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Albert Garcia‐romeu

Johns Hopkins University, Johns Hopkins Medicine

68 papers in the library · 4,562 citations · publishing 2013-2026

Papers

Predicting changes in substance use following psychedelic experiences: natural language processing of psychedelic session narratives

The American Journal of Drug and Alcohol Abuse June 5, 2021 David J. Cox, Albert Garcia‐romeu, Matthew W. Johnson 29 citations

People who quit or reduced using alcohol, cannabis, opioids, or stimulants after a psychedelic experience provided written narratives of that experience. Natural language processing extracted topic models from the narratives, and three machine learning algorithms predicted long-term drug reduction outcomes with about 65% accuracy. The quantitative descriptions of the experiences differed depending on which drug class was quit and whether the reduction was sustained. The findings suggest that analyzing written reports of psychedelic experiences with machine learning could help predict who will benefit from psychedelic therapy for substance use.

Mindfulness Training as an Intervention for Substance User Incarcerated Adolescents: A Pilot Grounded Theory Study

Substance Use & Misuse March 11, 2014 Sam Himelstein, Stephen Saul, Albert Garcia‐romeu et al. 28 citations

Teaching mindfulness to incarcerated adolescent substance users requires adapting instruction to their developmental stage, trauma histories, and restricted environment. Over one year, interviews with ten adolescents in an urban California detention facility revealed that effective teaching involves building trust, using concrete language, keeping sessions short, and integrating movement. The initial grounded theory emphasizes relationship, relevance, and repetition as core components. The findings suggest that standard mindfulness curricula need modification for this population, and that even within constraints, adolescents can engage with mindfulness practices.

Special considerations for evaluating psilocybin-facilitated psychotherapy in vulnerable populations

Neuropharmacology May 13, 2022 Cynthia E. Ortiz, Haley Maria Dourron, Noah W Sweat et al. 26 citations

Psilocybin-facilitated psychotherapy may be effective across many mental health conditions, but vulnerable populations, who carry a disproportionate mental health burden, have been largely excluded from clinical research. This report highlights the need to include these groups in studies, considering their problematic historical context and differential experiences with psychedelics. It offers actionable recommendations for future research, such as improved recruitment strategies, careful communication of subjective effects, building therapeutic alliance, multicultural competence, and flexible study designs. The authors call for expanded and improved research in this rapidly advancing field.

The Mystical Experience Questionnaire 4-Item and Challenging Experience Questionnaire 7-Item.

Psychedelic medicine (New Rochelle, N.Y.) March 1, 2024 Justin C Strickland, Albert Garcia‐romeu, Matthew W Johnson 20 citations

Brief four- and seven-item versions of the Mystical Experience Questionnaire (MEQ-4) and Challenging Effects Questionnaire (CEQ-7) show strong correspondence with the full 30- and 26-item scales. In a sample of 1,160 individuals who used psychedelics therapeutically outside research settings, total scores for the brief versus full versions correlated at r = 0.89 for the MEQ and r = 0.90 for the CEQ. Classic psychedelics like LSD and psilocybin produced higher scores on both brief and full versions than MDMA. Higher mystical experience scores on both versions were linked to greater reductions in depression and anxiety, while challenging experiences showed limited association with mental health changes. The brief scales substantially reduce participant burden while maintaining validity.

Knowledge, attitudes, and concerns about psilocybin and MDMA as novel therapies among U.S. healthcare professionals.

Scientific Reports November 14, 2024 Erin Wang, David S. Mathai, Natalie Gukasyan et al. 18 citations

Among 879 U.S. healthcare professionals surveyed online, most endorsed strong belief in the therapeutic promise of psychedelic-assisted therapy with psilocybin and MDMA, and showed moderate openness to clinical use and support for legal access, with higher ratings for psilocybin than MDMA. However, objective knowledge of therapeutic uses, risks, and pharmacology was low. Primary concerns included lack of trained providers, financial cost, and potential contraindications. Prior psychedelic use, self-rated knowledge, younger age, and professional role predicted greater openness, while physicians reported lower openness. Results indicate a pressing need for formal training to provide balanced, evidence-based information.

Psychedelic Experiences Increase Mind Perception but do not Change Atheist-Believer Status: A Prospective Longitudinal Study

Journal of Psychoactive Drugs May 7, 2024 Sandeep M. Nayak, Sydney H White, Samantha Hilbert et al. 18 citations

A prospective longitudinal study of 657 people planning a psilocybin experience outside a laboratory found that after the experience, participants reported increased perception of minds in various living and non-living entities such as plants and rocks, replicating earlier findings. However, the study found little to no change in participants' metaphysical beliefs, such as dualism, or in their self-reported Atheist-Believer status. These results contrast with cross-sectional studies suggesting psilocybin experiences alter Atheist-Believer status and non-naturalistic beliefs, but they support the relevance of mind perception and mentalization processes.

Mapping consent practices for outpatient psychiatric use of ketamine.

Journal of Affective Disorders September 1, 2022 David S. Mathai, Scott M Lee, Victoria Mora et al. 16 citations

Informed consent documents from 23 American ketamine clinics for psychiatric treatment cover most required elements but vary greatly in detail. Key gaps include poor communication about long-term side effects, alternative treatments, pre-treatment evaluations, support during treatment, psychological interventions, and dissociative effects. All forms are written at a readability level too high for many patients. The findings suggest that both patients and providers would benefit from more deliberate, evidence-informed consent processes to support shared decision-making as off-label ketamine use expands.

Parental Attitudes Toward Use of Ketamine in Adolescent Mood Disorders and Suicidality

Journal of Child and Adolescent Psychopharmacology October 1, 2021 David S. Mathai, Alexis G. McCathern, Andrew G. Guzick et al. 14 citations

Parents of adolescents show high acceptability toward using ketamine to treat suicidality, major depressive disorder, and bipolar disorder, despite the drug not being FDA-approved for psychiatric use in children. In a survey of 283 English-speaking parents, primary concerns included potential side effects and lack of FDA approval. Parents preferred short-term applications and less invasive routes of administration. A parent's own history of mental illness, familiarity with psychological treatments, and comfort using other mental health interventions for their children predicted greater acceptability. The findings indicate parental interest in ketamine as a treatment for pediatric mood disorders, pointing to future research and clinical directions.

Examining differences in the effects and contexts of naturalistic psilocybin use for White participants vs. Participants of Color: A longitudinal online survey study.

Journal of Affective Disorders February 1, 2025 Grant Jones, Matthew X. Lowe, Sandeep M. Nayak et al. 12 citations

Psilocybin, the psychoactive compound in magic mushrooms, is linked to improved mental wellbeing on average, but few studies examine how effects differ by race. In a large online longitudinal study of 2,833 people planning naturalistic psilocybin use, race/ethnicity moderated changes in spiritual wellbeing, cognitive flexibility, and emotion regulation (expressive suppression) at 2–3 months post-experience, but not at 2–4 weeks. Participants of Color reported minor differences in context and subjective effects, such as being more likely to set an intention before use. Both groups showed comparable reductions in anxiety and depression, with no significant moderation by race.

IUPHAR-review: The integration of classic psychedelics into current substance use disorder treatment models.

Pharmacological Research January 1, 2024 David B. Yaden, Andrea P Berghella, Peter S. Hendricks et al. 12 citations

Classic psychedelic-assisted therapies show initial promise for treating substance use disorders (SUDs) and may become legally available options. This article describes how these therapies could fit within current evidence-based SUD treatments, suggesting broad compatibility with most mainstream clinical approaches.

Shame, Guilt and Psychedelic Experience: Results from a Prospective, Longitudinal Survey of Real-World Psilocybin Use

Journal of Psychoactive Drugs February 7, 2025 Amy Lehrner, Heather Jackson, David S. Mathai et al. 11 citations

Among 679 adults using psilocybin in naturalistic settings, 68.2% reported acute feelings of shame or guilt during the experience, which were difficult to predict. The ability to constructively work through these feelings predicted wellbeing 2-4 weeks later. On average, psilocybin produced a small but significant decrease in trait shame maintained 2-3 months after use (Cohen's dz = 0.37), though trait shame increased in 29.8% of participants. The activation of self-conscious emotions with psychedelics warrants further attention as a challenging experience subcategory relevant to psychological outcomes, potentially creating a unique learning condition for shame-related memory reconsolidation.

Double-Blind Comparison of the Two Hallucinogens Dextromethorphan and Psilocybin: Experience-Dependent and Enduring Psychological Effects in Healthy Volunteers

Psychedelic Medicine August 30, 2023 Samantha Hilbert, David S. Mathai, Nathan D. Sepeda et al. 10 citations

Dissociatives like dextromethorphan may have clinical applications when used in supportive settings similar to those in psychedelic research, which prioritize optimizing psychologically valuable drug experiences. The analysis suggests that such contexts could enhance therapeutic outcomes.

A Field-Wide Review and Analysis of Study Materials Used in Psilocybin Trials: Assessment of Two Decades of Research

Psychedelic Medicine January 20, 2025 Marianna Graziosi, Gabrielle Agin-Liebes, Mary P Cosimano et al. 9 citations

Psilocybin and other serotonergic psychedelics are used in research settings with safety measures including controlled environments, staff presence, screening, and psychoeducation. An analysis of study materials from psilocybin trials over the past two decades found that psychoeducation documents varied but commonly emphasized biological and physical safety, psychological safety and well-being, aspects of setting, and the potential for expectancies. The materials prioritized biological and psychological safety across all sites. The authors also identified elements unrelated to safety that may contribute to participant expectancies and suggest these extrapharmacological factors be studied systematically to maximize safety while minimizing extraneous expectancies.

Exploring psychedelic use in athletes and their attitudes toward psilocybin-assisted therapy in concussion recovery

Therapeutic Advances in Psychopharmacology January 1, 2024 Baeleigh VanderZwaag, Albert Garcia‐romeu, Mauricio A. García-barrera 9 citations

Psychedelics were the third most used substance in the past year among athletes (35.8%), though regular use was low (7.5%). In a survey of 175 athletes and staff in Canada and the United States, 61.2% of athletes reported likely engaging in psilocybin-assisted therapy (PAT) for concussion recovery, and 71.1% of staff said they would support athletes using PAT. Attitudes toward psilocybin and knowledge of psilocybin predicted willingness to use or support PAT. The sports community may be receptive to PAT for managing persisting concussion symptoms.

Expanded access to psychedelic treatments: comparing American and Canadian policies.

Gen Psychiatr February 19, 2025 Jérémie Richard, Albert Garcia‐romeu, Jack E Henningfield 7 citations

The FDA's August 2024 decision that an additional phase III study is needed before considering approval of midomafetamine for PTSD may postpone the potential approval of this treatment by several years.

Psilocybin or Nicotine Patch for Smoking Cessation

JAMA Network Open March 10, 2026 Mw Johnson, Gideon P. Naudé, Peter S. Hendricks et al. 6 citations

A single high dose of psilocybin combined with cognitive behavioral therapy (CBT) led to significantly higher long-term smoking abstinence rates than nicotine patch treatment plus CBT. At six months, 40.5% of participants who received psilocybin had biochemically verified prolonged abstinence, compared to 10.0% of those using the nicotine patch. No serious adverse events were attributed to either treatment. The pilot trial randomized 82 psychiatrically healthy adult smokers and used an intention-to-treat analysis. The findings suggest psilocybin-assisted therapy may be a promising intervention for tobacco smoking cessation.

Acute subjective effects of psychedelics in naturalistic group settings prospectively predict longitudinal improvements in trauma symptoms, trait shame, and connectedness among adults with childhood maltreatment histories.

Progress in neuro-psychopharmacology & biological psychiatry April 2, 2025 C J Healy, Aaron Frazier, Stephen Kirsch et al. 6 citations

Adults with histories of childhood maltreatment who used psychedelic drugs with therapeutic intent at ceremonies or raves showed significant improvements in PTSD symptoms, complex PTSD symptoms, trait shame, social connectedness, and general connectedness from before the experience to two months afterward. The size of these improvements was large. Changes in these outcomes were linked to specific aspects of the acute psychedelic experience, such as subjective effects. The findings suggest that the social and psychological context of group psychedelic use may contribute to lasting mental health benefits for this population.

Long-term follow-up of psilocybin-facilitated smoking cessation: Abstinence outcomes and qualitative analysis of participant accounts

Drug and Alcohol Dependence November 1, 2015 Albert Garcia‐romeu, Tehseen Noorani, Roland R. Griffiths et al. 6 citations

In a long-term follow-up of a pilot study, 11 out of 15 original participants were interviewed an average of 30 months after receiving psilocybin as part of a smoking cessation treatment. At 6 months, 10 of 11 (91%) were abstinent from smoking; at long-term follow-up, 9 of 11 (82%) remained abstinent. Craving and temptation stayed significantly lower than at baseline and were not different from 6-month levels. Self-efficacy for abstinence remained persistently higher than baseline. Participants described profound psilocybin experiences and good rapport with staff as factors influencing treatment success.

Impact of psychedelics on craving in addiction: A systematic review.

Journal of psychopharmacology (Oxford, England) February 1, 2025 Sophie-Athéna Chapron, Guilhem Bonazzi, Laura Di Lodovico et al. 5 citations

A systematic review of 31 studies involving 2639 participants found that 12 studies reported a significant decrease in craving for alcohol, opioids, cocaine, or tobacco after psychedelic use. However, all but two studies had moderate to high risk of bias due to methodological issues, so the promising anti-craving effects must be interpreted cautiously. The review highlights the need for larger, well-controlled trials to better understand psychedelics' effects on craving, a core symptom of substance use disorders and a predictor of relapse.

Acute subjective effects of psychedelics in naturalistic group settings prospectively predict longitudinal improvements in trauma symptoms, trait shame, and connectedness among adults with childhood maltreatment histories

July 26, 2024 C. J. Healy, Aaron Frazier, Stephen Kirsch et al. 5 citations preprint

Adults with childhood maltreatment histories who used psychedelic drugs with therapeutic intent at ceremonies or raves showed significant improvements in PTSD symptoms, complex PTSD symptoms, trait shame, social connectedness, and general connectedness from before the experience to two months afterward, with effect sizes ranging from 0.73 to 1.12. The degree of improvement was linked to specific acute subjective effects of the psychedelic experience, suggesting that the psychosocial context of these group settings may contribute to therapeutic benefits.

Innovations in group‐based psilocybin‐assisted therapy of major depression in patients with cancer

Cancer December 18, 2023 Johannes Thrul, Zofia Kozak, Michael A. Carducci et al. 5 citations

Psilocybin, when administered in a group-based, assisted intervention, shows promise for treating depression in cancer patients. Two articles in Cancer report that this approach leads to persistent improvements in mood, building on earlier work that found psilocybin reduces existential distress in this population. The editorial discusses these findings, noting the positive effects on mood without specifying effect sizes or sample details.

Pilot study of psilocybin in patients with post-treatment lyme disease

Scientific Reports February 25, 2026 Albert Garcia‐romeu, Gideon P. Naudé, Alison W. Rebman et al. 2 citations

An estimated 10–20% of Lyme disease patients develop post-treatment Lyme disease (PTLD), a chronic syndrome with no established treatments. In an open-label pilot study of 20 participants with PTLD, two sessions of psilocybin (15 mg then 15 or 25 mg) with psychological support led to significant improvements in symptom burden and quality of life from enrollment through one month after the second dose, with benefits sustained at six months. At six months, general PTLD symptom burden decreased 40% from baseline, and mental and physical quality-of-life scores improved 13%. Mood, fatigue, sleep, and pain also improved. No serious adverse events occurred; common side effects were transient hypertension, headache, and tachycardia. The findings suggest psilocybin-assisted treatment is feasible and well-tolerated, warranting further research.