Skip to content

Psilocybin for addiction

Studies whose primary subject is both Psilocybin and Addiction, with an evidence synthesis read across the most-cited and most recent of them.

State of the evidence

Synthesized

Synthesized from 23 studies in the library · AI-generated, grounded in the abstracts below

Found by searching the library for Psilocybin, magic mushrooms, psilocin, psychedelic mushrooms, Addiction, substance use disorder, then ranked by relevance.

The research suggests psilocybin-assisted therapy may reduce heavy drinking and support smoking cessation, with the strongest single result being a randomized trial showing roughly a halving of heavy drinking days versus active placebo. However, results are inconsistent across studies: a systematic review found mixed effects on abstinence and relapse, and the evidence base is small, with most studies open-label or pilot in design. Durability beyond several months and effects in opioid or stimulant use disorders remain largely unestablished.

Evidence by study

Direction is which way each study's own result points, not our rating of the study. All 25 matching studies were reviewed; the 23 that directly address the question are shown here.

What the directions mean
Supports:
the study found the intervention worked, or its hypothesis held.
Opposes:
it found the opposite, no benefit or a harm.
No effect:
no significant difference either way.
Mixed:
effects in both directions within the same study.
Unclear:
the abstract does not report a direction.
Study Design Sample size Direction Finding
Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study 2015 single-group proof-of-concept study 10 Supports Abstinence did not increase before psilocybin but increased significantly after administration, with gains largely maintained to 36 weeks and no significant treatment-related adverse events.
Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction 2014 open-label pilot study 15 Supports 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up, a rate exceeding typical behavioral or pharmacological cessation rates.
Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder 2022 randomized controlled trial 95 Supports Psilocybin plus psychotherapy produced 9.7% heavy drinking days over 32 weeks versus 23.6% with diphenhydramine plus psychotherapy, a significant reduction.
Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. 2019 integrative review Supports Reviews report promising results for classic psychedelics in treating addiction and end-of-life distress, and note epidemiological associations between naturalistic use and positive mental health outcomes.
Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction 2015 open-label pilot study 15 Supports 12 of 15 participants (80%) showed biologically verified smoking abstinence at 6 months, and abstainers scored significantly higher on mystical experience measures while general drug intensity did not differ.
Psychedelics as Medicines: An Emerging New Paradigm 2016 theoretical or philosophical paper Supports Argues that psychedelics exert therapeutic effects by destabilizing brain network hubs and enabling network resetting, with preliminary evidence of efficacy in tobacco and alcohol addiction.
Psychedelics reopen the social reward learning critical period 2023 experimental study in mice Supports Psychedelic drugs reopen the social reward learning critical period in mice, with a time course proportional to human subjective effects, mediated by oxytocin-dependent plasticity and extracellular matrix reorganization.
Dynamic coupling of whole-brain neuronal and neurotransmitter systems 2020 observational study Supports Stimulation of 5-HT2A receptors with psilocybin causally explains functional brain effects, which the authors suggest may inform understanding of its therapeutic promise for addiction and other disorders.
Psychedelics not linked to mental health problems or suicidal behavior: A population study 2015 observational cohort 135095 No effect Lifetime psychedelic use was not significantly associated with increased likelihood of past-year mental health problems, suicidal thoughts or attempts, depression, or anxiety.
Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts 2018 qualitative follow-up study 12 Supports Participants reported vivid insights into self-identity and reasons for smoking, persistent interconnectedness, awe, and curiosity, and credited preparatory counseling and study rapport as vital to abstinence.
Psychedelics as anti-inflammatory agents 2018 review Supports Psychedelic 5-HT2A receptor agonists produce anti-inflammatory effects in animal and cellular models, which the authors propose may represent a new treatment strategy for inflammatory disorders.
Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey 2020 cross-sectional survey Supports Psychedelic use was associated with self-reported reductions in problematic substance use, though the design cannot determine causality.
Psychedelic Drugs in Biomedicine 2017 review Supports Preclinical and pilot clinical data suggest psychedelics are promising treatments for addiction, depression, and anxiety, but many questions about mechanisms, safety, and efficacy remain.
DARK Classics in Chemical Neuroscience: Psilocybin 2018 review Supports Preliminary studies show psilocybin has potential for treating alcohol addiction, tobacco addiction, OCD, major depressive disorder, and depression in terminally ill cancer patients.
Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder 2018 double-blind placebo-controlled clinical trial 3 Supports Case descriptions report individualized, vivid experiences of catharsis, forgiveness, self-compassion, and love, with lasting shifts in self-perception and relationship with alcohol.
643. A mechanism-informed clinical trial of psilocybin-assisted therapy for opioid use disorder: rationale and neurobiological framework 2026 clinical protocol Unclear Describes a phase II proof-of-concept trial protocol proposing that psilocybin-assisted therapy may address reward dysregulation, anhedonia, and social functioning deficits in opioid use disorder; no results are reported.
Psilocybin-Assisted Therapy for Alcohol Use Disorder: A Systematic Review of Clinical Evidence 2026 systematic review Mixed Across three eligible studies, psilocybin-assisted therapy was associated with reductions in heavy drinking days and an acceptable safety profile, but findings on abstinence and relapse prevention were mixed, with some studies showing no significant differences from controls.
Psilocybin-assisted psychotherapy for substance use disorders as a complex intervention: A systematic review of efficacy, mechanisms and psychotherapeutic frameworks 2026 systematic review Supports Across 17 studies, psilocybin-assisted psychotherapy was associated with reductions in substance use, higher abstinence rates, and improved psychological well-being, though findings were heterogeneous and design-dependent.
Safety, Efficacy, and Blinding Integrity of Psilocybin-Assisted Therapy for Substance Use Disorders: A Systematic Review of Randomized Controlled Trials 2026 systematic review Unclear Describes a planned single-reviewer systematic review of RCTs on the safety, efficacy, and blinding integrity of psilocybin-assisted therapy for substance use disorders; no results are reported.
E8‑Based Neurochemical Simulation Accelerates Psilocybin Therapy for Cocaine Addiction — E8 Intelligence Research 2026 theoretical or philosophical paper Unclear Proposes that an E8 geometry framework can model psilocybin's effects on cocaine addiction pathways and enable simulations to optimize dosing protocols.
Epigenome-wide association study of psilocybin-induced methylome changes in alcohol use disorder. 2026 longitudinal, placebo-controlled pilot study with epigenome-wide association study 37 Mixed Primary endpoints of abstinence duration and mean alcohol use were not reached, but psilocybin was associated with methylation changes in TLE4 and RASGRP4 and co-methylation networks linked to reductions in depressive symptoms and drinking behavior.
Methamphetamine-Fentanyl Polysubstance Administration Produces Social Deficits and Corticolimbic Stress-Reward Circuit Adaptations. 2026 experimental study Opposes Withdrawal from methamphetamine-fentanyl polysubstance treatment reduced social preference, and psilocybin did not restore sociability at the time point examined, though it altered CRHR1 expression in the medial prefrontal cortex depending on drug history.
Safety and Efficacy of Psilocybin-Assisted Therapy for Alcohol Use Disorder: Open-Label Extension of a Phase II Randomized Controlled Trial 2026 open-label extension of a Phase II randomized controlled trial Supports Psilocybin-assisted therapy was safe and associated with sustained reductions in heavy drinking days over 32 weeks.

Points of agreement

  • Multiple studies report reductions in heavy drinking or increased abstinence after psilocybin-assisted treatment for alcohol and tobacco use disorders.
  • The randomized trial and systematic reviews describe an acceptable safety profile in controlled research settings with selected participants.
  • Subjective or mystical-type experiences are repeatedly linked to treatment outcomes in tobacco cessation studies.
  • Reviews consistently call for larger, better-controlled trials because the current evidence base is small and preliminary.

Conflicts

  • The randomized trial found a significant reduction in heavy drinking days, while a systematic review reports mixed findings on abstinence and relapse with some studies showing no significant difference from controls.
  • One systematic review describes heterogeneous, design-dependent results, whereas another reports consistent sustained benefits when repeated high-dose sessions are combined with extended psychotherapy.
  • An epigenome-wide pilot study did not reach its primary abstinence and alcohol use endpoints, contrasting with positive drinking outcomes reported elsewhere.
  • An animal study found psilocybin did not restore social preference after polysubstance withdrawal, which does not support a simple pro-social mechanism.

Gaps

  • Durability of effects beyond roughly 6-12 months is largely unexamined.
  • Blinding integrity in double-blind trials is not yet systematically established.
  • Evidence for opioid, stimulant, and polysubstance use disorders is limited to protocols, animal work, or absent.
  • Optimal dosing, number of sessions, and the specific contribution of psychotherapy versus drug effect remain unclear.
  • Most trials use highly selected participants, limiting generalizability to broader clinical populations.
Browse these studies in the library

Common questions

What does the research agree on about psilocybin for addiction?
  • Multiple studies report reductions in heavy drinking or increased abstinence after psilocybin-assisted treatment for alcohol and tobacco use disorders.
  • The randomized trial and systematic reviews describe an acceptable safety profile in controlled research settings with selected participants.
  • Subjective or mystical-type experiences are repeatedly linked to treatment outcomes in tobacco cessation studies.
  • Reviews consistently call for larger, better-controlled trials because the current evidence base is small and preliminary.
Where do studies on psilocybin for addiction conflict?
  • The randomized trial found a significant reduction in heavy drinking days, while a systematic review reports mixed findings on abstinence and relapse with some studies showing no significant difference from controls.
  • One systematic review describes heterogeneous, design-dependent results, whereas another reports consistent sustained benefits when repeated high-dose sessions are combined with extended psychotherapy.
  • An epigenome-wide pilot study did not reach its primary abstinence and alcohol use endpoints, contrasting with positive drinking outcomes reported elsewhere.
  • An animal study found psilocybin did not restore social preference after polysubstance withdrawal, which does not support a simple pro-social mechanism.
What is still unknown about psilocybin for addiction?
  • Durability of effects beyond roughly 6-12 months is largely unexamined.
  • Blinding integrity in double-blind trials is not yet systematically established.
  • Evidence for opioid, stimulant, and polysubstance use disorders is limited to protocols, animal work, or absent.
  • Optimal dosing, number of sessions, and the specific contribution of psychotherapy versus drug effect remain unclear.
  • Most trials use highly selected participants, limiting generalizability to broader clinical populations.
How we analyze this

This synthesis reads the 15 most-cited and 10 most recent studies whose primary subject is Psilocybin for addiction, up to 25 in all. The most-cited set anchors the established evidence, and the recent set surfaces work that is too new to have gathered citations yet.

A study qualifies only when Psilocybin for addiction or a known alias appears in its title or keywords, so broad reviews that mention it only in passing are left out. Each study is read from its abstract, strongest evidence first, and the summary reports the direction of the results along with any conflicts and gaps.

The full method, including what a person does and does not review, is on the methods page.

Ask your own question in the Research Synthesis Tool

184 articles · 60 from the last two years · 1,260,278 participants across 54 studies reporting sample size

Common study designs

review 59 narrative review 7 systematic review 17 randomized controlled trial 11 theoretical or philosophical paper 6

Research volume by year

Compare topics →

180 studies whose primary subject is psilocybin for addiction since 2009

Studies about psilocybin for addiction per year, 2009 to 2026, peaking at 36 in 2025 Bar chart: one bar per year, taller where more studies were published that year. 0 20 40 2010 2015 2020 2025
2026 is partial
Show the numbers
Studies about psilocybin for addiction per year, 2009 to 2026, peaking at 36 in 2025
Year Studies
2009 1
2010 1
2011 0
2012 0
2013 2
2014 1
2015 4
2016 3
2017 4
2018 7
2019 4
2020 10
2021 20
2022 19
2023 24
2024 28
2025 36
2026 16

Research

Synthesize the evidence →

643. A mechanism-informed clinical trial of psilocybin-assisted therapy for opioid use disorder: rationale and neurobiological framework

International Journal of Neuropsychopharmacology September 9, 2026 Orla Mallon

Abstract Background Opioid Use Disorder (OUD) is associated with substantial morbidity and mortality, with relapse remaining common despite the availability of opioid agonist and antagonist pharmacotherapies. Scotland continues to experience a disproportionate burden of drug-related deaths relative to other parts of the United Kingdom and Europe, reflecting the ongoing clinical and public...

DOI: 10.1093/ijnp/pyag040.113 (opens in new tab)

Psilocybin-Assisted Therapy for Alcohol Use Disorder: A Systematic Review of Clinical Evidence

Psychoactives August 30, 2026 Laura Schäffert, Human-Friedrich Unterrainer

Background: Alcohol use disorder (AUD) remains a leading contributor to global morbidity, yet conventional treatments often yield suboptimal outcomes and high relapse rates. Psilocybin-assisted therapy has re-emerged as a potential intervention for substance use disorders, but its effectiveness and safety in AUD specifically remain to be comprehensively evaluated. Objective: To review and...

DOI: 10.3390/psychoactives5030022 (opens in new tab)

Psilocybin-assisted psychotherapy for substance use disorders as a complex intervention: A systematic review of efficacy, mechanisms and psychotherapeutic frameworks

Journal of Psychopharmacology August 17, 2026 Lana Strika-Bruneau, Chérine Elhssaini, Baptiste Fauvel et al.

Background: Psychedelic-assisted psychotherapy (PAP) shows promise for substance use disorders (SUDs), yet the respective contributions of pharmacological, experiential, psychotherapeutic, and contextual factors remain insufficiently understood. Objective: To synthesize contemporary clinical evidence on PAP for SUDs, with particular attention to therapeutic frameworks, dosing strategies,...

DOI: 10.1177/02698811261473436 (opens in new tab)

Safety, Efficacy, and Blinding Integrity of Psilocybin-Assisted Therapy for Substance Use Disorders: A Systematic Review of Randomized Controlled Trials

Open MIND June 26, 2026 Max Courtney

Substance use disorders (SUDs) represent a persistent global public health burden for which existing pharmacological and behavioral interventions show limited long-term efficacy across various patient populations (Sinha, 2011). Psilocybin-assisted therapy (PAT) has reemerged as a promising therapeutic treatment approach and has had renewed clinical interest with a growing amount of research...

DOI: 10.17605/osf.io/n4y2w (opens in new tab) Addiction Blinding Randomized controlled trial Adverse effect +10

E8‑Based Neurochemical Simulation Accelerates Psilocybin Therapy for Cocaine Addiction — E8 Intelligence Research

Zenodo (CERN European Organization for Nuclear Research) May 29, 2026 Andrew Stewart Caldin

E8 ANALYSIS PIPELINE — derived from: PRESSMAN Breaking Source URL: https://www.theguardian.com/science/2026/may/18/magic-mushrooms-treatment-cocaine-addiction-study The E8 geometry framework supplies a high‑dimensional root‑vector algorithm that can encode the coupled dynamics of serotonin‑2A receptor activation and dopamine pathways implicated in cocaine addiction. By embedding the...

DOI: 10.5281/zenodo.20436208 (opens in new tab) Psilocybin Neurochemical Cocaine use Cocaine dependence +5

Epigenome-wide association study of psilocybin-induced methylome changes in alcohol use disorder.

Translational Psychiatry May 26, 2026 Marvin M. Urban, Lea Zillich, Nathalie M. Rieser et al. 1 citation

The serotonergic hallucinogen psilocybin has shown potential as a treatment for psychiatric conditions like alcohol use disorder (AUD) and depression in clinical studies. Epigenetic mechanisms, including DNA methylation, are hypothesized to contribute to its lasting therapeutic benefits. In this exploratory study, we present the first methylome-wide analysis of psilocybin-induced changes in a...

DOI: 10.1038/s41398-026-03961-3 (opens in new tab) Full text (opens in new tab)

Therapeutic Potential of Psilocybin in Alcohol and Opioid Use Disorders: A Promising Role for Psychedelics

Pharmaceutical Sciences April 30, 2026 Elmira Zolali, Lance R Mcmahon, Samuel Obeng

Please don't use dangerous characters * Last Name Please don't use dangerous characters * Email Address Please enter a email address * Comments Please don't use dangerous characters * Security code The entered code is invalid. Generate New Image Type the code from the image Abstract View: 388 Your browser does not support the canvas element. yearsJanFebMarAprMayJunJulAugSepOctNovDec...

DOI: 10.34172/ps.026.43663 (opens in new tab) Full text (opens in new tab) Psilocybin Hallucinogen Alcohol Opioid +3

Methamphetamine-Fentanyl Polysubstance Administration Produces Social Deficits and Corticolimbic Stress-Reward Circuit Adaptations.

Research Square April 23, 2026 Leah M Salinsky, Joshua L Fox, Kyra C Diaz et al. preprint

Polysubstance use involving psychostimulants and opioids is increasingly prevalent and associated with elevated overdose risk, relapse vulnerability, and poor treatment outcomes. However, the neurobehavioral consequences of opioid-stimulant use remain poorly understood. We evaluated whether repeated methamphetamine-fentanyl polysubstance treatment disrupts social preference during withdrawal,...

DOI: 10.21203/rs.3.rs-9306429/v1 (opens in new tab) Full text (opens in new tab) Addiction Psilocybin Crhr1 Fentanyl +6

Safety and Efficacy of Psilocybin-Assisted Therapy for Alcohol Use Disorder: Open-Label Extension of a Phase II Randomized Controlled Trial

PsyArXiv March 26, 2026 Broc A. Pagni, Stephen Ross, Sarah E. Mennenga et al. preprint

Background: Psilocybin-assisted therapy (PAT) has shown promise for alcohol use disorder (AUD) in randomized controlled trials (RCTs). However, the effects of open-label administration following blinded treatment are unclear. Here, we present safety and efficacy data from an open-label extension of a Phase II RCT (NCT02061293) examining PAT for AUD. Methods: Adults with AUD (N = 59) received a...

DOI: 10.31234/osf.io/7xfek_v1 (opens in new tab)

New psychoactive substances (designer drugs): an approach to classification

Neurology Bulletin March 23, 2026 Azat R. Asadullin, Elvina A. Akhmetova, Ilia S. Efremov et al.

BACKGROUND: Substance use disorders remain a global public health problem. In recent decades, the drug market has undergone substantial changes, with traditional drugs increasingly replaced by new psychoactive substances characterized by high toxicity and strong addictive potential. Their distribution via the Internet and social media impedes control and increases risks to public health. AIM:...

DOI: 10.17816/nb689708 (opens in new tab) Addiction Lysergic acid diethylamide MDMA Psilocybin +10

Clinical trials

All psilocybin for addiction trials →