Classic Psychedelics for the Treatment of Substance Use Disorders
LSD was widely researched between the 1950s and the early 1970s for the treatment of alcohol use disorder with an overall trend of seeing statistically significant beneficial effects (Krebs & Johansen, 2012). Research in the 1970s focusing on the use of LSD for opioid addiction also found significant improvements in abstinence data when compared to a control group (Savage & McCabe, 1973)
Psilocybin is structurally similar to LSD and has shown great potential in terms of its ability to promote lasting abstinence from smoking with high success rates (Johnson et al., 2014; Johnson et al., 2017).
For example, one pilot study combining 2-3 doses of clinically-administered psilocybin in combination with cognitive behavioural therapy for tobacco smoking cessation found that 80% of participants were abstinent at the 6-month follow-up, based on self-report validated by urinary cotinine and breath carbon monoxide levels (Johnson et al., 2014). Subsequent long-term results reported that 67% of participants remained abstinent at 12 months, and 50% remained abstinent at long-term follow-up ranging from 16 to 57 months (Johnson et al., 2017).
Of further interest, most patients in this study found their psilocybin experiences to be incredibly personally and spiritually meaningful, rating them among the top five most significant events in their lives (Johnson et al., 2017). One even described the experience as being as if they had died a smoker and been returned to life as a non-smoker
(Johnson et al., 2017).
Smoking Cessation
Psilocybin has been investigate for its role in smoking cessation. Two key studies are Johnson et al., 2017 and Johnson et al., 2014.
Alcohol Use Disorder
Recent research has also been demonstrating the utility of psilocybin-assisted therapy in the treatment of alcohol use disorders. For example, an initial proof-of-concept study paired 1-2 doses of psilocybin with motivational enhancement therapy in the treatment of alcohol use disorder and showed a significant reduction in both percentages of drinking days and heavy drinking days over a nine-month follow-up period (Bogenschutz et al., 2015). A recently published double-blind randomized clinical trial using the same treatment approach found that those who received psilocybin in combination with psychotherapy showed robust decreases in the percentage of heavy drinking days over those who received placebo and psychotherapy (Bogenschutz et al., 2022).
In addition to smoking cessation and alcohol use, studies are also underway to assess the therapeutic potential of psilocybin-assisted therapy in the treatment of cocaine use at the University of Alabama at Birmingham and in the treatment of opioid use disorder at the University of Wisconsin.
Observation Studies for Substance Use Disorders
In addition to the clinical research, a growing body of literature using large-scale surveys has been showing correlations between classic psychedelic use and reductions in substance use and substance-related harms. If you are interested in exploring this body of literature in further detail, please use the links below to read the study abstracts.
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Did You Know?
A small but growing body of literature also indicates positive effects of the following plant-based psychedelic medicines on substance use and substance-related harms. A few examples of these studies have been provided below if you would like to take a closer look
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Ibogaine (e.g., Brown 2013; Schenberg et al., 2014)
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Ayahuasca (e.g., Thomas et al., 2013; Berlowitz et al., 2019)
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Mescaline (e.g., Garrity 2001; Albaugh & Anderson 1974)
Learn More
We invite you to consider watching these additional supplementary videos or reading these additional papers if you are interested in more information on the studies examining the use of psychedelic-assisted therapy for substance use disorders.
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Videos
The following videos are presentations of papers. If available, the associated published paper is linked under the Study column.
| Study | Duration | Presentation |
|---|---|---|
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35:18 |
Psilocybin-Facilitated Treatment for Addiction: Smoking Cessation |
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28:47 |
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32:25 |
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25:40 |
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25:23 |
Readings
The following references are further manuscripts that have been published on the psilocybin-assisted therapy for smoking cessation and alcohol use disorders trials outlined in this section that may be of further interest to some learners.
Smoking Cessation
Alcohol Use Disorder
References
Albaugh, B. J., & Anderson, P. O. (1974). Peyote in the treatment of alcoholism among American Indians. The American journal of psychiatry, 131(11), 1247–1250.
Argento, E., Socias, M. E., Hayashi, K., Choi, J., Mackay, L., Christie, D., Milloy, M. J., & DeBeck, K. (2022). Psychedelic use is associated with reduced daily opioid use among people who use illicit drugs in a Canadian setting. The International journal on drug policy, 100, 103518.
Berlowitz, I., Walt, H., Ghasarian, C., Mendive, F., & Martin-Soelch, C. (2019). Short-Term Treatment Effects of a Substance Use Disorder Therapy Involving Traditional Amazonian Medicine. Journal of psychoactive drugs, 51(4), 323–334.
Bogenschutz, M., & Forcehimes, A. (2016). Development of a psychotherapeutic model for psilocybin-assisted treatment of alcoholism. Journal of Humanistic Psychology, 57(4), 389-414.
Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A., Wilcox, C. E., Barbosa, P. C., & Strassman, R. J. (2015). Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. Journal of psychopharmacology (Oxford, England), 29(3), 289–299.
Bogenschutz, M. P., Podrebarac, S. K., Duane, J. H., Amegadzie, S. S., Malone, T. C., Owens, L. T., Ross, S., & Mennenga, S. E. (2018). Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder. Frontiers in pharmacology, 9, 100.
Bogenschutz, M. P., Ross, S., Bhatt, S., Baron, T., Forcehimes, A. A., Laska, E., Mennenga, S. E., O'Donnell, K., Owens, L. T., Podrebarac, S., Rotrosen, J., Tonigan, J. S., & Worth, L. (2022). Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA psychiatry, 79(10), 953–962.
Brown T. K. (2013). Ibogaine in the treatment of substance dependence. Current drug abuse reviews, 6(1), 3–16.
Garcia-Romeu, A., Davis, A. K., Erowid, F., Erowid, E., Griffiths, R. R., & Johnson, M. W. (2019). Cessation and reduction in alcohol consumption and misuse after psychedelic use. Journal of psychopharmacology (Oxford, England), 33(9), 1088–1101.
Garcia-Romeu, A., Davis, A. K., Erowid, E., Erowid, E., Erowid, F., Griffiths, R. R., & Johnson, M. W. (2020). Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey. Frontiers in Psychopharmacology, 10.
Garcia-Romeu, A., Griffiths, R. R., & Johnson, M. W. (2014). Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction. Current drug abuse reviews, 7(3), 157–164.
Grarity, J. F. (2001). Jesus, Peyote, and the Holy People: Alcohol Abuse and the Ethos of Power in Navajo Healing. Medical Anthropology Quarterly, 14(4), 521-42.
Krebs, T. S., & Johansen, P. Ø. (2012). Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. Journal of psychopharmacology (Oxford, England), 26(7), 994–1002.
Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P., & Griffiths, R. R. (2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of psychopharmacology (Oxford, England), 28(11), 983–992.
Johnson, M. W., Garcia-Romeu, A., & Griffiths, R. R. (2017). Long-term follow-up of psilocybin-facilitated smoking cessation. The American journal of drug and alcohol abuse, 43(1), 55–60.
Johnson, M. W., Garcia-Romeu, A., Johnson, P. S., & Griffiths, R. R. (2017). An online survey of tobacco smoking cessation associated with naturalistic psychedelic use. Journal of psychopharmacology (Oxford, England), 31(7), 841–850.
Nielson, E. M., May, D. G., Forcehimes, A. A., & Bogenschutz, M. P. (2018). The Psychedelic Debriefing in Alcohol Dependence Treatment: Illustrating Key Change Phenomena through Qualitative Content Analysis of Clinical Sessions. Frontiers in pharmacology, 9, 132.
Noorani, T., Garcia-Romeu, A., Swift, T. C., Griffiths, R. R., & Johnson, M. W. (2018). Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts. Journal of psychopharmacology (Oxford, England), 32(7), 756–769.
Pisano, V. D., Putnam, N. P., Kramer, H. M., Franciotti, K. J., Halpern, J. H., Holden, S. C. (2017). The association of psychedelic use and opioid use disorders among illicit users in the United States. Journal of Psychopharmacology, 31(5).
Savage, C., & McCabe, O. L. (1973). Residential psychedelic (LSD) therapy for the narcotic addict. A controlled study. Archives of general psychiatry, 28(6), 808–814.
Schenberg, E. E., de Castro Comis, M. A., Chaves, B. R., & da Silveira, D. X. (2014). Treating drug dependence with the aid of ibogaine: a retrospective study. Journal of psychopharmacology (Oxford, England), 28(11), 993–1000.
Sessa, B., Higbed, L., O'Brien, S., Durant, C., Sakal, C., Titheradge, D., Williams, T. M., Rose-Morris, A., Brew-Girard, E., Burrows, S., Wiseman, C., Wilson, S., Rickard, J., & Nutt, D. J. (2021). First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Journal of psychopharmacology (Oxford, England), 35(4), 375–383.
Thomas, G., Lucas, P., Capler, N. R., Tupper, K. W., & Martin, G. (2013). Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada. Current drug abuse reviews, 6(1), 30–42.