The compound in psychedelic mushrooms helped heavy drinkers cut back or quit altogether on the more stringent psilocybin test for alcoholism.
More research is needed to see if the effect lasts and if it works in a larger study. Many who took a placebo instead of psilocybin also managed to drink less, likely because all study participants were highly motivated and received talk therapy.
Psilocybin, found in many types of mushrooms, can cause hours of intense hallucinations. Native people have used it in healing rituals, and scientists are investigating whether it can relieve depression or help long-term smokers quit. It is illegal in the US, although Oregon and many cities have decriminalized it. Starting next year, Oregon will allow its supervised use by licensed brokers.
The new research, published Wednesday in JAMA Psychiatry, is “the first modern, rigorous, controlled trial” of whether it can also help people struggling with alcoholism, said Fred Barrett, a Johns Hopkins University neuroscientist who was not involved. in the study.
In the study, 93 patients took a capsule containing psilocybin or a placebo, lay on a couch, blindfolded, and listened to recorded music through headphones. They received two such sessions, one month apart, and 12 speaking sessions.
During the eight months after their first dosing session, the psilocybin-treated patients fared better than the other group, consuming heavy alcohol about 1 in 10 days on average versus about 1 in 4 days for the placebo group . Almost half of those given psilocybin stopped drinking altogether compared to 24% of the control group.
Only three conventional drugs—disulfiram, naltrexone, and acamprosate—have been approved for the treatment of alcohol use disorder, and there have been no new drug approvals in nearly 20 years.
Although it is not known exactly how psilocybin works in the brain, researchers believe it increases connections and, at least temporarily, changes the way the brain is organized.
“More parts of the brain are talking to more parts of the brain,” said Dr. Michael Bogenschutz, director of NYU Langone’s Center for Psychedelic Medicine, who led the research.
Less is known about how durable these new connections might be. In theory, combined with talk therapy, people may be able to break bad habits and adopt new attitudes more easily.
“There is a possibility that the functional organization of the brain is actually changed in a relatively permanent way,” Bogenschutz said.
Patients described life-changing insights that gave them lasting inspiration, Bogenschutz said.
Mary Beth Orr, 69, of Burien, Washington, said her psilocybin-induced hallucinations — flying over breathtaking landscapes and telepathically merging with creative people throughout history — taught her she wasn’t alone.
Before enrolling in the study in 2018, Orr had five or six drinks each night and more on the weekends.
“The amount was unacceptable and yet I couldn’t stop,” he said. “There was no off switch that I could access.”
During her first experience with psilocybin, she saw a vision of her late father, who gave her a pair of eagle eyes and said, “Go.” She told the healers attending her: “These eagle eyes cannot see the face of God, but they know where He is.”
He stopped drinking completely for two years and now has a glass of wine occasionally. More than talk therapy, he credits psilocybin.
“Alcohol made me irrelevant and indifferent,” Orr said. Now, “I’m connected to my children and loved ones in a way that just precludes the desire to be alone with alcohol.”
Patients taking psilocybin had more headaches, nausea and anxiety than those taking the placebo. One subject reported suicidal thoughts during a psilocybin session.
In an experiment like this, it’s important that patients don’t know or guess whether they got the psilocybin or the dummy drug. To try to achieve this, the researchers chose a generic antihistamine with some psychoactive effects as a placebo.
However, most patients in the study correctly guessed whether they got psilocybin or the placebo pill.
Paul Mavis couldn’t guess. The 61-year-old from Wilton, Connecticut took the placebo but still stopped drinking. For one thing, talk therapy helped, pointing out that his emotional life stalled at age 15, when he started drinking to numb himself.
And he described a life-changing moment during a placebo session: He imagined the death of a loved one. Suddenly, an intense, impotent sadness came over him.
“I was crying, which is not typical for me. I was sweating. I was lost,” he said. “As I try to reconcile this sadness, why do I feel this?
“In the moment, I thought, ‘Drinking equals death.’ He said he has never had a drink since.
Dr. Mark Willenbring, former director of treatment research at the National Institute on Alcohol Abuse and Alcoholism, said more research is needed before psilocybin can be considered an effective addition to talking therapy. He noted that talking with a therapist helped both groups—those who took psilocybin and those who didn’t—and the added benefit of psilocybin appeared to wear off over time.
“It’s tempting, absolutely,” Willenbring said. “Does more research need to be done? Yes. Is it ready for prime time? No.”
The Associated Press Health and Science Section is supported by the Howard Hughes Medical Institute Science Education Division. AP is solely responsible for all content.