The compound in psychedelic mushrooms helped heavy drinkers cut back or stop altogether in the more rigorous testing of psilocybin for alcoholism.
More research is needed to see if the effect lasts and if it works in a larger study. Many who took a dummy drug instead of psilocybin were also able to drink less, likely because all study participants were highly motivated and received speech therapy.
Psilocybin, found in several species of mushrooms, can cause hours of vivid hallucinations. Indigenous people have used it in healing rituals, and scientists are exploring whether it can alleviate depression or help longtime smokers quit. It is illegal in the US, although Oregon and several cities have decriminalized it. Starting next year, Oregon will allow its use supervised by licensed facilitators.
The new research, published Wednesday in JAMA Psychiatry, is “the first modern, rigorous, controlled study” of whether it can also help people struggling with alcohol, said Fred Barrett, a neuroscientist at Johns Hopkins University who was not involved in the study. study.
In the study, 93 patients took a capsule containing psilocybin or a dummy drug, lay on a couch, eyes covered, and listened to recorded music on headphones. They received two such sessions, one month apart, and 12 speech therapy sessions.
During the eight months after the first dosing session, the patients who took psilocybin fared better than the other group, drinking heavily in about 1 in 10 days on average versus about 1 in 4 days for the sham pill group. Nearly half of those taking psilocybin stopped drinking completely compared to 24% of the control group.
Only three conventional drugs — disulfiram, naltrexone and acamprosate — are approved to treat alcohol use disorder, and there have been no new drug approvals in nearly 20 years.
While it’s not known exactly how psilocybin works in the brain, researchers believe it increases connections and, at least temporarily, changes the way the brain organizes itself.
“More parts of the brain are talking to more parts of the brain,” said Dr. Michael Bogenschutz, director of the NYU Langone Center for Psychedelic Medicine, who led the research.
Less is known about how lasting these new connections might be. In theory, combined with talk therapy, people might be able to break bad habits and adopt new attitudes more easily.
“There is the possibility of actually changing the functional organization of the brain 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 — soaring over breathtaking landscapes and merging telepathically with creative people throughout history — taught her that she was not alone.
Before enrolling in the study in 2018, Orr had five or six drinks every night and more on weekends.
“The amount was unacceptable and yet I couldn’t stop,” she said. “There was no switch I could access.”
During her first experience with psilocybin, she had a vision of her late father, who gave her a pair of eagle eyes and said, “Go.” She told therapists monitoring her, “These eagle eyes can’t see the face of God, but they know where it is.”
She stopped drinking for two years and now has a glass of wine every now and then. More than talk therapy, she credits psilocybin.
“It made alcohol irrelevant and uninteresting to me,” Orr said. Now, “I am tied to my children and loved ones in a way that excludes the desire to be alone with alcohol.”
Patients who received psilocybin had more headaches, nausea and anxiety than those who received the dummy drug. One person reported thoughts of suicide during a psilocybin session.
In an experiment like this, it is important that the patients do not know or guess whether they were given psilocybin or the dummy drug. To try to achieve this, the researchers chose a generic antihistamine with some psychoactive effects as a placebo.
Still, most patients in the study correctly guessed whether they received psilocybin or the dummy pill.
Paul Mavis couldn’t guess. The 61-year-old man from Wilton, Connecticut, was given the placebo but still stopped drinking. On the one hand, talk therapy helped, suggesting to him that his emotional life stopped at age 15, when he started drinking to feel numb.
And he described a life-changing moment during a session where he was taking the fictional drug: he imagined the death of a loved one. Suddenly, intense, crippling pain overwhelmed him.
“I was crying, which is not typical for me. I was sweating. I was helpless,” she said. “While I’m trying to reconcile this pain, like, why am I feeling this?
“I instantly thought, ‘Drinking equals death’.” He said he hasn’t had a drink since then.
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 speech therapy. He noted that talking to a therapist helped both groups — those who received psilocybin and those who did not — and the added benefit of psilocybin seemed to fade over time.
“It’s tempting, absolutely,” Willenbring said. “Is more research needed? Yup. Are you ready for prime time? No.”
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