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Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder

Michael P. Bogenschutz, Samantha K. Podrebarac, Jessie H. Duane, Sean S. Amegadzie, Tara C. Malone, Lindsey T. Owens, Stephen Ross, Sarah E. Mennenga

Frontiers in Pharmacology February 20, 2018 DOI: 10.3389/fphar.2018.00100 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Double-blind placebo-controlled clinical trial Open-label Qualitative Peer reviewed
Sample size 3
Population Participants in an ongoing trial of psilocybin-assisted treatment for alcohol use disorder
Intervention Psilocybin-assisted treatment
Topics Addiction Meditation Psilocybin Psychedelic-assisted therapy
Keywords Psychotherapist Hallucinogen Clinical psychology Qualitative research Feeling
Citations 125
Key findings Psilocybin-assisted treatment elicits individualized, vivid experiences involving catharsis, forgiveness, self-compassion, and love, along with lasting shifts in self-perception and relationship with alcohol.

Abstract

After a hiatus of some 40 years, clinical research has resumed on the use of classic hallucinogens to treat addiction. Following completion of a small open-label feasibility study, we are currently conducting a double-blind placebo-controlled clinical trial of psilocybin-assisted treatment of alcohol use disorder. Although treatment effects cannot be analyzed until the study is complete, descriptive case studies provide a useful window into the therapeutic process of psychedelic-assisted treatment of addiction. Here we describe treatment trajectories of three participants in the ongoing trial to illustrate the range of experiences and persisting effects of psilocybin treatment. Although it is difficult to generalize from a few cases, several qualitative conclusions can be drawn from the data presented here. Although participants often find it difficult to describe much of their psilocybin experience, pivotal moments tend to be individualized, extremely vivid, and memorable. Often, the qualitative content extends beyond the clinical problem that is being addressed. The participants discussed in this paper experienced acute and lasting alterations in their perceptions of self, in the quality of their baseline consciousness, and in their relationship with alcohol and drinking. In these cases, experiences of catharsis, forgiveness, self-compassion, and love were at least as salient as classic mystical content. Finally, feelings of increased "spaciousness" or mindfulness, and increased control over choices and behavior were reported following the drug administration sessions. Ultimately, psilocybin-assisted treatment appears to elicit experiences that are extremely variable, yet seem to meet the particular needs of the individual.

In the evidence

This study is part of the evidence base for 2 syntheses in the library. Here is how each one recorded it.

  • Psilocybin-assisted treatment elicited vivid experiences involving catharsis, forgiveness, self-compassion, and love, along with lasting shifts in self-perception and relationship with alcohol.

    Synthesized

  • Case descriptions report individualized, vivid experiences of catharsis, forgiveness, self-compassion, and love, with lasting shifts in self-perception and relationship with alcohol.

    Synthesized

Comparable studies

Other randomized controlled trials on psilocybin and meditation, most cited first.

Study Year Design Participants
Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors Healthy participants 2017 Randomized controlled trial n = 75
Psilocybin-assisted mindfulness training modulates self-consciousness and brain default mode network connectivity with lasting effects. Participants following a single administration of psilocybin during a 5-day mindfulness... 2019 Randomized, double-blind, placebo-controlled study n = 38
Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat. Meditators participating in a 5-day mindfulness group retreat 2019 Randomized controlled trial n = 39
Meditating on psychedelics. A randomized placebo-controlled study of DMT and harmine in a mindfulness retreat Experienced meditators 2024 Randomized controlled trial n = 40
Psilocybin enhances insightfulness in meditation: a perspective on the global topology of brain imaging during meditation. Experienced meditators 2024 Randomized controlled trial n = 36

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