Psychotherapeutic Interventions in Clinical Trials of Psychedelics for the Treatment of Alcohol Use Disorder

Alcohol use disorder (AUD) is the most common substance use disorder in the USA, with a considerable burden of disease. In recent years, psychedelics have emerged as particularly promising in treating AUD. In this paper, we review trials of classic and non-classic psychedelics in the treatment of AUD to determine whether there is substantial evidence, either confirming or refuting the need for accompanying psychotherapy on clinical effect for the treatment of AUD and whether any of the therapy methods are superior to others in this context. We found no study directly comparing different modalities of psychotherapy. Most trials did not include a psychotherapy-free arm to assess the psychedelic compounds independently. Only a few studies have compared arms with and without psychotherapy and no significant differences in the magnitude of improvement between arms were found. Moreover, many of the trials with a psychotherapy-free arm had methodological shortcomings such as poorly defined outcomes, small numbers of participants, and short follow-up periods. There is a lack of high-quality empirical evidence confirming or refuting the necessity for concomitantly delivered psychotherapy during psychedelic trials for AUD. Therefore, future clinical trials should be designed in a manner that can shed light on the relationship between psychedelic treatment and use of psychotherapy.