Psilocybin Therapy for Addiction: What the Research Shows

Overview: Researchers are exploring the potential of psilocybin-assisted therapy for addiction, building on historical studies with LSD. Recent studies show promising results in treating alcohol and tobacco addiction, with significant reductions in substance use and high rates of abstinence. Psilocybin therapy, coupled with psychotherapy, offers hope for those struggling with addiction, but further research is needed to understand long-term effects and mechanisms fully.

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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.

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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.

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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.

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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.

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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.

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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.

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Psilocybin Therapy for Alcohol Addiction

In a pioneering study conducted 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.

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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.

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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.

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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.

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

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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 delved into the effects of psilocybin on individuals struggling with alcohol dependence. This proof-of-concept study aimed to investigate the potential of psilocybin therapy as a novel approach to tackling alcohol addiction.

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The study enlisted ten volunteers diagnosed with alcohol dependence, who underwent supervised sessions where they orally ingested psilocybin. These sessions were coupled with Motivational Enhancement Therapy, along with specialized therapy sessions focused on preparation for and reflection after the psilocybin experience.

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Following psilocybin administration, abstinence rates showed a significant increase. Impressively, these gains were not fleeting; they were largely sustained up to 36 weeks post-treatment.

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In this study, there was an interesting correlation between the intensity of effects experienced during the initial psilocybin session and subsequent changes in drinking behavior. Participants who reported stronger effects during their first session showed more pronounced improvements in drinking habits. Moreover, these individuals also exhibited decreased craving for alcohol and increased confidence in their ability to abstain. 

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Importantly, the study also found no significant adverse events related to the treatment, highlighting its safety profile.

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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, the researchers further explored whether psilocybin-assisted therapy could offer a new avenue for individuals struggling with alcohol dependence.

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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.

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Participants were randomly assigned to receive either psilocybin or a placebo (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.

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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.

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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.

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Psilocybin Therapy for Tobacco Addiction 

In 2014, psychologist and psychedelic researcher Dr. Matthew Johnson and colleagues delved into the potential of using psilocybin-assisted therapy to combat tobacco addiction. Their study targeted individuals heavily dependent on nicotine, who had been smokers for an average of 31 years. 

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The approach was innovative, combining doses of psilocybin — ranging from 20 to 30 mg per 70 kg of body weight — with CBT. The results were striking. Compared to traditional smoking cessation medications, this novel treatment approach led to significantly higher rates of abstinence among participants.

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A follow-up study conducted twelve months later revealed that 60% of the study's participants were still confirmed to be abstinent from smoking — confirmed through biological tests. This success rate surpassed the effectiveness typically observed with the best-approved medications for tobacco cessation by approximately 30%.

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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. But what exactly is a systematic review?

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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.

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In this particular review, the authors found promising evidence suggesting that psilocybin-assisted therapy could have a beneficial effect on symptoms related to addiction. However, they highlight the need for larger trials specifically targeting patients struggling with addiction to conclusively determine the effectiveness of psilocybin-assisted therapy in this population.

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A Look at Therapeutic Mechanisms

The authors of this review also delved into the proposed mechanisms through which psychedelics, like psilocybin, might exert their therapeutic effects on addiction.

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These mechanisms operate on both biological and psychological levels. For instance, psychedelics may induce neuroplasticity in the brain — essentially, the brain’s ability to rewire and adapt in response to experiences. This biological process could play a crucial role in breaking patterns of addiction.

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Additionally, the authors discuss the psychological aspect of the psilocybin experience, highlighting the significance of mystical-type experiences induced by psilocybin. They suggest that the degree to which a patient undergoes such an experience during a psilocybin session may act as a crucial mediator for the enduring effects of the therapy. This proposed working mechanism sheds light on why psychedelics may show effectiveness across various types of addiction, unlike many current pharmacological treatments that are specific to certain substances.

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By targeting both biological and psychological aspects of addiction, psilocybin-assisted therapy offers a novel approach to tackling substance use disorders, warranting further investigation in future research endeavors.

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

These findings shed light on the potential of psilocybin-assisted psychotherapy as a promising avenue for addressing addiction and lay a solid foundation for further exploration. With preliminary results surpassing conventional treatments, this approach offers hope for those battling the grip of nicotine and alcohol dependence.

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However, further research is essential to fully understand the long-term effects and potential benefits of this innovative treatment approach. Researchers emphasize the need for more controlled trials involving larger participant samples to more comprehensively understand the potential efficacy and underlying mechanisms of psychedelic therapy for alcohol dependence.

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As research in this field progresses, there is hope for more effective and holistic approaches to support individuals on their healing journey.