In what researchers are calling the first published randomized trial to examine the effects of psilocybin on any type of addiction, people who underwent two psychedelic mushroom “trips” with the help of a psychotherapist reduced “their days of heavy drinking by 83% over eight months,” said senior study author and psychiatrist Dr. Michael Bogenschutz, director of the NYU Langone Center for Psychedelic Medicine, in a news conference.
“I’d say (psilocybin) saved my life,” said 32-year-old study participant Jon Kostas at the news conference. “My first AA meeting was at 16 years old. I was 25 when I found the clinical trial and by that time, I was ‘treatment-resistant.’ I had tried everything to no avail.”
At the end of the eight-month trial, 48% of the patients who used psilocybin reported quitting alcohol use entirely, according to the researchers, who collected hair and fingernail samples to confirm reports of abstinence. That’s twice as many as those in the placebo group who were able to abstain, Bogenschutz said.
“If these effects hold up in future trials, psilocybin will be a real breakthrough in the treatment of alcohol use disorder,” said Bogenschutz, a professor of psychiatry at NYU Grossman School of Medicine. He is also a paid consultant to several companies bringing psychedelics to market.
However, while the treatment “seems to help a significant percentage of people,” it is not a cure-all, said Dr. David Hellerstein, professor of clinical psychiatry at the Columbia University Irving Medical Center. He was not involved in the research.
“Therefore, it may open new avenues for significant progress with this devastating condition.”
What’s old is new again
This isn’t the first time science has studied the use of psychedelics for alcohol use disorder, defined today as the inability to stop drinking even when it causes physical or emotional harm to the drinker or others.
No longer administered solely in the relative safety of a lab or psychiatrist’s office, LSD began to feature in horror stories of bad “acid” trips at colleges and concerts — headlines that appeared alongside images of anti-Vietnam protests and Woodstock attendees.
“Studies come to a screeching halt,” Hellerstein said. “We are now just beginning to make up for decades of lost time.”
A worrisome rise in drinking
The new study enrolled 93 people with a diagnosed alcohol disorder who all had drunk heavily at least four days in the prior month. The researchers defined heavy drinking as five or more drinks in a day for men and four or more drinks a day for women.
Each person also underwent a series of psychotherapy sessions for 12 weeks that included motivational and cognitive behavioral techniques aimed at reducing drinking.
“Psychotherapy was an integral part of the treatment model, and so we can’t make any statements about what the psilocybin would be doing in terms of therapeutic effects without that psychotherapeutic platform,” Bogenschutz said.
In fact, the placebo group reduced their heavy drinking by 51% with only the therapy intervention, the study found, compared with an 83% reduction in those who received both psilocybin and therapy.
However, the study was not truly blinded: About 95% of those involved correctly guessed whether they were taking psilocybin or the antihistamine, the researchers said.
That’s an issue, Hellerstein said, since people participating in such studies have a strong expectation that a “trip on a psychedelic will help them, so it is very difficult to separate medication effects from the expectation for major improvement.”
Consequently, it can be challenging to “prove that the psychedelic experience and treatment are the cause of improvement,” Hellerstein added.
One of the participants in the study, 60-year-old Paul Mavis of Wilton, Connecticut, was able to stop drinking even though he was part of the placebo group.
He credits that success to the intensive therapy he received during the study. “I haven’t had a drink or even a craving — it’s weird. It was if I never drank in my life,” Mavis said in a news conference about the research.
Mavis said he did take a dose of psilocybin, under supervision, toward the end of the study.
“This was a profound, deeply moving, mind-altering but still very, very exceptional experience,” Mavis said, adding that it was not one he would rush to repeat, especially without the help of a therapist.
“No, this was this was a very profound thing that should be done under serious supervision in my humble opinion,” he said.
As Mavis noted, the level of psychotherapy used in the study was intensive, which is common with studies involving hallucinogens. Future research should investigate whether similar results can be achieved with less therapy to make the intervention more scalable, Hellerstein said.
“Expert and time intensive psychotherapy is often not available in many locations and settings,” he said. “If the psilocybin trip alone leads to decreased alcohol use, with very minimal psychotherapy support, that could make it possible to extend the treatment much more broadly.”