To the uninitiated, psilocybin—the substance that gives ‘magic mushrooms’ their psychedelic qualities—could be dismissed as a recreational drug. The U.S. government has declared it to be a Schedule 1 drug, which is similar to other psychedelics. This means that it could easily be misused and cannot currently have any medical uses. According to medical science experts, however, psilocybin offers promising treatments for many health problems. Experts are increasingly recognizing that psilocybin is a low-risk, effective tool for helping patients quit using other drugs. Given that more than 100,000 people died after overdosing on opioids and other drugs in the U.S. last year, it’s an understatement to say it’s urgent to find new, effective treatments for substance use disorder.
The research supporting psilocybin’s use in this context has been growing for a while now. The most recent of these studies was published in Scientific Reports on April 7, looked at data from 214,505 U.S. adults in the National Survey on Drug Use and Health (NSDUH) from 2015 to 2019, and found an association between past use of psilocybin—at any time in their lives—and a reduced risk of opioid use disorder. Scientists use 11 criteria to determine if someone has opioid use disorder. Researchers examined data from 214,505 adults in the United States. They found a strong correlation between past psilocybin usage and lower odds of 7 items, as well as marginally lower odds of 2 others.
There’s a major caveat with this study: because it was looking at correlations, it didn’t find any definitive proof that psilocybin use in-and-of-itself reduces the risk of opioid use disorder. While the researchers controlled for things like educational attainment, annual household income, and age, there may be social or personal characteristics that make psilocybin users different from people who didn’t decide to use the drug, says Grant Jones, a graduate researcher at Harvard University who co-authored the study. “Maybe there’s different psychological profiles that make [some people] more immune to developing substance use disorders; we don’t know,” says Jones.
However, this study confirms that psilocybin may be worth exploring as a possible treatment for substance misuse disorder. Albert Garcia-Romeu and others co-authored the 2017 Johns Hopkins University pilot research that showed most of the 15 participants had been able to stop smoking for at minimum 16 months. They received two to three high-level, moderate, or even high doses of Psilocybin. In 2015, Michael Bogenschutz (a New York University Grossman School professor of psychology) conducted a similar proof-of concept study on alcohol abuse disorder. He found that addicts were more likely to abstain from using psilocybin. Observational studies, including Jones’ report and additional research from Garcia-Romeu, have also found that psilocybin is associated with a reduced risk of using substances like cocaine, marijuana, and opioids.
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Research has also shown that psilocybin can be used to treat depression. A small, randomised clinical trial was published in JAMA In 2020, it was found that psilocybin assisted therapy reduced major depression symptoms quickly. The effects were statistically significant for at least four more weeks. A second study was published in this year’s The. Journal of Psychopharmacology,A small number of depression patients who had received two doses of Psilocybin along with support therapy showed that 75% of them still experienced some relief and 58% of the participants were completely free from their symptoms. Jones co-authored another study, which was published in the earlier part of this year by The. Journal of PsychopharmacologyMatthew K. Nock and he reviewed NSDUH data to find that psilocybin usage was linked with a decreased risk of developing major depressive episodes.
Despite all that, Jones acknowledges that there’s still a lot to learn about psychedelics. “The thing that always strikes me about psychedelic research is that even though there’s an immense amount of excitement, and a lot of attention, and a lot of a lot of financial support that’s flowing into the space, the actual body of literature is still very sparse,” Jones said. “I think we’re exploring the boundaries of the benefits of well-being.”
How can psilocybin be used to help with addiction treatment?
Several clinical trials focused on mental illnesses like depression have shown that psilocybin appears to boost patients’ moods, even weeks after taking the drug. Although the exact mechanism is still unknown, researchers do have some suggestions. For example, psilocybin appears to increase the brain’s neuroplasticity—the ability for neural networks to shift and rewire. A study was published in April 11. Nature Medicine, for example, researchers found that psilocybin helped to broadly build more connections between different parts of the brain, while simultaneously reducing interactions between brain areas connected with depression—and, in terms of outcomes, psilocybin use seemed to reduce patients’ depressive symptoms. Bogenschutz says that psilocybin seems to be able to help people break from their old habits and make them more adaptable. “It increases the capacity of the brain to change, and therefore for thinking and behavior to change.”
In addition, evidence from animal trials suggests psilocybin’s effect on mental wellbeing may be connected, in part, to its ability to reduce inflammation—an immune response in the body’s tissues to dangers ranging from stress to physical injuries, which researchers have found is associated with psychiatric disorders like depression.
Biological mechanisms aren’t the only reason scientists are excited about psilocybin and other psychedelics—there’s also the psychological experience of taking the drugs. “The types of experiences that people often have with these drugs can be highly meaningful, insightful, and also sometimes spiritual in nature,” says Garcia-Romeu. “When you ask them, those experiences are the reason that they’re making these better choices, and they’re making these behavioral changes.”
Unique advantages of psilocybin
Two characteristics make psilocybin a promising treatment option for people with mental disorders, according to researchers. It is not addictive, but it does have some side effects that can be dangerous if it’s not administered in controlled conditions. The second benefit is that psilocybin has long-lasting effects. This means that people will only need to take the drug intermittently and are less likely to experience side effects. “That’s a huge advantage in terms of safety…compared to taking a pill every day, and having that side effect profile follow you for months, possibly years, depending on how long you take it,” says Matthew Johnson, a professor in psychedelics and consciousness at Johns Hopkins University.
In many ways, research on psilocybin’s potential is still just beginning. After the U.S. tightened regulation of drug research in 1960s, almost all U.S.-based psychedelic research came to an abrupt halt. The U.S. criminalized possession and manufacturing of psilocybin. Scientists are still “reopening the books” on psychedelics to make up for decades of stalled research, says Garcia-Romeu. Only a few published clinical trials on psilocybin have been done for substance abuse disorders. Many of these trials involved very few participants.
But the resulting evidence has been accumulating, and is generating an increasing amount of scientific attention on the possibilities of the drug—including, last fall, the first federal grant for studying a psychedelic treatment in 50 years, for a double-blind randomized trial looking into psilocybin as a smoking cessation tool. In Bogenschutz’s words, science has reached a “first tipping point where there’s now enough evidence [that] it’s really hard not to take the potential of psychedelics seriously.”
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Researchers in addiction science eagerly await the findings of this and other emerging research on the potential for psychedelics. The treatment of substance abuse disorders is often undertreated and there are few effective options. For example, only a minority of Americans with alcohol use disorder—the most common substance use disorder in the U.S.—Receiving treatment. According to a Washington University School of Medicine study, only 6.6% of all alcoholics were receiving the needed care from 2015 through 2019.
In Bogenschutz’s opinion, the psychology and physiology underlying addiction to any given substance has a lot in common with that driving addiction to other such dependencies. And that, he believes, is what makes psychedelics so promising a therapeutic for substance abuse—it seems, he says, to be a sort of panacea for addiction. “Something about psychedelic treatment of addiction that is exciting, is that the ways the mechanisms we hope it will work, are not really specific to any particular addiction,” he says. “[These drugs] could represent a therapeutic breakthrough for alcohol use disorder, other addictions, mood and anxiety disorders—a whole host of conditions.”
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