Psychedelic Augmentation of 12-Step Engagement: A Novel, Accessible Approach to Enhance Community-Based Recovery from Substance Use Disorders.
Nicky J. Mehtani, Maha N. Mian, Gabrielle Agin-Liebes, Allison R. Coker, Christopher Huebner, Brian T Anderson, Jennifer Mitchell
Journal of Psychoactive Drugs November 10, 2025 DOI: 10.1080/02791072.2025.2583960 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Sample size | 9 |
| Population | Individuals in remission from alcohol, opioid, and stimulant use disorders who used psychedelics in combination with 12-Step engagement |
| Interventions | Ayahuasca Ibogaine Psilocybin Peyote 12-Step program engagement |
| Topics | Addiction |
| Keywords | Community-based treatment Substance use disorders 12-step recovery Pychedelics |
| Citations | 1 |
| Key findings | Participants reported that combining ayahuasca, ibogaine, psilocybin, and/or peyote with 12-Step work reduced SUD-related cravings and deepened actionable Step-work, with perceived synergy at Steps 2, 4, and 11. They also described tensions with abstinence-oriented philosophies and risks of unsupervised psychedelic use. The authors present these as preliminary, non-generalizable pilot findings and call for further research. |
Abstract
Amid an evolving psychedelic drug policy landscape and limitations of existing substance use disorder (SUD) treatments, a novel addiction recovery paradigm has emerged involving augmentation of 12-Step program engagement with therapeutic psychedelic use. A preliminary qualitative analysis was initiated to describe this movement by examining real-world experiences of participants in remission from alcohol, opioid, and stimulant use disorders. Between November 2022 and February 2023, data collection was piloted with nine individuals reporting ayahuasca, ibogaine, psilocybin, and/or peyote use in combination with 12-Step engagement. Participants were intentionally recruited through a community partner to explore this emerging phenomenon; findings are not intended to generalize to broader 12-Step communities. Motivations included challenges with sobriety, psychological distress during abstinence, dissatisfaction with existing SUD treatments, and the relative accessibility of this community-based approach compared to clinical care. Participants highlighted reduced SUD-related cravings, psychospiritual mechanisms of behavior change, and synergistic effects of psychedelics with Steps 2, 4, and 11. Tensions with abstinence-oriented philosophies were acknowledged, and risks related to unsupervised psychedelic use were central to participants' narratives; however, participants ultimately found that psychedelics enhanced their recovery by deepening actionable Step-work and improving psychosocial well-being. Pilot findings underscore a need for further research into this low-cost, accessible approach.
Comparable studies
Other qualitative studies on addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts Participants who completed a psilocybin-facilitated smoking cessation pilot study | 2018 | Qualitative follow-up study using semi-structured interviews and thematic analysis | n = 12 |
| Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence—Qualitative Results Therapists, expert researchers, and individuals who underwent ayahuasca-assisted... | 2014 | Qualitative study | n = 29 |
| Exploring ayahuasca‐assisted therapy for addiction: A qualitative analysis of preliminary findings among an Indigenous community in Canada Indigenous adults in Canada who participated in ayahuasca-assisted ceremonial retreats | 2019 | Qualitative study | n = 11 |
| Self-reported negative outcomes of psilocybin users: A quantitative textual analysis Users who self-reported psilocybin experiences on an online platform | 2020 | Qualitative study | n = 346 |
| Reports of self-compassion and affect regulation in psilocybin-assisted therapy for alcohol use disorder: An interpretive phenomenological analysis. non-Hispanic White cisgender men and women with alcohol use disorder | 2023 | Qualitative study | n = 13 |
Citations in the library
Cites 8
- Validation of the revised Mystical Experience Questionnaire in experimental sessions with psilocybin Journal of Psychopharmacology October 6, 2015
- Assessment of addiction severity among ritual users of ayahuasca Drug and Alcohol Dependence June 17, 2010
- Containment Matters: Set and Setting in Contemporary Psychedelic Psychiatry Philosophy, Psychiatry, & Psychology 2021
- Enhancing equity-oriented care in psychedelic medicine: Utilizing the EQUIP framework International Journal of Drug Policy August 27, 2021
- Psychedelics and substance use disorder treatment. International review of neurobiology 2025
and 3 more in the library