A small study on the therapeutic effects of using psychedelic substances to treat alcohol use disorder found that just two doses of psilocybin magic mushrooms combined with psychotherapy led to an 83% drop in binge drinking among participants.
Those who received a placebo reduced their alcohol intake by 51%.
By the end of the eight-month trial, nearly half of those given psilocybin had stopped drinking altogether, compared with about a quarter of those given the placebo, according to the researchers.
The study, published Wednesday in JAMA Psychiatry, is the latest in new research exploring the benefits of mind-altering substances to treat a range of mental health issues, from depression, anxiety and stress disorder. post-traumatic stress disorder to the existential fear experienced by terminally ill patients.
While most psychedelics remain illegal under US federal law, the Food and Drug Administration (FDA) is evaluating the potential therapeutic uses of compounds such as psilocybin, LSD and MDMA, the latter known as ecstasy.
Michael Bogenschutz, director of the Langone Center for Psychedelic Medicine at New York University and the study’s principal investigator, said the findings offer hope for the nearly 15 million Americans who struggle with binge drinking — about 5% of all adults. Excessive use of alcohol kills approximately 140,000 people a year in the country.
“These results are encouraging,” said Bogenschutz. “Alcohol use disorder is a serious public health problem, and the effects of currently available treatments and medications tend to be small.”
The randomized double-blind study 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.
Participants, all struggling with binge drinking, also participated in 12 therapy sessions that began several weeks before they received their first shots and continued for a month after their final shot.
Psilocybin dosage was determined according to the participants’ weight, and their heart rate and blood pressure were monitored during the eight-hour sessions.
Although none of the participants who received psilocybin reported serious adverse effects, the study had a notable limitation: after each session, nearly all participants were able to successfully guess whether they had received psilocybin or placebo.
“Twisted expectations may have influenced the results,” the authors wrote, “so this question remains a challenge for clinical research on psychedelics.”
Mary Beth Orr, one of the study participants who received psilocybin, said the treatments helped alter her destructive relationship with alcohol. Although she never passed out and described herself as a “elegant drinker”, her life was marred by the nightly drinking that made her unhappy the next morning.
“I spent a lot of time every day thinking about not drinking at night,” said Orr, 69, a retired art museum technician who lives near Seattle. “I wanted to stop, but I couldn’t.” Psilocybin sessions were sometimes exasperating, she said, but ultimately enlightening.
Mystical and dreamlike journeys included bursts of color, fantastical creatures, and an emotional encounter with her late father.
“It was like a beautiful spectacle, with jewelry and the feeling of running through a tunnel with figures of deities looking at me from niches in the walls,” she said. Two therapists guided her as she lay on a couch, her eyes masked, while soft music played through her headphones.
Though less colorful and emotional, the second session was anchored by a crucial underwater conversation with a relative that she said had caused her immense pain over the years. At the end, she wished her relative well, and they said goodbye with a kiss.
The main message, Orr said, was forgiveness, understanding and love, for others and for herself. “I’m not afraid of feelings anymore and I’m living a deeper life,” she said.
More than three years after his last session, Orr said he rarely drinks, but allows himself a glass of wine every now and then. “It’s not that I monitor my drinking, it’s just that I don’t think about it, which is the glorious part for me.”
Scientists don’t fully understand how psilocybin and other psychedelics work in the mind, but the drugs are believed to promote neuroplasticity or a reprogramming of the brain, allowing those with psychiatric problems to find new ways to cope with illness and self-destructive behavior.
Matthew W. Johnson, a psychedelic researcher at Johns Hopkins Medicine who was not involved in the study, said he was encouraged by the results, in part because of the comparatively large size and double-blindness of the study.
Earlier, promising work on psilocybin and alcohol use disorder, he noted, had only ten participants.
“It really moves the field forward,” said Johnson, a professor of psychiatry and behavioral sciences who is conducting a federally funded study on the use of psilocybin to stop smoking.
Bogenschutz, the study’s lead author, said a subsequent trial will include more than 200 participants and will test the effectiveness of a single dose of psilocybin. The trial will also use a different placebo, vitamin niacin.
On Monday, the FDA approved the trial, which will be the largest study of psilocybin paired therapy for the treatment of alcohol use disorder.
Translated by Luiz Roberto M. Gonçalves
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