BJon Kostas, at the age of 25, was determined to overcome his addiction to alcohol. He had started drinking at age 13 and had cycled through different treatments—going to Alcoholics Anonymous meetings, taking pharmaceutical medications, and trying in-patient rehab—but nothing worked. Ever since 2015, however, when he took part in a clinical trial that combined talk therapy and psilocybin—the psychedelic active ingredient in magic mushrooms—Kostas has quit drinking. “I’m forever grateful and indebted,” he says. “This saved my life.”
Published Aug. 24, in the Journal, a randomized clinical trial JAMA Psychiatry, found that in combination with psychotherapy, psilocybin helped treat people’s alcohol use disorder. Analyzing a group of 93 patients with the condition—Kostas among them— for 32 weeks, researchers found that patients who had received psilocybin plus psychotherapy (48 in total) reduced their drinking by 83% within eight months of their first dose, compared to 51% among those who had received a placebo. Nearly half of people treated with psilocybin stopped drinking completely, compared to less than a quarter of those who’d only received the placebo.
“If these effects are replicated, I think this really would represent a breakthrough,” says Dr. Michael Bogenschutz, director of the New York University Langone Center for Psychedelic Medicine and the senior author of the study. “The effects seem to persist. And the effects are larger than those of any of the treatments that are currently available,” which includes methods like in-patient rehab, talk therapy, and medications.
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The society could benefit from a more efficient treatment of alcohol addiction. The U.S. Centers for Disease Control and Prevention estimate that approximately 95,000 Americans will die each year due to alcohol-related causes. A 2021 federal analysis of Americans pre-pandemic found that while about 5% of U.S. adults—about 14.1 million people—had alcohol use disorder in the last year, only 7% of them received any treatment, and just under 3% were treated with medication. Although approved medication such as Naltrexone can be effective in treating alcohol use disorder, it has been proven that they are not very efficient.
New research supports the idea that psilocybin might be a treatment option for people with substance abuse disorders. Bogenschutz, along with other researchers, found in 2015 that psilocybin assisted therapy was effective in treating alcohol dependence in small groups of patients. Bogenschutz along with some other researchers also published an in-depth study in 2014. It found that smoking cessation can be achieved by using psilocybin together with talk therapy. The federal grant awarded to the research team for the first psychedelic therapy in more than 50 years was last year. It will be used to continue the work with multisite, three-year studies.
Psilocybin’s effectiveness may have to do with how it affects the brain, says Bogenschutz. Studies have shown that psilocybin may promote neuroplasticity. It allows people to think differently and act differently. Researchers have also found that psilocybin helps treat depression—which often occurs alongside substance use disorder. Bogenschutz states that the promise of psilocybin as a treatment is in its ability to have a lasting, strong effect, unlike medication that needs to be repeated over and over. “It really suggests that we’re treating the underlying disorder, rather than simply treating the symptoms,” says Bogenschutz.
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While the results of this study are encouraging, there’s still a long way to go before psilocybin can be used to treat a wider population. In the clinical trial, psilocybin was administered to only 50 people. More research is needed on this larger population. Plus, the placebo used in the trial, diphenhydramine—an antihistamine—isn’t a perfect substitute for psilocybin, as psychedelic drugs produce unique hallucinogenic effects. Bogenschutz adds that people shouldn’t experiment with psilocybin outside of clinical settings, because it may be more risky in an uncontrolled environment, in part because patients’ experiences can feel extreme. For instance, some patients feel severe anxiety while under the drug’s influence.
The study also didn’t include the full range of people who could benefit from psilocybin-assisted treatment. Bogenschutz pointed out that participants had an average of less drinking intensity than those who are typically involved in clinical trials. (According to Bogenschutz, that’s likely because the trial may have appealed to people who were already coping with their disorder.) To ensure that psilocybin assisted therapy does not treat alcohol addiction and other conditions, the researchers deliberately excluded people with mental disorders such as depression.
However, Bogenschutz says it’s possible that patients with more severe disease might benefit even more from the treatment, especially if psilocybin can address the problems that underlie not only alcohol use disorder, but also mental-health issues like depression and anxiety, and even other kinds of substance use disorders. “People with co-occurring disorders and addictions might be an ideal population for this kind of treatment, because they might be able to benefit simultaneously for both disorders,” he says. Their hope is that “this more flexible pattern of brain function allows people to change their thoughts and behaviors in ways that allow them to be happier, healthier, people.”
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