Psilocybin Therapy for Addiction: What the Research Shows

Overview: Researchers are investigating the potential of psilocybin-assisted therapy for addiction, building on early studies with psychedelics like LSD. Recent trials have shown promising results, particularly in reducing alcohol and tobacco use, with high rates of abstinence reported. When combined with psychotherapy, psilocybin offers new hope for those struggling with addiction. However, further research is necessary to fully understand its long-term effects and the mechanisms driving its therapeutic impact.

‍

Psychedelic Therapy for Addiction: Early Signs of Promise

In the early exploration of psychedelic therapy for addiction, researchers conducted a meta-analysis — a comprehensive review of data from multiple studies — to understand the effectiveness of the psychedelic drug lysergic acid diethylamide (LSD) in treating alcohol addiction. This analysis compiled findings from six randomized clinical trials — studies designed to evaluate the effectiveness of a treatment — conducted between 1966 and 1971.

‍

In these trials, participants with alcohol dependence were either treated with LSD or received comparator conditions, which included other forms of therapy or no treatment at all. The aim was to compare the outcomes between those who received LSD and those in control groups who did not.

‍

Among the 325 participants who received treatment with LSD in these trials, a notable trend emerged. During the first posttreatment follow-up, which occurred within a range of 1 month to 12 months after treatment, participants who had been treated with LSD showed remission nearly twice as often as those in the comparator conditions.

‍

To quantify this observation, researchers calculated the odds ratio for improvement. This statistical measure helps assess the likelihood of a certain outcome — in this case, improvement in alcohol dependence —- between two groups. The odds ratio for improvement was found to be 1.96, favoring LSD treatment. In other words, individuals who received LSD were almost twice as likely to show improvement compared to those who did not receive it.

‍

Although these early findings pointed to the potential of psychedelic therapy in addressing addiction, it's important to interpret these results cautiously and within the context of the time period in which these studies were conducted.

‍

In more recent years, researchers have endeavored to address these limitations and better understand the effectiveness and safety of psychedelic therapy as a treatment for addiction. In particular, the combination of the psychedelic compound found in “magic mushrooms,” psilocybin, and therapy has produced encouraging results in individuals grappling with addiction, including dependencies on substances such as tobacco and alcohol.

‍

Psilocybin Therapy for Alcohol Addiction

In a pioneering study by Rydzyński and colleagues in 1968, researchers explored the potential of psilocybin as a treatment for alcohol use disorder. The study included 31 patients grappling with alcohol dependency.

‍

The treatment regimen was multifaceted. Patients first received doses of psilocybin ranging from 6 to 30 milligrams (mg), followed by sessions with LSD, dosed between 100 and 800 micrograms (mcg). For every three LSD sessions, a psilocybin session was incorporated, with each session spaced apart by around a week. Alongside these psychedelic sessions, patients also underwent psychotherapy to complement their treatment journey.

‍

As the study progressed, the researchers observed a significant shift in treatment strategy. They found that psilocybin yielded more favorable results with fewer negative effects compared to LSD. Consequently, the use of LSD was discontinued, and the focus shifted solely to psilocybin treatment.

‍

The outcomes were promising. Over a mean follow-up period of 6 years, 32% of patients achieved complete abstinence from alcohol. Additionally, a substantial 58% of patients reported experiencing a “satisfactory therapeutic effect” from the treatment.

‍

This early study laid the groundwork for further exploration into the potential of psilocybin-assisted therapy for addiction. 

‍

Modern Research on Psilocybin for Alcohol Use Disorder

In a 2015 study led by Dr. Michael Bogenschutz, Director of the NYU Langone Center for Psychedelic Medicine, researchers explored the effects of psilocybin on individuals with alcohol dependence. This proof-of-concept study sought to evaluate whether psilocybin-assisted therapy could offer a novel and effective approach for treating alcohol addiction, an area where conventional treatments often face significant limitations.

‍

The study involved ten volunteers diagnosed with alcohol dependence, who participated in supervised sessions where they ingested psilocybin orally. These sessions were integrated with Motivational Enhancement Therapy, along with specialized therapy sessions designed to help participants prepare for and reflect on their psilocybin experience.

‍

Following the psilocybin sessions, abstinence rates significantly increased, and these improvements were largely maintained for up to 36 weeks post-treatment. Interestingly, the study found a correlation between the intensity of the effects experienced during the initial psilocybin session and subsequent changes in drinking behavior. Participants who reported stronger effects in their first session showed greater reductions in alcohol consumption, along with decreased cravings and increased confidence in their ability to abstain.

‍

Importantly, the study also found no significant adverse events related to the treatment, highlighting its promising safety profile. This finding is particularly encouraging, as it suggests that psilocybin-assisted therapy could be a relatively safe intervention for individuals struggling with alcohol dependence, warranting further investigation in larger clinical trials.

‍

The findings provided early evidence of psilocybin's potential to reduce alcohol use, opening the door for more extensive research into its therapeutic applications for addiction.

‍

‍

Breaking New Ground: Psilocybin Therapy Shows Promise in Treating Alcohol Use Disorder

In a more recent study, again led by Dr. Michael Bogenschutz and his team, researchers further investigated whether psilocybin-assisted therapy could provide a new treatment option for individuals struggling with alcohol dependence. This study aimed to build on earlier findings, exploring in greater depth how psilocybin might help reduce alcohol consumption and support long-term recovery, offering a potential alternative to conventional treatments for addiction.

‍

The study recruited 93 adults between the ages of 25 and 65 who had been diagnosed with alcohol dependence and had a history of heavy drinking. Over a span of 12 weeks, participants engaged in structured psychotherapy sessions, incorporating motivational enhancement therapy and cognitive behavioral therapy (CBT) techniques.

‍

Participants were randomly assigned to receive either psilocybin or a placebo (the antihistamine medicine diphenhydramine) during two day-long treatment sessions at weeks 4 and 8 of the study. The dosages administered were carefully controlled, with psilocybin given at 25 mg per 70 kg of body weight for the first session and adjusted to 25-40 mg per 70 kg for the second session. The placebo, diphenhydramine, was given at 50 mg for the first session and adjusted to 50-100 mg for the second session.

‍

The results of the study revealed promising outcomes for the group that received psilocybin-assisted therapy. Participants in this group showed significant reductions in both the number of heavy drinking days and the average daily alcohol consumption compared to those who received the placebo. Over the 32-week double-blind period, the percentage of heavy drinking days was notably lower at 9.7% for the psilocybin group compared to 23.6% for the diphenhydramine group.

‍

By the end of the trial, 50% of participants in the psilocybin group reported abstaining from alcohol — a significant achievement in the context of alcohol use disorder treatment.

‍

Psilocybin Therapy for Tobacco Addiction 

In 2014, psychologist and psychedelic researcher Dr. Matthew Johnson and his colleagues conducted a small pilot study exploring the use of psilocybin-assisted therapy to combat tobacco addiction. The study focused on individuals with a long history of nicotine dependence, who had been smokers for an average of 31 years. This innovative approach combined doses of psilocybin—ranging from 20 to 30 mg per 70 kg of body weight—with cognitive-behavioral therapy (CBT).

‍

In this open-label pilot study, the observed smoking cessation rate substantially exceeded those commonly reported for traditional behavioral and/or pharmacological therapies for smoking cessation, which typically achieve less than 35% success. At the 6-month follow-up, 12 of 15 participants (80%) reported not smoking for at least the past seven days—a common measure of short-term abstinence—highlighting the potential of psilocybin-assisted therapy as a promising approach for smoking cessation.

‍

At the 12-month follow-up, 10 of 15 participants (67%) were confirmed as abstinent from smoking. A long-term follow-up conducted at an average of 30 months after the first psilocybin session found that 9 participants (60%) remained abstinent. Additionally, 13 participants (87%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives.

‍

These results suggest that psilocybin, in the context of a structured treatment program, holds significant potential for promoting long-term smoking abstinence. However, further research is needed to explore psilocybin-facilitated treatment for substance use disorders.

‍

Recent Insights on Psilocybin for Addiction

In a recent systematic review exploring the therapeutic potential of psilocybin in addiction, researchers undertook a comprehensive analysis of existing clinical trials. A systematic review is a meticulous and structured overview of all available evidence on a particular topic. Researchers sift through numerous studies, critically evaluate their quality, and synthesize their findings to provide a comprehensive understanding of the subject matter.

‍

In this particular review, the authors identified one double-blind, placebo-controlled randomized controlled trial (RCT) and three small clinical trials, all of which combined psilocybin with some form of psychotherapy. Three of these studies were conducted in the 21st century, focusing on patients with alcohol and tobacco use disorders. The results were promising, as all four studies showed a beneficial effect of psilocybin-assisted therapy on addiction.

‍

However, the authors emphasize the need for larger trials specifically targeting patients struggling with addiction to conclusively determine the effectiveness of psilocybin-assisted therapy in this population.

‍

The Dual Effects of Psilocybin: Targeting the Brain and Mind in Addiction

The authors of this review explored several proposed mechanisms through which psychedelics, like psilocybin, may exert their therapeutic effects on addiction. These mechanisms operate at both biological and psychological levels, suggesting a multifaceted approach to addressing substance use disorders.

‍

On the biological level, one of the key mechanisms is the induction of neuroplasticity—the brain’s ability to adapt and form new neural connections in response to experiences. This process is thought to be important in helping to disrupt the entrenched patterns of thought and behavior associated with addiction. By promoting neural flexibility, psilocybin may create opportunities for individuals to adopt healthier behaviors and perspectives, though more research is needed to fully understand the extent of its impact.

‍

On the psychological level, the review highlights the significance of mystical-type experiences often induced by psilocybin. These profound, often transformative experiences are thought by some to play a crucial role in the therapy’s long-term effectiveness. The intensity of these mystical experiences, often characterized by a sense of unity, sacredness, deeply felt positive mood, transcendence of time and space, and ineffability (difficulty putting the experience into words), is proposed to be a key mediator of psilocybin’s therapeutic impact. The authors suggest that the stronger the mystical experience a patient undergoes during a session, the more enduring the therapeutic effects may be.

‍

In addition to mystical experiences, psychological or spiritual insights gained during psilocybin sessions may also play an important role in the therapeutic process. These insights can lead to deep self-reflection and emotional breakthroughs, helping individuals confront underlying issues related to their addiction and fostering personal growth. Notably, research has shown that greater self-reported psychological insight after psychedelic use is linked to reduced alcohol and tobacco consumption, further highlighting the potential significance of insight-driven experiences in long-term recovery.

‍

This dual-action mechanism—targeting both the brain’s biology and the psyche—sets psilocybin apart from many existing pharmacological treatments, which tend to be substance-specific and do not address the broader psychological and experiential components of addiction. Psilocybin’s ability to work across different types of addiction, coupled with its potential to promote both biological and psychological healing, makes it a promising candidate for further research in the treatment of substance use disorders.

‍

Of course, successful outcomes in psilocybin-assisted therapy also rely heavily on the integration process. Integration involves reflecting on and incorporating insights gained during the psychedelic experience into daily life, which is crucial for sustaining the psychological benefits and making lasting behavioral changes. This step is essential for ensuring the long-term effectiveness of the therapy.

‍

From Discovery to Recovery: Evaluating Psilocybin’s Potential in Addiction Treatment

The growing body of research sheds light on psilocybin-assisted psychotherapy as a promising new approach for treating addiction. Early studies, particularly in nicotine and alcohol dependence, suggest that psilocybin may offer benefits beyond conventional treatments by addressing both biological and psychological aspects of addiction. This dual-action approach opens new possibilities for those struggling with long-standing substance use issues.

‍

However, much remains to be understood. Further research, particularly larger, controlled clinical trials, is crucial to validate these findings, establish long-term efficacy, and uncover the underlying mechanisms driving psilocybin’s therapeutic effects. A deeper understanding will help determine how psilocybin can be safely and effectively integrated into mainstream addiction treatment.

‍

As the field of psychedelic research progresses, the hope is that psilocybin-assisted therapy will provide a more comprehensive, holistic solution for individuals seeking recovery from addiction—one that not only targets the brain but also fosters personal growth, insight, and healing.