A small study on the therapeutic effects of using psychedelics to treat alcohol use disorder found that just two doses of the psilocybin magic mushroom paired with psychotherapy resulted in an 83 percent drop in heavy drinking in participants. Those given the placebo reduced their alcohol intake by 51 percent.
According to the researchers, by the end of the eight-month trial, about half of those who received psilocybin had completely stopped drinking compared to those given a placebo.
The study, published Wednesday in JAMA Psychiatry, is the latest in a cascade of new research exploring the benefits of mind-altering compounds for treating a range of mental health problems, from depression, anxiety and post-traumatic stress disorder. There is an experience of existential fear. finally getting sick.
Although most psychedelics remain illegal under federal law, the Food and Drug Administration is weighing potential medical uses for compounds such as psilocybin, LSD and MDMA, a drug known as ecstasy.
The director of the NYU Langone Center for Psychedelic Medicine and the study’s principal investigator, Dr. Michael Bogenschutz said the findings offered hope for the nearly 15 million Americans who struggle with excessive drinking — about 5 percent of all adults. Excessive alcohol consumption kills an estimated 140,000 people each year.
“These are exciting results,” said Dr. Bogenschutz. “Alcohol use disorder is a serious public health problem, and the effects of currently available treatments and medications are small.”
The double-blind randomized trial followed 93 participants for 32 weeks and divided them into two groups: one received psilocybin and the other a placebo in the form of antihistamine pills. The participants, all of whom struggled with excessive drinking, also participated in 12 therapy sessions, which began several weeks before receiving their first dose and continued for one month after the last dose. Psilocybin dosage was determined according to the participants’ weight, and their heart rate and blood pressure were monitored during the eight-hour session.
Although none of the participants who received psilocybin reported serious adverse effects, the study had one notable limitation: after each session, nearly all study subjects were able to successfully predict whether they had received psilocybin or a placebo. Or not. “Biased expectations could have influenced the results,” the authors wrote, “so this issue remains a challenge for clinical research on psychedelics.”
Mary Beth Orr, one of the study participants who received psilocybin, said the treatment helped change her destructive relationship with alcohol. Although she never blacked out and described herself as a “perfect drinker,” her life was cut short by nighttime alcoholism that left her feeling miserable in the morning.
Orr, 69, a retired museum art technician living near Seattle, said, “I spent a lot of time every day thinking about not drinking in the evenings.” “I wanted to stop but couldn’t.”
The psilocybin sessions, she said, were at times disturbing but ultimately illuminating. Mysterious, dream-like journeys included vivid splashes of colour, an imaginary creature and an emotional encounter with her dead father. “It was like a grand show, with ornaments and the feeling of running through a tunnel with deity figures staring me down in the walls,” she said. Two therapists acted as her guides as she lay on a couch, her eyes covered with a mask while soothing music was put into her headphones.
Although less colorful and exhilarating, the second season was anchored by an important, underwater conversation with a family member, whom she said had caused her great pain over the years. In the end, she wished the relative well, and they parted with a kiss.
The takeaway message, she said, was one of forgiveness, understanding, and love, both for others and for ourselves. “I’m no longer afraid of emotions, and I’m living a darker life,” she said.
More than three years after her last season, Ms. Orr said she rarely drinks, but allows herself the occasional drink. “It’s not that I monitor my drinking, it’s just that I don’t think about it, which is the proud part of me.”
Scientists don’t fully understand how psilocybin and other psychedelics work on the brain, but the drugs are thought to promote neuroplasticity, or brain rewiring, which makes people with psychiatric problems more likely to suffer from their illness and self-destruct. Finding new ways to address the behaviors helps.
Dr. Matthew W. Johnson, a psychedelic researcher at Johns Hopkins Medicine who was not involved in the JAMA study, said he was encouraged by the results because of the study’s comparatively large size and double-blind design. He said the previous, promising trial on psilocybin and alcoholic use disorder had only 10 participants.
“It really pushes the field forward,” said Dr. Johnson, who is conducting a federally funded study on the use of psilocybin for smoking cessation.
He said the promise of psychedelics was particularly exciting given the current crop of anti-addiction therapies, most of which target greed, withdrawal or drug-mediated reward receptors in the brain. In contrast, psilocybin and other psychedelic compounds appear to affect the psychological basis of addiction, Dr. Johnson said.
“This study adds to the literature suggesting that psychedelics may have general anti-addiction efficacy, which is actually an oddity because it is rare for a potential drug to be effective for many forms of addiction,” he said.
Dr. Bogenschutz, lead author of the study, said the subsequent trial will include more than 200 participants and will test the efficacy of a single dose of psilocybin. The trial will also use a different placebo, the vitamin niacin.
On Monday, the FDA approved the trial, which will be the largest to study the use of psilocybin-paired therapy to treat alcohol use disorder.
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