The current psychedelic revolution isn’t full of flower power, trippy lightshows, and peace signs—it is instead a revolution of the brain’s functionality while seeking inner peace from any number of afflictions and addictions. The legacy of the counterculture still has impacts to this day, but psychedelic substances that potentially improve neural plasticity—such as psilocybin—continue to have the biggest repercussions from that era.
Alcohol and substance abuse continue to destroy lives and families; however, clinical studies and peer-reviewed research have shed light on the potential efficacy of psilocybin to improve the quality of life for people suffering from these afflictions.
According to researchers, treatments for alcohol addiction are among the lowest of all mental health disorders. Just 9% receive treatment, and there are only 3 established medication options. The odds and numbers are even worse if combined with another disorder.
However, the last several years have yielded some eye-raising results regarding the efficacy of psychedelics, including psilocybin, to help control alcohol use disorder (AUD). Many of these studies continue into other phases in the hope of yielding even more positive correlations leading to effective change in combating AUD.
One peer-reviewed clinical trial that continues yielding results influencing other studies and phases is the double-blind, randomized, placebo-controlled study published by JAMA Psychiatry in 2022. The trial’s goal was to examine whether 2 high doses (25–40 mg) of psilocybin combined with psychotherapy reduced the number of “heavy drinking days” by participants with AUD. The study defines heavy drinking as “5 or more drinks in a day for a man and 4 or more drinks in a day for a woman.”
Participants included adults ranging from 25 to 65 years old with a prior diagnosis of alcohol dependency, along with 4 heavy drinking days over the course of the previous 30 days.
Psychotherapy supplementation with a cognitive behavioral therapy and motivational enhancement focus occurred at 12 weeks. Researchers randomly gave half the patients doses of psilocybin; the others received a placebo (diphenhydramine) during 2-day-long medication sessions at weeks 4 and 8. Researchers analyzed the study results during the 32-week double-blind period after the first administered dose.
Post-interview results of the study demonstrated that during the 32-week double-blind period, the group that received psilocybin only had heavy drinking days 9.7% of the time. The placebo group experienced heavy drinking days at a rate of 23.6% during the same period.
The amount of daily alcoholic drinks was also lower among the participants who received psilocybin. The study administrators also noted that none of the participants who received psilocybin reported serious adverse effects, further reducing stigma associated with any potential harm. Mild and temporary adverse effects, however, such as headaches (43.8%), anxiety, and nausea, were more common in the psilocybin group but resolved either with anxiety medication (10 mg diazepam for 2 patients) or self-limited without further issues.
Results demonstrated the positive correlation between psilocybin ingestion combined with psychotherapy to help combat heavy drinking and AUD. The trial’s methodologies continue to be very influential in driving further studies, trials, and phases seeking elaboration on these important findings.
Researchers extrapolated data from 13 volunteers who received doses of psilocybin, showing even more insights about the use of psilocybin to combat alcohol-related dependency. A common lifestyle theme that popped up was that many of the interviewees developed dangerous coping mechanisms early and later in life to tamp down unwanted feelings—leading to alcohol as a crutch.
Data from 13 of the study volunteers who were given doses of psilocybin were extrapolated for a more detailed understanding of participants’ own subjective experiences. Findings highlighted increased self-compassion, self-awareness, connectedness, and a sense of belonging. These self-improvements demonstrate the potential for psilocybin assisted therapy in mitigating stress and emotional volatility—an important foundation to prevent relapse during cravings and stressful situations.
A proposed double-blind, randomized, placebo-controlled trial currently in the Phase II recruiting stage seeks to build from the success and methodologies of the groundbreaking 2022 JAMA study. This study will feature placebo and psilocybin dose groups split among 62 in-patient rehabilitation participants (aged 21–64) with severe AUD. Researchers will introduce elements of commitment and acceptance therapy during the 4-week inpatient rehab stay, as well as integration sessions to help patients properly process their psychedelic experiences into valuable insights for personal growth.
Researchers will use an established baseline percentage before inpatient entry to examine changes in heavy drinking days. They will also analyze other criteria, such as:
READ: Should Cannabis Be Considered a Treatment Option for Alcohol and Drug Recovery?
Addiction is a topic that many people can sympathize with—if you don’t have any addiction issues yourself, chances are you have a friend or family member who does. Substance abuse disorders (SUD) worldwide have been very significant, especially with opioid abuse. The World Health Organization (WHO) reported increased drug-related deaths on every continent, with an economic weight of $442 billion a year. Current treatments provide inadequate success rates, with 20% of individuals relapsing after just 30 days, and 40% after 6 months.
That’s where psychedelics like psilocybin come in. Psychedelic research from the mid-20th century began to scratch the surface of how non-addictive substances like psilocybin can help with addiction issues. Federal prohibition starting in 1971 drastically curtailed these advances.
The last 10 years have re-established an urgency in understanding how psychedelic substances like psilocybin can help a bevy of mental health disorders, including substance abuse. These treatments show success on a larger scale compared to conventional therapeutic and pharmaceutical reduction strategies.
One retrospective study from 2017 examined past data of 358 people addicted to smoking cigarettes, who also took classic psychedelics like psilocybin a few times in their lives. The results showed 137 participants quit smoking, 100 reduced smoking, and the rest (121) stopped but eventually resumed smoking again.
Researchers also polled 444 people with 4.5 years of substance abuse issues on average before taking psychedelics like LSD (43%) and psilocybin (29%). 96% of participants qualified as having a substance use disorder (SUD) before their psychedelic experiences; afterward, researchers considered only 27% as still having a SUD.
Similarly, researchers conducted another retrospective survey of over 343 people who suffered, on average, for about 7 years from addictions, including stimulants and opiates. These subjects all reported using classic psychedelics like psilocybin, by which they reported reduced alcohol consumption. Researchers found that 83% of the group no longer suffered from AUD following their psychedelic experiences.
Many participants associated their experiences with profound changes in their personal value systems and priorities. Larger doses were associated with greater personal insight from mystical-like phenomena, leading to a more substantial reduction in substance abuse, alcohol intake, and related issues.
Modern-era clinical trials are underway or are still waiting to be published to establish the efficacy of psilocybin to combat addictions to substances like cocaine and opioids.
Psilocybin-facilitated Treatment for Cocaine Use is a phase II, double-blind study seeking brain and body chemistry assessments for correlations between psilocybin therapy and cocaine use reduction and elimination. Researchers are also preparing to publish clinical trials on methamphetamine and opioid addiction, and how psilocybin can potentially help counter them.
Some of the main processes enabling psilocybin’s efficacy is the change of thought patterns, readjusting internal reward circuitry, fixing neurotransmitter deficits, and promotion of neural plasticity in the brain stem. Some of the subjective changes are as simple as increased engagement and empathy with the world, instead of relying on addictive coping mechanisms when faced with fear or stress.
Researchers still badly need more studies on the effects of psilocybin on neurotransmitters and brain functionality to confirm the viability of psilocybin to treat mental health disorders, especially AUD and SUD. However, we can’t overlook the already promising results from clinical trials, research, and studies.
We await the results of several high-profile clinical trials on psilocybin and addiction, which researchers expect to publish soon. Anyone suffering from addiction in the meantime, or who knows someone suffering, can take respite in knowing there actually might be a real solution out there on the horizon.
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