Psilocybin-Assisted Psychotherapy Reduces Heavy Drinking

Psilocybin, a chemical compound derived from mushrooms, has been a topic of interest for researchers focused on neuropsychiatric conditions, specifically substance use disorders. A double-blind, randomized clinical trial in JAMA Psychiatry found that psilocybin in combination with psychotherapy — called psilocybin-assisted psychotherapy, correlated with a reduced number of heavy drinking days in adults with alcohol use disorder.

Researchers narrowed participants in this study to patients between 25 and 65 with an alcohol dependence diagnosis. Patients were observed at specific weeks in a 32 week time frame. At weeks four and eight, patients participated in 8 hour sessions where they received either psilocybin or a control, diphenhydramine.

Over this timespan, all participants had 12 psychotherapy sessions distributed before, after, and between the medication sessions. Patients who had received psilocybin had 9.7% heavy drinking days at the end of the 32 weeks. Those taking the control had a 13.9% higher percentage of heavy drinking days at 23.6%.

“In this randomized clinical trial in participants with AUD, psilocybin administered in combination with psychotherapy was associated with robust and sustained decreases in drinking, which were greater than those observed following active placebo with psychotherapy. These results support further study of psilocybin-assisted treatment for adults with AUD,” concluded the investigators in the publication.

To date, this study has the largest sample size of any trial focused on psilocybin. Many researchers are hesitant to conduct clinical trials on psychedelics, considering the known and unknown risks associated with their use.

The trial design that involved monitoring patients before, during, and after psychedelic administration may have helped alleviate some of those concerns. Additionally, the patient’s blood pressure and heart rate were monitored at the psychedelic administration sessions.

Researchers considering exploring psilocybin use for neuropsychiatric treatments may consider implementing similar safeguards into their study design. Additional studies may consider the longitudinal effects of psilocybin on alcohol use disorder, how the dosage of psilocybin impacts heavy drinking days, or the effects of psilocybin in other substance use disorders.

For many physicians, substance use disorders can be some of the most challenging conditions to treat. Relapses and treatment-resistant variations of these conditions are common. With this data available, physicians may consider a new treatment route for the treatment of alcohol use disorder.