More research is needed to see if the effect lasts and whether it works in a larger study. Many who took a dummy drug instead of psilocybin also succeeded in drinking less, likely because all study participants were highly motivated and received talk 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 ease depression or help longtime smokers quit. It’s illegal in the U.S., though Oregon and several cities have decriminalized it. Starting next year, Oregon will allow its supervised use by licensed facilitators.
The new research, published Wednesday in JAMA Psychiatry, is “the first modern, rigorous, controlled trial” of whether it can also help people struggling with alcohol, said Fred Barrett, a Johns Hopkins University neuroscientist who wasn’t involved in the study.
In the study, 93 patients took a capsule containing psilocybin or a dummy medicine, lay on a couch, their eyes covered, and listened to recorded music through headphones. They received two such sessions, one month apart, and 12 sessions of talk therapy.
During the eight months after their first dosing session, patients taking psilocybin did better than the other group, drinking heavily on about 1 in 10 days on average vs. about 1 in 4 days for the dummy pill group. Almost half who took psilocybin stopped drinking entirely compared with 24% of the control group.
Only three conventional drugs — disulfiram, naltrexone and acamprosate — are approved to treat alcohol use disorder and there’s 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.
Less is known about how enduring those new connections might be. In theory, combined with talk therapy, people might be able to break bad habits and adopt new attitudes more easily.
Patients described life-changing insights that gave them lasting inspiration, Bogenschutz said.
Patients receiving psilocybin had more headaches, nausea and anxiety than those getting the dummy drug. One person reported thoughts of suicide during a psilocybin session.
In an experiment like this, it’s important that patients don’t know or guess if they got the psilocybin or the dummy drug. To try to achieve this, the researchers chose a generic antihistamine with some psychoactive effects as the placebo.
Still, most patients in the study correctly guessed whether they got the psilocybin or the dummy pill.
Dr. Mark Willenbring, former director of treatment research at the National Institute for Alcohol Abuse and Alcoholism, said more research is needed before psilocybin can be considered an effective addition to talk therapy. He noted that talking with a therapist helped both groups — those who got psilocybin and those who didn’t — and the added benefit of psilocybin appeared to wear off over time.
“It’s tantalizing, absolutely,” Willenbring said. “Is more research required? Yes. Is it ready for prime time? No.”
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