Therapeutic effect of psilocybin in addiction: A systematic review

Summary & key facts

This systematic review searched for clinical trials of psilocybin for substance use problems up to September 2, 2022. The authors found four trials with 151 patients that tested psilocybin combined with psychotherapy for alcohol or tobacco use. These small trials, including one randomized placebo-controlled trial, reported reductions in heavy drinking and high quit rates for smoking, but the evidence is limited and larger, well-controlled trials are needed to know how effective psilocybin-assisted therapy really is.

Key facts:

• The review included four clinical trials reported in six articles, with a total of 151 patients.
• Psilocybin doses in the trials ranged from 6 mg to 40 mg.
• Three trials focused on alcohol use disorder and one trial focused on tobacco (smoking) use disorder.
• In a pilot alcohol study (n = 10), the percentage of heavy drinking days fell by a mean of 26.0 percentage points between baseline and weeks 5–12 (95% CI = 8.7–43.2, p = 0.008).
• In a single-arm alcohol study (n = 31), 32% (10 of 31) of participants became completely abstinent from alcohol, with a mean follow-up of 6 years.
• In the double-blind, placebo-controlled randomized trial (n = 95), the percentage of heavy drinking days over the 32-week double-blind period was lower for psilocybin than for placebo (mean difference 13.9 percentage points, 95% CI = 3.0–24
• In a smoking pilot study (n = 15), 7-day point-prevalence smoking abstinence was 80% (12/15) at 26 weeks and 67% (10/15) at 52 weeks.
• All four clinical trials combined psilocybin with some form of psychotherapy (preparation, the psychedelic session, and integration were typically part of treatment).
• The authors state that all included trials indicated a beneficial effect but note the small number and small size of trials and call for larger randomized controlled trials to confirm effectiveness.

Abstract

BackgroundPsychedelic-assisted therapy (e.g., with lysergic acid diethylamide [LSD]) has shown promising results as treatment for SUDs. Previous systematic r...

Topics

Chemical synthesis and alkaloids Neurotransmitter Receptor Influence on Behavior Psychedelics and Drug Studies

Categories

Clinical Psychology Psychology Social Sciences

Tags

Addiction Clinical psychology Clinical trial Hallucinogen Internal medicine Law Medicine MEDLINE Political science Psilocybin Psychiatry Psychology Systematic review