Hallucinogen Use Disorders, and Psychedelics for the Treatment of Substance Use Disorders (2025-2026 Recording)-Hallucinogen Use Disorders, and Psychedelics for the Treatment of Substance Use Disorders Recording

Video Transcription

Video Summary

The lecture reviewed hallucinogens and psychedelics in addiction medicine, emphasizing both their risks and therapeutic promise. Dr. Suzuki traced the field’s resurgence from early Hopkins studies on psilocybin and ketamine to today’s growing public interest, sparked in part by <em>How to Change Your Mind</em>. He explained that psychedelics are widely used in the U.S., especially among young adults, yet they account for far fewer emergency visits than alcohol or opioids.  

He outlined major drug classes: classic serotonergic psychedelics such as LSD, psilocybin, mescaline, and DMT; dissociatives like ketamine; empathogens like MDMA; atypical agents such as ibogaine; and deliriants. The core mechanism of classic psychedelics is 5-HT2A agonism, with effects strongly shaped by “set and setting.” He also reviewed brain effects, including reduced default mode network activity, neuroplasticity, and possible reopening of critical periods.  

The talk stressed adverse outcomes: acute intoxication, prolonged toxidromes from novel analogs, hallucinogen use disorder, ketamine-related bladder damage, hallucinogen persisting perceptual disorder (HPPD), and rare but serious psychosis or dangerous behavior. He also highlighted the importance of supervision, preparation, and integration, as well as concerns about underground therapy and therapist misconduct.  

On treatment of substance use disorders, the evidence remains early but promising. Ketamine has the strongest data so far, with small trials suggesting benefit for alcohol and cocaine use disorders. Psilocybin has encouraging but mixed results, and ibogaine remains largely observational, limited by cardiac toxicity. Overall, psychedelics are not a cure-all, and more rigorous, diverse research is needed before broad clinical adoption.

Keywords

hallucinogens

psychedelics

addiction medicine

psilocybin

ketamine

MDMA

LSD

5-HT2A agonism

set and setting

default mode network

neuroplasticity

hallucinogen use disorder

HPPD

substance use disorder treatment

cardiac toxicity