Can psychedelics help treat addiction by rebalancing brain chemistry? 

A review of recent studies suggests that psychedelics, particularly psilocybin, may help treat substance use disorders by balancing dopamine levels in the brain, which can reduce cravings and the risk of relapse. This article will delve into the science behind this, the clinical evidence, and the potential for psychedelic-assisted therapy to revolutionize addiction treatment.

Rebalancing the Brain: How Psychedelics Could Revolutionize Addiction Treatment

Addiction is a complex and devastating condition that affects millions of people worldwide. For decades, the primary approaches to treatment have centered on behavioral therapies and medications that often have limited success rates and high relapse rates. However, a new wave of research into the therapeutic potential of psychedelics is offering a glimmer of hope for a more effective way to treat substance use disorders (SUDs). A recent review of clinical trials and neurobiological studies suggests that psychedelics, such as psilocybin, may work by rebalancing the brain's dopamine system, a key player in the cycle of addiction. This novel approach could represent a paradigm shift in how we understand and treat addiction, moving beyond simply managing symptoms to addressing the underlying neurobiological roots of the disease.

The Brain on Addiction: The Role of Dopamine

To understand how psychedelics might help in the treatment of addiction, it is first necessary to understand the role of dopamine in the brain. Dopamine is a neurotransmitter that plays a crucial role in the brain's reward system. When we engage in pleasurable activities, such as eating or socializing, our brain releases dopamine, which creates a feeling of pleasure and reinforces the behavior. In addiction, drugs of abuse hijack this system, causing a surge of dopamine that is far greater than what is produced by natural rewards. This intense pleasure reinforces the drug-taking behavior, and over time, the brain adapts to the presence of the drug, leading to tolerance, dependence, and the compulsive drug-seeking behavior that is the hallmark of addiction. A 2022 study in JAMA Psychiatry on psilocybin for alcohol use disorder provides a clear example of the clinical relevance of targeting these systems [2].

The constant overstimulation of the dopamine system by drugs of abuse can lead to a state of dopamine depletion, where the brain is no longer able to produce normal levels of dopamine on its own. This can lead to a state of anhedonia, or the inability to feel pleasure, which can be a major driver of relapse. Individuals in this state may feel that they can only feel pleasure when they are using the drug, which creates a vicious cycle of addiction. The challenge for addiction treatment is to find a way to break this cycle and to restore balance to the brain's dopamine system. This is where psychedelics may offer a new and promising approach. A comprehensive 2025 review in Medicina highlights the growing body of clinical trials investigating psychedelic therapy for SUDs, underscoring the need for new treatment options [3].

Psychedelics and Dopamine: A New Path to Balance

A 2025 scoping review published in the British Journal of Pharmacology has provided a comprehensive overview of the current state of research into the use of psychedelics for the treatment of SUDs [1]. The review, which analyzed both clinical trials and neurobiological studies, found that psychedelics, particularly psilocybin, may have a unique ability to modulate the dopamine system in a way that is beneficial for addiction recovery. The review highlighted a key finding from in vivo microdialysis studies in rats, which showed that high-dose psilocybin produced a sustained, mild increase in extracellular dopamine in the nucleus accumbens, a key brain region involved in reward and addiction. This is a significant finding, as it suggests that psilocybin may be able to restore tonic dopamine levels, which are often depleted in individuals with addiction. This restoration of dopamine homeostasis could help to reduce cravings and the risk of relapse, providing a neurobiological basis for the therapeutic effects of psilocybin in addiction treatment.

The review also noted that the majority of clinical trials of psychedelics for SUDs have been open-label and have lacked placebo-treated controls, highlighting the need for more rigorous research in this area. However, the preliminary findings from these trials have been very promising. A 2025 study in The Lancet eClinicalMedicine on psilocybin-assisted therapy for relapse prevention in alcohol use disorder found that a single dose of psilocybin combined with brief psychotherapy could reduce relapse rates and alcohol use in patients with AUD [4]. This study provides further clinical evidence to support the neurobiological findings from the scoping review, and it suggests that psilocybin-assisted therapy could be a powerful new tool for helping individuals to maintain their recovery from addiction.

The Clinical Evidence: A Wave of Promising Results

The neurobiological rationale for using psychedelics to treat addiction is compelling, and it is supported by a growing body of clinical evidence. The 2025 scoping review identified 34 unique clinical trials investigating the use of psychedelics for a range of SUDs, including alcohol, cannabis, cocaine, methamphetamine, nicotine, and opioid use disorders [1]. While many of these trials are still in their early stages, the results that have been published so far have been overwhelmingly positive. The most common SUD being investigated is alcohol use disorder (AUD), and several studies have shown that psilocybin-assisted therapy can lead to significant reductions in drinking and cravings. A 2025 study in the American Journal of Psychiatry found that psilocybin-assisted therapy for AUD was associated with positive personality changes, including reduced neuroticism and increased extraversion and openness, which are factors that are known to be protective against relapse [5].

Beyond AUD, researchers are also exploring the potential of psychedelics to treat other SUDs. There is a growing interest in the use of psilocybin for nicotine addiction, and early studies have shown that it can be significantly more effective than traditional smoking cessation treatments. There is also emerging research into the use of psychedelics for cocaine and opioid addiction, although this research is still in its very early stages. The broad applicability of psychedelics across a range of SUDs suggests that they may be targeting a common underlying mechanism of addiction, which is a very exciting prospect. The fact that these treatments are showing promise in some of the most difficult-to-treat addictions is a testament to their transformative potential of psychedelic medicine.

A New Hope for Recovery: The Future of Psychedelic-Assisted Therapy for SUDs

The convergence of neurobiological and clinical evidence is painting a very hopeful picture for the future of psychedelic-assisted therapy for SUDs. The ability of psychedelics to modulate the dopamine system and to promote neuroplasticity, the brain's ability to change and adapt, may provide a powerful one-two punch against the entrenched patterns of addiction. The psychedelic experience itself can also be a powerful catalyst for change, providing individuals with a new perspective on their lives and their addiction. Many people who have undergone psychedelic-assisted therapy for addiction report having profound spiritual experiences that help them to break free from the cycle of craving and relapse. This combination of neurobiological and psychological effects may be what makes psychedelic-assisted therapy so uniquely effective.

Of course, there is still much to learn. More research is needed to understand the long-term effects of psychedelic-assisted therapy for SUDs, and to determine which individuals are most likely to benefit from this type of treatment. It is also crucial that this therapy is delivered in a safe and ethical manner, with trained professionals who can provide the necessary support and guidance. The road to mainstream acceptance and accessibility will be a long one, but the journey has begun. The promising results from the research to date are a powerful motivator for continued investigation, and they offer a new sense of hope to the millions of people who are struggling with the devastating consequences of addiction.

Conclusion: A Paradigm Shift in Addiction Medicine

The treatment of addiction is on the cusp of a major paradigm shift. The emerging evidence for the efficacy of psychedelic-assisted therapy is challenging our old models of addiction and opening up new possibilities for healing. The ability of psychedelics to rebalance the brain's dopamine system and to promote profound psychological and spiritual experiences may provide a more holistic and effective approach to addiction treatment than anything we have seen before. While there is still much work to be done, the future of addiction medicine looks brighter than it has in a long time. The revolution may not be televised, but it may just be psychedelic.

References

[1] Wittenkeller, L., et al. (2025). Psychedelics as pharmacotherapeutics for substance use disorders: A scoping review on clinical trials and perspectives on underlying neurobiology. British Journal of Pharmacology. https://pubmed.ncbi.nlm.nih.gov/40891276/

[2] Bogenschutz, M. P., et al. (2022). Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder: a randomized clinical trial. JAMA Psychiatry. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2795625

[3] Hogea, L., et al. (2025). The Therapeutic Potential of Psychedelics in Treating Substance Use Disorders: A Review of Clinical Trials. Medicina. https://www.mdpi.com/1648-9144/61/2/278[

4] Rieser, N. M., et al. (2025). Psilocybin-assisted therapy for relapse prevention in alcohol use disorder. The Lancet eClinicalMedicine. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00081-1/fulltext[

5] Pagni, B. A., et al. (2025). Multidimensional personality changes following psilocybin-assisted therapy in patients with alcohol use disorder: Results from a double-blind, placebo-controlled clinical trial. American Journal of Psychiatry. https://psychiatryonline.org/doi/abs/10.1176/appi.ajp.20230887

Disclaimer: Psychedelic Assisted Psychotherapy has not been approved by any regulatory agencies in the United States, and the safety and efficacy are still not formally established at the time of this writing.