Since its emergence as a “popular” hallucinogen in the late 1930s (Liester, 2014, p. 146),
lysergic acid diethylamide (LSD) has been alternately viewed as a dangerous, recreational substance and a medically sound means of treating a range of illnesses. Ironically, in fact, LSD is most widely used in clinical settings to treat alcoholism and narcotic addictions, as the treatments are based on evidence that LSD itself is non-addictive. Liester’s 2014 article, “A review of lysergic acid diethylamide (LSD) in the treatment of addictions: historical perspectives and future prospects,” essentially supports these uses. Liester presents much credible evidence of the efficacy of LSD as frequently weakening alcohol and narcotic addictions.
At the same time, and while noting documented benefits of LSD so applied, the author adds qualifications; it is generally held, for example, that prior research is often biased. Nonetheless, Liester affirms that optimism, if necessarily cautious, is justified in LSD as an addiction response (2014, p. 154), and because of its non-addictive properties. The article cites multiple studies supporting ongoing usage of LSD to treat addiction, and particularly as addiction rates are consistently rising globally. This view is further supported by research indicating significant value of LSD in psychotherapy contexts, as in treating schizophrenia and other severe mental illnesses (Schmid et al, 2015, p. 552). Here as well, and importantly, LSD benefits are largely attributed to both its inducing of beatific emotional states and its not creating addictive states.
The above evidence of value notwithstanding, however, it is at least arguable that clinical applications of LSD are not entirely responsible, and because addiction to LSD, or with other hallucinogens, is never easily defined. More exactly, and as even research supporting LSD as treatment acknowledges, psychological addiction is often as powerful as the physical. There is a consistent ambiguity noted in most studies of LSD as pathologically or physically addictive. Extensive research affirms that the drug is only rarely physically addictive, which relates to its being increasingly applied for pain and/or clinical anxiety relief (Beidel, Frueh, & Hersen, 2014, p. 674). What frequently occurs is that inconsistent study designs are less credible because, as noted by Liester and as in LSD used in alcoholism treatment, criteria for improvement widely vary (2014, p. 149). The primary issue is that an addictive personality is highly vulnerable to transferring one dependence for another, and this risk factor is increased because of the agreeable effects of LSD.
In study after study, users experience states of euphoria or “oceanic boundlessness,” just as their behaviours become significantly improved regarding anxieties, depression, and more severe psychological illnesses. With LSD, there are no physical withdrawals symptoms as associated with addiction. At the same time, however, numbers of experts assert that the emotional and psychological effects are more than sufficient to generate addictive states. This risk is further compounded by the evidence of increased tolerance with sustained usage (CAMH, 2012), inducing users to increase dosages and frequency of usage.
Ultimately, there is no discounting that LSD, carefully administered, assists in the treatment of addictions. As Liester himself emphasizes, nonetheless, caution must be consistently applied in any such scenario. Ironically or otherwise, the reality is that the vast majority of LSD users, addicted to other substances or not, experience highly pleasurable mental and emotional states, which inevitably lead to desires for additional such experiences. There is no strict dichotomy between biological and psychological conditions, just as addiction typically reflects interactions of both. More importantly, it is irresponsible to minimize the psychological alone. Ultimately, then, Liester’s basic endorsement of LSD as effective in treating addiction is reasonable and well-supported, even as it is equally critical that the author’s emphasis on caution be applied in any such treatment.