Impact of psychedelics on craving in addiction: A systematic review

Background: In the context of the need to increase treatment options for substance use disorders, recent research has evaluated the therapeutic potential of psychedelics. However, there is an incomplete understanding of psychedelics’ effects on craving, a core symptom of addictive disorders and a predictor of substance use and relapse. Aims: To determine if the use of psychedelics is associated with changes in craving in humans. Methods: A systematic review of the literature, using PubMed, PsycInfo, and Scopus databases up to May 2023. We included all studies assessing any substance craving levels after psychedelic use (protocol registration number CRD42021242856). Results: Thirty-eight published articles were included, corresponding to 31 studies and 2639 participants, pertaining either to alcohol, opioid, cocaine, or tobacco use disorders. Twelve of the 31 included studies reported a significant decrease in craving scores following psychedelic use. All but two studies had methodological issues, leading to moderate to high risk of bias scores. Conclusions: Some psychedelics may show promising anti-craving effects, yet the diversity and high risk of bias of extant studies indicate that these results are to be considered with caution. Further well-controlled and larger-scale trials should be encouraged.