In a small proof-of-concept study, ten volunteers with alcohol dependence received one or two supervised doses of psilocybin alongside therapy. Abstinence did not increase during the first four weeks of treatment but increased significantly after psilocybin administration, with gains largely maintained up to 36 weeks. The intensity of effects during the first psilocybin session strongly predicted reduced drinking and craving and increased abstinence self-efficacy in the following weeks. No serious adverse events occurred. These preliminary findings support larger controlled trials to test efficacy and mechanisms.
Two doses of psilocybin, given alongside psychotherapy, substantially reduced heavy drinking in people with alcohol use disorder compared to an active placebo (diphenhydramine) plus psychotherapy. Over 32 weeks, heavy drinking days averaged 9.7% in the psilocybin group versus 23.6% in the placebo group—a mean difference of 13.9 percentage points. Daily alcohol consumption was also lower with psilocybin. No serious adverse events occurred in the psilocybin group. The findings support further research into psilocybin-assisted treatment for alcohol use disorder.
In an open-label pilot study of psilocybin-assisted treatment for alcohol dependence, researchers analyzed 17 debriefing sessions conducted the day after psilocybin medication sessions. Participants described key phenomena related to changes in their drinking behavior and the acute subjective effects of psilocybin. The findings illuminate change processes in patients' own words during clinical sessions, shedding light on potential therapeutic mechanisms and how participants express the effects of psilocybin. This study is unique in analyzing actual clinical sessions rather than interviews conducted separately from treatment.
Research into the clinical value of classic hallucinogens and other psychedelics has increased markedly in the past two decades. Effective experimental and clinical use requires psychotherapeutic models tailored to the disorder and integrated with the drug's pharmacological effects. This paper provides an overview of the history of psychedelic-assisted treatment, reviews known therapeutic mechanisms, and considers the purposes of psychotherapy in research and clinical contexts. The authors describe a therapy model they developed for a trial of psilocybin-assisted treatment for alcoholism and discuss advantages and disadvantages of alternative models, emphasizing the need for research to determine the most effective approaches for established indications.
Classic psychedelics like psilocybin may help people change their behavior in substance use disorders. This paper describes the protocol for a multi-site, double-blind, randomized controlled trial that tested psilocybin-assisted psychotherapy in 96 alcohol-dependent volunteers. Participants received either psilocybin or an active placebo (diphenhydramine) during two dosing sessions, alongside a structured 12-week psychotherapy platform. The primary outcome was the proportion of heavy drinking days over 32 weeks after the first dose. Secondary outcomes included safety, abstinence, craving, and self-efficacy. The primary results are reported elsewhere; this paper focuses on the rationale and design decisions.