Journal of Psychopharmacology
September 11, 2014
Mary P Cosimano, Matthew W. Johnson, Albert Garcia‐romeu et al.
910 citations
In an open-label pilot study, 15 nicotine-dependent smokers received moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin as part of a structured 15-week smoking cessation program. At 6-month follow-up, 12 of 15 participants (80%) showed seven-day point prevalence abstinence, a rate substantially exceeding the typical 35% or less reported for other behavioral or pharmacological therapies. The authors note the open-label design prevents definitive conclusions about efficacy, but the findings suggest psilocybin may be a potentially useful adjunct to smoking cessation treatment.
The American Journal of Drug and Alcohol Abuse
July 21, 2016
Matthew W. Johnson, Albert Garcia‐romeu, Roland R. Griffiths
702 citations
A follow-up of a small pilot study found that two to three moderate to high doses of psilocybin (20 and 30 mg/70 kg) combined with cognitive behavioral therapy for smoking cessation led to high long-term abstinence rates. At 12 months, 10 of 15 participants (67%) were confirmed abstinent; at a longer follow-up averaging 30 months, 9 participants (60%) remained abstinent. Most participants rated the psilocybin experiences among the five most personally meaningful and spiritually significant events of their lives. The results suggest psilocybin, within a structured treatment program, holds promise for promoting long-term smoking abstinence and warrants further research.
Current Drug Abuse Reviews
January 9, 2015
Albert Garcia‐romeu, Roland R. Griffiths, Matthew W. Johnson
480 citations
In an open-label pilot study, 15 smokers received 2 or 3 doses of psilocybin alongside cognitive behavioral therapy for smoking cessation. Twelve of 15 participants (80%) had biologically verified smoking abstinence at 6-month follow-up. Those who quit scored significantly higher on a measure of psilocybin-occasioned mystical experience than those who relapsed, while general drug intensity did not differ between groups. Nine of 15 participants (60%) met criteria for a complete mystical experience. Smoking cessation outcomes correlated with measures of mystical experience on session days and with retrospective ratings of personal meaning and spiritual significance. The results suggest mystical experience may mediate psychedelic-facilitated addiction treatment.
Journal of Psychopharmacology
May 14, 2019
Albert Garcia‐romeu, Alan K. Davis, Fire Erowid et al.
286 citations
In a survey of 343 people who had problematic alcohol use for an average of seven years and then used psychedelics in non-clinical settings, 83% no longer met criteria for alcohol use disorder after the experience. Most respondents were White males in the USA who took moderate or high doses of LSD or psilocybin. They rated the experience as highly meaningful and insightful, and 28% said changes in life priorities or values helped reduce alcohol misuse. Greater dose, insight, mystical-type effects, and personal meaning were linked to larger reductions in drinking. The results suggest naturalistic psychedelic use may reduce problematic alcohol use, supporting further research into psychedelic-assisted treatment.
Journal of Psychopharmacology
June 25, 2018
Tehseen Noorani, Albert Garcia‐romeu, Thomas Cody Swift et al.
285 citations
In a follow-up study of a psilocybin-facilitated smoking cessation pilot, 12 of 15 original participants were interviewed about 30 months after their psilocybin sessions. Participants described gaining vivid insights into their self-identity and reasons for smoking, and reported that experiences of interconnectedness, awe, and curiosity persisted long after the drug's acute effects. The content of the psilocybin experience overshadowed short-term withdrawal symptoms. Participants also emphasized the importance of preparatory counseling, strong rapport with the study team, and a sense of momentum from being engaged in the treatment. Beyond quitting smoking, many reported lasting positive changes such as increased aesthetic appreciation, altruism, and pro-social behavior.
Exp Clin Psychopharmacol
August 1, 2016
Albert Garcia‐romeu, Brennan Kersgaard, Peter H. Addy
198 citations
Hallucinogens are grouped into classes—psychedelics, entactogens, dissociatives, and others—based on how they work in the brain and their chemical structure. While these classes have different primary mechanisms, they all can temporarily and profoundly change consciousness, affecting body sensations, perception, thinking, and emotions. These effects likely explain their recreational use, but a growing body of evidence suggests therapeutic applications beyond abuse potential. This review covers data on several hallucinogen classes, focusing on psychedelics, entactogens, and dissociatives, where clinical utility is best documented. It traces historical insights, compares classes from molecular to behavioral levels, and presents up-to-date clinical research with implications for therapeutic value.
International Review of Psychiatry
July 4, 2018
Albert Garcia‐romeu, William A. Richards
186 citations
Serotonergic hallucinogens (psychedelics) have been used for millennia, but their integration into Western therapeutic practice is relatively new. Mid-20th-century work developed therapeutic models using both low (psycholytic) and high (psychedelic) doses, often combined with psychoanalytic concepts, and established the importance of set (mindset) and setting (environment) for safe, effective use. Recent clinical and pharmacological research has revisited these substances' therapeutic potential. This article reviews past and present models of psychedelic therapy and discusses key considerations for future research and clinical applications.
Frontiers in Psychiatry
January 22, 2020
Earth Erowid, Fire Erowid, Albert Garcia‐romeu et al.
155 citations
A cross-sectional, self-report survey found that people who use psychedelics reported reductions in problematic substance use, including alcohol, opioids, and stimulants. The authors note that because the study is cross-sectional and relies on self-reports, it cannot determine whether psychedelics caused these changes. However, the results suggest a potential for psychedelics to reduce problematic substance use and support further clinical research into psychedelic-assisted treatment for substance use disorders.
Journal of Psychopharmacology
January 18, 2017
Matthew W. Johnson, Albert Garcia‐romeu, Patrick S. Johnson et al.
129 citations
A survey of 358 people who quit or reduced smoking after using a psychedelic (like psilocybin or LSD) in a non-laboratory setting at least one year earlier found that 38% reported continuous smoking cessation, with 74% of those abstinent for over two years. Another 28% reported a lasting reduction in smoking, from a median of 300 cigarettes per month before to 1 per month after. The remaining 34% temporarily reduced smoking but relapsed, typically within 3–6 months. Those who relapsed rated their psychedelic experience as less personally meaningful and spiritually significant than the other groups. Across all groups, participants reported less severe withdrawal symptoms like depression and craving after psychedelic use compared with past quit attempts. Changes in life priorities and values were cited as the most important psychological factor.
Journal of Psychopharmacology
February 20, 2021
Albert Garcia‐romeu, Frederick S. Barrett, Theresa M. Carbonaro et al.
101 citations
Psilocybin, a naturally occurring psychedelic, shows promise for treating mood and substance use disorders when given in structured settings. Most trials have adjusted the dose by body weight, but fixed dosing is simpler and cheaper. Analyzing data from ten previous studies (total 288 participants) that used weight-adjusted doses of 20 or 30 mg per 70 kg, or a fixed dose approximating 25 mg, no significant associations emerged between body weight or sex and the subjective effects (mystical, challenging, or intensity). Across body weights from 49 to 113 kg, body weight did not affect psilocybin's subjective effects, suggesting fixed dosing is as effective and more practical than weight-adjusted dosing.
ACS Pharmacology & Translational Science
December 29, 2020
Justin C Strickland, Albert Garcia‐romeu, Matthew W. Johnson
89 citations
The musical genre played during psilocybin sessions may influence mystical experiences and smoking cessation outcomes. In a small study of ten participants receiving psilocybin for tobacco smoking cessation, overtone-based music led to higher mystical experience scores than Western classical music. Six of ten participants chose overtone-based music for a third session. Biologically confirmed smoking abstinence was 66.7% for those choosing overtone-based playlists versus 50% for Western classical. These results question the assumed unique benefit of Western classical music typically used in psychedelic therapy and support further experimental examination of session components.
Frontiers in Psychiatry
September 19, 2023
Hillary Jackson, Sara So, Abigail Yaffe et al.
87 citations
A large prospective survey of adults planning to take psilocybin outside clinical settings found that, on average, participants reported lasting reductions in anxiety, depression, and alcohol misuse, along with improvements in cognitive flexibility, emotion regulation, spiritual wellbeing, and extraversion, and decreases in neuroticism and burnout after use. However, a minority reported persisting negative effects: 11% at 2–4 weeks and 7% at 2–3 months after use, including mood fluctuations and depressive symptoms. The study included 2,833 respondents at baseline, 1,182 at 2–4 weeks, and 657 at 2–3 months post-use. Participants were primarily college-educated White men in the United States, mean age 40, who used dried psilocybin mushrooms (mean dose 3.1 grams) for self-exploration.
Drugs Education Prevention and Policy
April 30, 2021
Johannes Thrul, Albert Garcia‐romeu
78 citations
Research into the therapeutic potential of highly restricted Schedule I hallucinogens, such as the classic psychedelic psilocybin and the entactogen MDMA, is expanding. These substances, long prohibited under federal law, are now being studied for possible benefits in mental health treatment, though their legal status limits investigation.
Chronic Stress
January 1, 2021
Alan K. Davis, Yitong Xin, Nathan D. Sepeda et al.
66 citations
Among 313 Black, Indigenous, and people of color (BIPOC), acute psychedelic effects were associated with decreases in racial trauma symptoms. Greater psychological insight and less intense challenging experiences during the psychedelic session predicted larger symptom reductions. Increases in psychological flexibility partially mediated these improvements. The findings suggest psychedelics may help reduce racial trauma in BIPOC, with psychological flexibility playing a key mediating role.
Culture, Medicine and Psychiatry
December 1, 2022
Daniel R George, Ryan Hanson, Darryl Wilkinson et al.
65 citations
An international ban on psychedelics in 1971 restricted clinical use of these ancient substances, but structured psychedelic use—long part of ritual healing—is regaining credibility in Western medicine for treating mental health conditions amid rising 'Deaths of Despair' (excess mortality from suicide, drug overdose, and alcoholism). Using a historical lens, the authors examine psychedelic therapies over time, translate ancient lessons to contemporary practice, and interrogate practical and ethical questions for mainstream medicine. Reflecting on COVID-19's contributions to global mental health burden, they argue that a 'psychedelic renaissance' anchored in antiquity could shift healthcare toward more humane practices attentive to underlying causes of distress and supportive of human flourishing.
Qualitative Research
September 29, 2014
Albert Garcia‐romeu, Samuel Himelstein, Jacob Kaminker
64 citations
Self-transcendent experiences (STEs) are moments when a person feels connected to something larger than themselves, yet their nature and process are not well understood. Through in-depth interviews with 15 healthy adults, three major themes emerged: the context in which the experience occurs, the phenomenology or what it feels like, and the aftermath or long-term effects. The context includes the setting, the phenomenology involves perceptual changes, and the aftermath includes lasting impacts. These findings help build a preliminary theory of STEs in healthy adults, offering a clearer picture of how these experiences unfold and what they mean for individuals.
The International Journal of Neuropsychopharmacology
May 10, 2021
Natalie Gukasyan, David B. Yaden, Matthew W. Johnson et al.
56 citations
Psychedelic substances produce unusual changes in conscious experience, leading some to propose they offer unique insights into consciousness. However, psychedelics are unlikely to provide information relevant to the "hard problem of consciousness," which involves explaining how first-person experience emerges. Instead, they bear on multiple "easy problems of consciousness," involving relations between subjectivity, brain function, and behavior. This review discusses common meanings of "consciousness" regarding psychedelics and considers models of their effects on the brain linked to explanatory claims about consciousness. It calls for epistemic humility about psychedelic research's potential to explain the hard problem while noting ways psychedelics may advance study of specific aspects of consciousness.
Frontiers in Psychology
March 25, 2022
David S. Mathai, Victoria Mora, Albert Garcia‐romeu
51 citations
Ketamine, a dissociative drug used as an anesthetic since the 1970s, also shows promise for psychiatric applications, especially when combined with psychological interventions. A review of historical and modern approaches discusses the clinical relevance of ketamine's acute psychoactive effects and proposes a unique model for using esketamine with Acceptance and Commitment Therapy (ACT). The authors suggest considerations for advancing medication-assisted psychotherapy as a field.
Kennedy Institute of Ethics journal
December 1, 2022
Neşe Devenot, Aidan Seale-Feldman, Elyse Smith et al.
50 citations
Psychedelic medicine relies on set and setting, but the specific therapeutic frameworks used alongside the drugs are rarely studied. Analyzing a treatment manual and post-session reports from a pilot psilocybin-assisted smoking cessation study, this article shows how therapeutic frameworks interact with psilocybin to rapidly reshape participants' identity and sense of self. Multiple domains of identity shift were identified that appear to serve as mechanisms for quitting smoking, each present in the manualized treatment. As psychedelic medicine becomes mainstream, consensual, evidence-based approaches to identity shift that respect patient autonomy and encourage empowerment should become key in psychedelic bioethics.
Child and Adolescent Mental Health
February 11, 2013
Elizabeth S. Barnert, Samuel Himelstein, Sarah Herbert et al.
50 citations
Incarcerated adolescent males who took part in a one-day meditation retreat and a 10-week meditation programme reported higher scores in self-regulation, along with psychological enhancement. No behavioral change was observed. Six themes emerged from the data: enhanced well-being, increased self-discipline, increased social cohesiveness, expanded self-awareness, resistance to meditation, and future meditation practice. The findings suggest that meditation training for incarcerated youth is a feasible and promising intervention.
EClinicalMedicine
August 1, 2024
Marcus Hughes, Albert Garcia‐romeu
42 citations
A systematic review of 39 studies published between 1994 and 2024 found that ethnoracial diversity remains low in clinical psychedelic research. Among all included studies (n=1393), 85.0% of participants identified as non-Hispanic White, 2.9% as Black, 5.9% as Latinx/Hispanic, 3.2% as Asian, 1.9% as Indigenous, and 3.7% as mixed race. In studies conducted in the USA (n=1074), 84.5% were White, 3.4% Black, 7.4% Latinx/Hispanic, 4.0% Asian, 1.4% Indigenous, and 3.7% mixed race. The proportion of White to non-White participants decreased in US studies after 2017, indicating some progress, but minoritized groups remain underrepresented.
Journal of psychopharmacology (Oxford, England)
April 1, 2015
Peter H. Addy, Albert Garcia‐romeu, Matthew Metzger et al.
38 citations
In a double-blind, randomized, placebo-controlled trial, 30 healthy individuals who inhaled Salvia divinorum reported rapid, intense, and unique experiences. The experience included marked changes in auditory, visual, and internal bodily sensations, loss of normal self and environmental awareness, and various delusional phenomena. Three main themes and 10 subthemes of acute intoxication emerged from qualitative analysis of interviews and follow-ups, supported by quantitative Hallucinogen Rating Scale data. The findings provide an initial framework for understanding the subjective effects of this emerging drug of abuse and also examine its abuse potential post hoc.
Psychopharmacology
April 1, 2023
David S. Mathai, Sandeep M. Nayak, David B. Yaden et al.
36 citations
For esketamine, a form of ketamine used for treatment-resistant depression, there is no clinically meaningful link between how dissociated a person feels during the drug experience and how much their depression improves. Analyzing data from 576 participants across two clinical trials, researchers measured dissociation with the Clinician-Administered Dissociative States Scale (CADSS) and depression with the Montgomery-Åsberg Depression Rating Scale (MADRS). A statistical model found no significant interaction between dissociation and antidepressant effect over four weeks. A separate analysis showed that each additional point on the dissociation scale on day 1 was associated with a very small 0.
American Journal of Bioethics
May 2, 2024
Edward Jacobs, B. Earp, Paul S. Appelbaum et al.
29 citations
A workshop on psychedelic ethics, the first Hopkins-Oxford Psychedelic Ethics (HOPE) meeting, was held in August 2023 at the University of Oxford to address ethical issues surrounding psychedelics. The organizers (BDE, DBY, EJ) aimed to foster interdisciplinary discussion on topics such as informed consent, therapeutic use, and societal implications. The report outlines the workshop's structure, key themes, and proposed guidelines for ethical research and practice in the field.
Journal of Psychopharmacology
July 1, 2023
Justin N Bonnieux, Baeleigh VanderZwaag, Zahra Premji et al.
29 citations
A scoping review of 42 studies on psilocybin's effects on cognition and creativity in adults found that macrodoses tended to impair cognitive performance and creativity during the acute phase (minutes to hours after intake), while microdoses tended toward creative enhancement. The few macrodosing studies that included post-acute measures (1–85 days) reported primarily null but some positive effects. Psilocybin was mostly administered orally (83%) in bodyweight-adjusted doses (74%) to healthy participants (90%). Only 26% of studies explicitly reported safety outcomes, and among those, only one reported serious adverse reactions. The findings are limited by methodological concerns and inadequate assessment of long-term effects.