Effectiveness and Experiences of Psychedelic-Based Interventions for the Treatment of Alcohol Use Disorder: A Mixed Methods Systematic Review

Background: Alcohol use disorder (AUD) is a serious condition that affects millions worldwide and can have devastating and far-reaching health, social and economic consequences. Current treatment rates, which refer to the percentage of the total population living with AUD receiving treatment, remain low. The treatments that do exist, such as medications and behavioural treatments, are not always considered effective. Therefore, there is a need for alternative treatment options. Utilising psychedelic drugs to treat AUD is one method that is currently being explored and may have potential. The aim of this mixed methods systematic review is to identify and synthesize contemporary research on the effectiveness and experiences of those receiving psychedelic in a clinical setting. Methods: The review was conducted according to the Joanna Briggs Institute (JBI) guidelines for mixed- methods systematic reviews. The following databases were searched to retrieve relevant recent studies from 2000-2022: MEDLINE, CINAHL PsycINFO, PsycARTICLES, Psychology and Behavioural ScienceCollection, PubMed and Cochrane Central Register of Controlled Trials (CENTRAL). Eligible studieswritten in the English language consisting of quantitative or qualitative study designs examining either the effectiveness and/or experiences of individuals in receiving psychedelics for treatment of AUD in a clinical setting were included. Data extraction and quality appraisal was conducted utilizing JBI SUMARI software. A narrative synthesis was conducted for the quantitative component of the review while a meta-aggregative approach was undertaken for the qualitative synthesis. Results: 8 Studies, 4 of quantitative design and 4 of qualitative design, were included. The quantitative studies examined the effectiveness and safety of psychedelics in utilizing psychedelics in treating AUD, while the qualitative studies examined participants' experiences of receiving them. Quantitative studies reported an overall increase in abstinence and decrease in drinking days following treatment, while the qualitative studies reported mostly positive experiences of receiving psychedelic treatment via case studies, interviews, or analysis of debriefing sessions. However, due to the mostly 'poor' and 'moderate' quality appraisal ratings of included studies, the results should be interpreted with caution. Conclusion: Overall, results revealed mostly positive outcomes and experiences of receiving treatment with psychedelics for AUD. However, due to the small number of studies conducted in recent years, small sample sizes, heterogeneity of studies affecting the overall quality of studies, there is a need to conduct further studies aiming to overcome these limitations. Keywords: Psychedelics; Hallucinogens; Psilocybin; LSD; MDMA; Ketamine; Psychotherapy; Alcohol Use Disorder; Alcoholism; Alcohol Addiction; Alcohol Dependence; Adults