory membership. METHODS Participants (ages 14-20; N = 836) attending an ED who screened positive for risky drinking and enrolled in a randomized-controlled trial of brief alcohol interventions were assessed at baseline, 3-, 6-, and 12-months. We used group-based trajectory modeling to determine characteristic trajectories of blackout frequency over 12-months in relation to baseline characteristics: demographics, substance use, delinquency, depression/anxiety symptoms, sexual assault, dating violence, and peer and sibling influences. RESULTS We identified four groups: No/Low blackouts (n = 248; 29.7%), Declining blackouts (n = 92; 11.0%), Moderate blackouts (n = 337; 40.3%) and High blackouts (n = 159; 19.0%); group membership did not differ based on intervention receipt. In adjusted analyses, compared to the No/Low group all other groups had higher odds of having an alcohol-related baseline ED visit. Female sex, alcohol consumption, prescription drug misuse, sexual assault while incapacitated due to substances, and negative peer influences were positively associated with membership in the High group; College/Greek life involvement was also highest. Negative peer influences and being in high school (vs. College/Greek life) also distinguished the Moderate group. CONCLUSION Blackout frequency was largely stable over time and riskier trajectories were marked by risk factors such as negative peer influences and college/Greek life involvement. Findings may inform targeted interventions, particularly for women who were in higher risk trajectories.
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Affiliation(s)
- Erin E Bonar
- Addiction Center, University of Michigan Department of Psychiatry, Ann Arbor, MI.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - Jason E Goldstick
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA.,Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca M Cunningham
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA.,Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Anne C Fernandez
- Addiction Center, University of Michigan Department of Psychiatry, Ann Arbor, MI
| | - Alan K Davis
- Addiction Center, University of Michigan Department of Psychiatry, Ann Arbor, MI.,Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Mark A Ilgen
- Addiction Center, University of Michigan Department of Psychiatry, Ann Arbor, MI.,Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, MI, USA
| | - Maureen A Walton
- Addiction Center, University of Michigan Department of Psychiatry, Ann Arbor, MI.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
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Luoma JB, Davis AK, Watts R, McCracken LM. Integrating contextual behavioral science with research on psychedelic assisted therapy: Introduction to the special section. Journal of Contextual Behavioral Science 2020. [DOI: 10.1016/j.jcbs.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Davis AK, Averill LA, Sepeda ND, Barsuglia JP, Amoroso T. Psychedelic Treatment for Trauma-Related Psychological and Cognitive Impairment Among US Special Operations Forces Veterans. Chronic Stress (Thousand Oaks) 2020; 4:2470547020939564. [PMID: 32704581 PMCID: PMC7359647 DOI: 10.1177/2470547020939564] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND U.S. Special Operations Forces Veterans are at increased risk for a variety of mental health problems and cognitive impairment associated with military service. Current treatments are lacking in effectiveness and adherence. Therefore, this study examined psychedelic treatment with ibogaine and 5-methoxy-N,N-dimethyltryptamine for trauma-related psychological and cognitive impairment among U.S. Special Operations Forces Veterans. METHOD We conducted a survey of Veterans who completed a specific psychedelic clinical program in Mexico between 2017 and 2019. Questions probed retrospective reports of mental health and cognitive functioning during the 30 days before and 30 days after treatment. A total of 65 people completed treatment during this time frame and were eligible for contact. Of these, 51 (78%) completed the survey and were included in data analyses (mean age = 40; male = 96%; married = 55%; Caucasian/White = 92%; Operation Enduring Freedom/Operation Iraqi Freedom Service = 96%). RESULTS Results indicated significant and very large reductions in retrospective report of suicidal ideation (p < .001; d = -1.9), cognitive impairment (p < .001; d = -2.8), and symptoms of posttraumatic stress disorder (p < .001; d = -3.6), depression (p < .001; d = -3.7), and anxiety (p < .001; d = -3.1). Results also showed a significant and large increase in retrospective report of psychological flexibility (p < .001; d = 2.9) from before-to-after the psychedelic treatment. Increases in the retrospective report of psychological flexibility were strongly associated with retrospective report of reductions in cognitive impairment, and symptoms of posttraumatic stress disorder, depression, and anxiety (rs range -0.61 to -0.75; p < .001). Additionally, most participants rated the psychedelic experiences as one of the top five personally meaningful (84%), spiritually significant (88%), and psychologically insightful (86%) experiences of their lives.Limitations: Several limitations should be considered including the retrospective, self-report, survey design of the study, and the lack of randomization and blinding, thus making these finding preliminary. CONCLUSION U.S. Special Operations Forces Veterans may have unique treatment needs because of the sequela of problems associated with repeated trauma exposure and the nature of the exposure. Psychedelic-assisted therapy with these under-researched psychedelics may hold unique promise for this population. However, controlled studies are needed to determine whether this treatment is efficacious in relieving mental health and cognitive impairment among U.S. Special Operations Forces Veterans.
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Affiliation(s)
- Alan K. Davis
- College of Social Work, The Ohio State University, Columbus, OH, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Lynnette A. Averill
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, National Center for PTSD, West Haven, CT, USA
| | - Nathan D. Sepeda
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | | | - Timothy Amoroso
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, National Center for PTSD, West Haven, CT, USA
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Davis AK, Barrett FS, Griffiths RR. Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. J Contextual Behav Sci 2019; 15:39-45. [PMID: 32864325 DOI: 10.1016/j.jcbs.2019.11.004] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Prior research has shown that acute subjective psychedelic effects are associated with both spontaneous and intended changes in depression and anxiety. Psychedelics are also theorized to produce increases in psychological flexibility, which could explain decreases in depression and anxiety following a psychedelic experience. Therefore, the present cross-sectional survey study sought to examine whether psychological flexibility mediated the relationship between acute psychedelic experiences and spontaneous or intended changes in depression and anxiety among a large international sample of people who reported having used a psychedelic (n=985; male=71.6%; Caucasian/white=84.1%; M age=32.2, SD=12.6). A regression analysis showed that acute effects (i.e., mystical and insightful effects) were significantly associated with decreases in depression/anxiety following a psychedelic experience. A path analysis revealed that, while controlling for age and sex, increases in psychological flexibility fully mediated the effect of mystical and insightful experiences on decreases in depression and anxiety following a psychedelic experience. This suggests that psychological flexibility may be an important mediator of the therapeutic effects of psychedelic drugs. Future prospective experimental studies should examine the effect of psychedelic drug administration on psychological flexibility in order to gain a better understanding of the psychological processes that predict therapeutic effects of psychedelics.
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Affiliation(s)
- Alan K Davis
- College of Social Work, The Ohio State University, Columbus, OH 43210.,Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Frederick S Barrett
- Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA.,Department of Neuroscience, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
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Abstract
BACKGROUND Meta-analysis of randomized studies using lysergic acid diethylamide (LSD) for alcohol use disorder (AUD) showed large, significant effects for LSD efficacy compared to control conditions. Clinical studies suggest potential anti-addiction effects of LSD and mechanistically-related classic psychedelics for alcohol and other substance use disorders. AIMS To supplement clinical studies, reports of psychedelic use in naturalistic settings can provide further data regarding potential effects of psychedelics on alcohol use. METHODS An anonymous online survey of individuals with prior AUD reporting cessation or reduction in alcohol use following psychedelic use in non-clinical settings. RESULTS 343 respondents, mostly White (89%), males (78%), in the USA (60%) completed the survey. Participants reported seven years of problematic alcohol use on average before the psychedelic experience to which they attributed reduced alcohol consumption, with 72% meeting retrospective criteria for severe AUD. Most reported taking a moderate or high dose of LSD (38%) or psilocybin (36%), followed by significant reduction in alcohol consumption. After the psychedelic experience 83% no longer met AUD criteria. Participants rated their psychedelic experience as highly meaningful and insightful, with 28% endorsing psychedelic-associated changes in life priorities or values as facilitating reduced alcohol misuse. Greater psychedelic dose, insight, mystical-type effects, and personal meaning of experiences were associated with a greater reduction in alcohol consumption, controlling for prior alcohol consumption and related distress. CONCLUSIONS Although results cannot demonstrate causality, they suggest that naturalistic psychedelic use may lead to cessation or reduction in problematic alcohol use, supporting further investigation of psychedelic-assisted treatment for AUD.
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Affiliation(s)
- Albert Garcia-Romeu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alan K Davis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Roland R Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Arterberry BJ, Davis AK, Walton MA, Bonar EE, Cunningham RM, Blow FC. Predictors of empirically derived substance use patterns among sexual minority groups presenting at an emergency department. Addict Behav 2019; 96:76-81. [PMID: 31048112 DOI: 10.1016/j.addbeh.2019.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 11/28/2022]
Abstract
AIM Minority sexual orientation (i.e., Lesbian, Gay, Bisexual; LGB) is a risk indicator for mental health and substance use problems. Findings are inconsistent across studies investigating LGB substance use and risk factors, possibly due to heterogeneity in LGB subgroups. To inform models of substance use risk, we identified empirical patterns of substance use and related risk behaviors among LGB individuals. METHOD LGB participants (N = 343; Mage = 35.5, SD = 11.8; 71.4% = Female; 80.5% = White) were screened in an Emergency Department as part of a randomized controlled trial of an alcohol brief intervention. We conducted latent class analyses using the AUDIT-C (12 month; frequency, quantity, & binge) and ASSIST (12 month; illicit or misused prescription substance). Multinomial regression was performed to test predictors of class membership including depression symptoms, driving after alcohol or marijuana, and sexually transmitted infection (STI) history. RESULTS A 3-class model fit best and included "low use alcohol, marijuana, and tobacco users," (Low use; n = 244) "hazardous alcohol, tobacco and marijuana users," (Hazardous; n = 74) and "high-risk polysubstance users" (HPU; n = 25). The Low use class comprised the largest proportion of the sample across age, race/ethnicity, and sexual orientation. Compared to the Low use class, higher likelihood of depression symptoms, driving after alcohol or marijuana use, and STI was found for both Hazardous and HPU classes. CONCLUSION Researchers and clinicians should consider substance use patterns within the LGB population to inform interventions that address a variety of complex needs such as allocating more support for LGB individuals endorsing high-risk polysubstance use.
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Affiliation(s)
- Brooke J Arterberry
- Department of Psychology, Lagomarcino Hall, 901 Stange Road, Ames, IA 50011-1041, USA.
| | - Alan K Davis
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA; University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Maureen A Walton
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; University of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, MI 48109, USA
| | - Erin E Bonar
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; University of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, MI 48109, USA
| | - Rebecca M Cunningham
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, MI 48109, USA; University of Michigan School of Medicine, Department of Emergency Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; University of Michigan School of Public Health, Health Behavior and Health Education, 1415 Washington Heights Ann Arbor, MI 48109, USA
| | - Frederic C Blow
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; Veterans Affairs Ann Arbor Healthcare System, Center for Clinical Management Research, Health Services Research & Development, 2215 Fuller Road, Ann Arbor, MI 48105, USA
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