More research is needed to see if the result endures and whether it works in a larger study. Many who took a dummy drug instead of psilocybin also succeeded in cutting short, likely because all study participants were highly motivated and received talk therapy.
Psilocybin, discovered in several species of mushrooms, can cause hours of vivid hallucinations. Indigenous people have used it in healing rituals, and scientists are investigating whether it can ease sadness or help longtime smokers quit. It’s illegal in the U.S., though Oregon and several cities have decriminalized it. Starting next year, Oregon will allow its supervised use by licensed facilitators.
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The new research, issued Wednesday in JAMA Psychiatry, is “the first modern, rigorous, controlled trial" of whether it can also help people struggling with alcohol, said Fred Barrett, a Johns Hopkins University neuroscientist who wasn't involved in the study.
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In the study, 93 patients took a capsule including psilocybin or a dummy medicine, lay on a couch, their eyes covered, and listened to recorded music through headphones. They received two such sessions, one month apart, and 12 sessions of talk therapy.
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During the eight months after their first dosing session, patients taking psilocybin fared better than the other group, drinking heavily on about 1 in 10 days on average vs. about 1 in 4 days for the dummy pill group. About half who took psilocybin quit drinking entirely compared with 24% of the control group.
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Only three conventional drugs — disulfiram, naltrexone and acamprosate — are allowed to treat alcohol use disorder, and there have been no new drug approvals in nearly 20 years.
While it’s not exactly revealed how psilocybin works in the brain, researchers believe it increases connections and, at least temporarily, changes how the brain organizes itself.
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“More parts of the brain are talking to more parts of the brain,” said Dr. Michael Bogenschutz, director of the NYU Langone Center for Psychedelic Medicine, who led the research.
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It is uncertain how much time those new connections might take place. Speculatively, combined with talk therapy, people might be able to break bad habits and adopt new attitudes more easily.
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“There’s a possibility of really shifting in a relatively permanent way the functional organization of the brain,” Bogenschutz said. Patients described life-changing insights that gave them lasting inspiration, Bogenschutz said.
Mary Beth Orr, 69, of Burien, Washington, said her psilocybin-induced hallucinations — flying over breathtaking landscapes and merging telepathically with creative people throughout history — taught her she wasn't alone.
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Before registering in the study in 2018, Orr had five or six drinks every evening and more on weekends.
“The quantity was unacceptable, and yet I couldn’t stop," she said. “There was no off switch that I could access.”
During her first psilocybin experience, she saw a vision of her late father, who gave her a pair of eagle eyes and said, “Go.” She told the therapists monitoring her: “These eagle eyes can’t see God’s face, but they know where it is.”
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She ceased drinking entirely for two years and now has an occasional glass of wine. More than talk therapy, she credits psilocybin.
“It made alcohol irrelevant and uninteresting to me,” Orr said. Now, “I am tethered to my children and my loved ones in a way that just precludes the desire to be alone with alcohol."
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Patients taking psilocybin had more headaches, nausea and anxiety than those getting the dummy drug. One person reported thoughts of suicide during a psilocybin session.
In an experiment like this, patients mustn't know or guess if they got the psilocybin or the dummy drug. To achieve this, the researchers chose a generic antihistamine with some psychoactive effects as the placebo.
Still, most patients in the study correctly guessed whether they got the psilocybin or the dummy pill.
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