Magic mushrooms’ psilocybin could help people overcome alcohol addiction

In a new study, researchers combined psilocybin, the psychedelic compound in magic mushrooms, with psychotherapy to treat alcohol addiction.

Included in the research were 93 people with alcohol addiction who had no major psychiatric disorders nor had used psychedelics in the past year. These people were divided into two groups; one group was given two doses of psilocybin while the other received two doses of antihistamine placebo. In addition to medication, all participants were offered psychotherapy sessions for 12 weeks; four sessions before the first medication dose, four between the first and second doses, and four during the month after treatment.

From the start of the study to week 32, both groups showed a decrease in drinking, but the psilocybin group had more notable improvements. The rate of heavy drinking dropped by around 83 percent in the psilocybin group, while the decrease in the place group was about 51 percent.

Eight months after their initial dose, 48 percent of the psilocybin group had completely ceased drinking, as opposed to 24 percent of the placebo group.

Eliminating cravings

"I stopped drinking right after my first psilocybin session. It worked that quickly for me," Jon Kostas, a trial participant in the psilocybin group, told reporters at a news conference on August. 24. "This eliminated all my cravings."

"The therapeutic effects of psilocybin and therapy were 'considerably larger' than those reported for existing drugs used to treat alcohol use disorder, and it's 'remarkable' that the effects persisted for months after treatment," said Dr. Michael Bogenschutz, lead study author and the director of the NYU Langone Center for Psychedelic Medicine, at the news conference. "If these effects hold up in future trials, psilocybin could be a breakthrough in the treatment of alcohol use disorder," he added.

Moderate and short-termed side effects such as headache, nausea, and anxiousness were more commonly seen in the psilocybin group than in the placebo group. Besides that, several major adverse events, such as severe vomiting and psychiatric admissions, happened during the trial outside the clinic. However, all of these were seen in the placebo group.

The only limitation of the study is that the clinical trial was not completely blind. The researchers stated that almost 95 percent of the trial participants were aware of whether they were taking psilocybin or an antihistamine, making it challenging to separate medication effects from the expectation for significant improvement."

The results of the study were published in the journal JAMA Psychiatry.

Abstract:

Importance: Although classic psychedelic medications have shown promise in the treatment of alcohol use disorder (AUD), the efficacy of psilocybin remains unknown.

Objective: To evaluate whether 2 administrations of high-dose psilocybin improve the percentage of heavy drinking days in patients with AUD undergoing psychotherapy relative to outcomes observed with active placebo medication and psychotherapy.

Design, Setting, and Participants: In this double-blind randomized clinical trial, participants were offered 12 weeks of manualized psychotherapy and were randomly assigned to receive psilocybin vs diphenhydramine during 2-day-long medication sessions at weeks 4 and 8. Outcomes were assessed over the 32-week double-blind period following the first dose of study medication. The study was conducted at 2 academic centers in the US. Participants were recruited from the community between March 12, 2014, and March 19, 2020. Adults aged 25 to 65 years with a DSM-IV diagnosis of alcohol dependence and at least 4 heavy drinking days during the 30 days prior to screening were included. Exclusion criteria included major psychiatric and drug use disorders, hallucinogen use, medical conditions that contraindicated the study medications, use of exclusionary medications, and current treatment for AUD.

Interventions: Study medications were psilocybin, 25 mg/70 kg, vs diphenhydramine, 50 mg (first session), and psilocybin, 25-40 mg/70 kg, vs diphenhydramine, 50-100 mg (second session). Psychotherapy included motivational enhancement therapy and cognitive behavioral therapy.

Main Outcomes and Measures: The primary outcome was the percentage of heavy drinking days, assessed using a timeline follow-back interview, contrasted between groups over the 32-week period following the first administration of study medication using multivariate repeated-measures analysis of variance.

Results: A total of 95 participants (mean [SD] age, 46 [12] years; 42 [44.2%] female) were randomized (49 to psilocybin and 46 to diphenhydramine). One participant (1.1%) was American Indian/Alaska Native, 5 (5.3%) were Black, 16 (16.8%) were Hispanic, and 75 (78.9%) were non-Hispanic White. Of the 95 randomized participants, 93 received at least 1 dose of study medication and were included in the primary outcome analysis. The percentage of heavy drinking days during the 32-week double-blind period was 9.7% for the psilocybin group and 23.6% for the diphenhydramine group, a mean difference of 13.9%; (95% CI, 3.0–24.7; F1,86 = 6.43; P = .01). Mean daily alcohol consumption (number of standard drinks per day) was also lower in the psilocybin group. There were no serious adverse events among participants who received psilocybin.

Conclusions and Relevance: Psilocybin administered in combination with psychotherapy produced robust decreases in the percentage of heavy drinking days over and above those produced by active placebo and psychotherapy. These results provide support for further study of psilocybin-assisted treatment for AUD.