While it may be a novel concept for many today, the practice of using psychedelics as a treatment for addiction goes back more than half a century in the Western world. In fact, in the early 1960’s, Bill Wilson, the founder of Alcoholics Anonymous, openly expressed his enthusiasm about lysergic acid diethylamide (LSD)’s potential to treat alcohol addiction.
By the late 1960s, the psychedelics were fueling the hippie and anti-war movements. Timothy Leary, the psychonaut and Harvard professor who encouraged American youth to “Tune In, Turn On, Drop Out,” had become a counterculture icon.
Sensing a threat to the existing power structures as well as an opportunity to stigmatize political enemies, President Nixon declared drug abuse “public enemy number one” and promptly placed most popular psychedelic substances on Schedule I as part of the Comprehensive Drug Abuse Prevention and Control Act of 1970. As a result, psychedelic research ground to a halt until the late 1990s.
Over the past few years, as the science pours in, traditional healthcare models have proven to be inadequate, and emotional and mental crises have intensified, an increasing number of academics and clinicians are taking a closer look at psychedelics once again. One of their main research areas is addiction.
This research has become increasingly relevant as substance abuse and substance use disorders (and other addictive disorders like gambling, sex, and food addiction) are more widespread than ever, for a variety of reasons -- more people are disconnected from themselves, their emotions, and their spirit; depression, anxiety, loneliness, and unresolved traumas have become epidemics; and substances that can lead to addiction are easily accessible and even legally marketed.
Currently, a conservative estimate of 10% of adults in the US have qualified for a substance use disorder at some point in their lives. The opioid crisis has destroyed countless families and communities, with no end in sight. In the US, drug-related overdose deaths topped 100,000 in 2020.
With rising levels of substance use and misuse, many in the medical and research communities have come to recognize the serious shortcomings of modern addiction treatment. For those who are trauma-informed, it’s clear that addiction is both a condition of its own AND a response to the pain of unresolved traumas and overwhelming emotions.
As a result, effective addiction treatments must focus on compassionate care for the underlying emotional and mental conditions of addiction. The band-aid strategies of conventional addiction treatment are proving increasingly insufficient for many struggling with these deeply rooted issues.
Addiction treatment researchers are now focusing specific attention on psilocybin — the main hallucinogenic compound found in magic mushrooms – as a growing number of people have experienced it to be one of the safest and most effective ways to heal, grow, and let go of patterns that no longer serve them.
Read on for a deep dive into how psilocybin may be a catalyst for bringing true healing for those struggling with substance abuse.
The term addiction can often be vague and misleading. Some medical professionals prefer using the term substance use disorder (SUD).
SUD is considered a mental disorder or a condition that affects a person’s brain and behavior, making them unable to control their use of legal and/or illegal substances.
While ideas around addiction are popularly attributed to people who are hopelessly addicted to illegal drugs, SUD also applies to legal substances like alcohol, nicotine, and prescription medications.
This includes those who become addicted to medications prescribed for a host of ailments. For example, a small percentage of people with chronic pain are at risk to develop addiction in response to prescribed opioid medications such as oxycodone, hydrocodone, or codeine. Because these opioid-based medications produce feelings of pleasure (for some) and block pain, users who have not developed healthy mechanisms to cope with and process pain can come to rely too heavily on the instant relief that opioids provide.
Similarly, people can and do become physiologically dependent on their prescribed antidepressants, anti-anxiety medications, or medications to treat conditions like attention-deficit disorder. Eventually, SUD can progress to the point where it interferes with relationships, school, and work due to the effects of associated emotional, social, and behavioral changes.
Some of the symptoms of substance use disorder include:
Researchers have found that half of people with SUD also struggle with another mental disorder. Most often, these co-occurring mental disorders include anxiety, depression, and/or post-traumatic stress disorder (PTSD). This concurrence often results because people with anxiety, depression, and PTSD try to self-medicate with substances.
By trying to escape the pains of their mental health challenges, some people turn to legal and illegal drugs for help. In the end, they may become addicted to the substance(s) in a negative downward spiral.
Traditionally, SUD is treated in a few different ways. One way is through the use of behavioral therapies, including cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT). These therapies seek to support patients in learning how to cope, change their behavior, and become more aware of their emotions. Talk therapies such as these, whether in group or individual settings, seek to treat both SUD and other underlying mental conditions, like depression, which may actually be the root of SUD.
Another way to treat SUD is through the use of medication. The medications used to treat opioid use disorder include methadone, buprenorphine (suboxone), and naltrexone. In general, these drugs act to decrease cravings and minimize various withdrawal symptoms such as nausea, irritability, and confusion. The medications used to treat alcohol use disorder include acamprosate, naltrexone, and rarely disulfiram. Medications to treat nicotine dependence include varenicline (Chantix), bupropion (Zyban), and nicotine replacement products like Nicorette gum or patches.
In some cases, individuals may choose to enter an inpatient rehab center, where they can live in a substance-free environment with the support of therapists and peers. Sober living homes can also be an option for those who want a controlled environment where they are protected from some of the triggers that can cause addictive behaviors.
Faith-based 12-step programs have been helpful for many. These 12-step programs rely on a biopsychosocial and spiritual approach within a group (fellowship) or mentor-mentee relationship (sponsorship) to help those struggling with addiction. A relatively new idea, Psychedelics in Recovery has been gaining popularity as “a fellowship of people in 12-step programs who also have an interest in psychedelics and/or plant medicines as an aid to [their] recovery.”
Despite advances in therapy and medication treatment protocols, substance use disorders are still challenging to treat effectively beyond the short-term. For example, it is estimated that 50-60% of people who receive treatment will relapse 6-12 months afterwards.
The issue is that some of these treatments rarely get to the root of the problem. Some forms of treatment are based on misunderstandings of the cause of addiction.
As Dr. Gabor Mate says, “Addiction is not a choice that anybody makes, it’s not a moral failure, it’s not an ethical lapse, it’s not a weakness of character, it’s not a failure of will, which is how our society depicts addiction, nor is it an inherited brain disease, which is how the medical community tends to see it, but it actually is a response to human suffering.”
Therapy can be helpful, but medications only help people stave off withdrawal, reduce craving or numb their emotions. That’s because these medications function in the brain like the effects of the original drug, but with little or no “high” or intoxication. Once people stop taking these medications, they often relapse because these drugs don’t facilitate any kind of deeper healing.
Medication is rarely sufficient for those seeking true restoration of health and wellbeing. What people need is community, mentorship, and spiritual guidance. In his book, The Body Keeps the Score, Dr. Bessel van der Kolk writes, “Social support is a biological necessity, not an option, and this reality should be the backbone of all prevention and treatment.” In this sense, communities of mutual-aid support groups, like 12-step groups, really do help but the spiritual or religious components of such programs often prevent and deter people from connecting more deeply within these fellowships.
Another issue is that, as previously mentioned, addiction often exists alongside anxiety, depression, or PTSD. Unfortunately, talk therapy and medications, either by themselves or in combination, are often insufficient in helping people overcome these difficult mental health challenges. Furthermore, mental health issues are not typically discussed openly in 12-step groups and considered an “outside issue”.
Given the shortcomings of conventional addiction treatment approaches, researchers are exploring the immense potential of psychedelics as alternative addiction treatment. Psilocybin can help people gain powerful insights, become aware of their problems, and consciously face them as a powerful journey toward long-term healing and recovery.
Did you know that psychedelics were at the forefront of addiction research throughout the 1950’s and well into the 1960s? Before psychedelics were banned, they were often used to help people heal from the disconnection and unresolved trauma that regularly result in excessive and self-destructive alcohol consumption.
Pioneering researchers Humphry Osmond and Abram Hoffer, in the Canadian province of Saskatchewan, began treating individuals suffering from alcoholism with LSD in 1953. They found that the psychedelic experience helped many people recover from addiction.
Various studies were performed throughout the 1950s and 1960s with much success. In fact, one of these initial studies in 1955 paved the way for the modern psychedelic trial. Researchers found the optimum environment and strategy to perform these psychedelic experiments.
Additionally, Osmond and Hoffer observed that their patients’ subjective psychedelic “trip” experience helped them reflect, become self-aware, and stop using alcohol.
One of the researchers reported:
“It was rather common for patients to claim significant insights into their problems, to feel that they had been given a new lease on life, and to make a strong resolution to discontinue their drinking.”
In fact, Bill Wilson, the co-founder of Alcoholics Anonymous, believed LSD could help individuals quit drinking by helping them experience a spiritual awakening and “find a power greater than themselves.”
In 2012, decades after Nixon passed the Controlled Substances Act, a meta-analysis examined the success rate of these early studies on the effects of psychedelics for treating alcohol addiction. Overall, 536 people were treated in these early trials, and researchers found that 59% were able to quit alcohol after just one dose of LSD.
In the last decade, the focus of research has turned to psilocybin as a potential addiction treatment. The success of LSD in studies performed decades ago inspired researchers to use psilocybin because they theorized that it could work in the same way as LSD.
Psilocybin may have become more preferred than LSD as the object of research for two main reasons: first, because it carries less stigma than LSD making it easier to gain permission to work with it, and second, because it is shorter-acting without losing efficacy.
The logic followed that if psilocybin can help people understand and resolve their traumas, it can help weaken or dissolve their addictions. As Dr. Mate says, “not why the addiction, but why the pain?”
Researchers tested this hypothesis by performing a few small-scale studies. The first was performed in 2014 by Dr. Matthew Johnson and Dr. Albert Garcia-Romeu which examined whether psilocybin could be successful in helping people quit smoking cigarettes.
Fifteen people were chosen to participate in this study, all of whom were heavy smokers who reported having smoked nearly a pack a day for decades. Also important to note is that each participant had tried to quit smoking an average of six times during their lifetime.
The study took place over a period of fifteen weeks, with two psilocybin doses given; the first on week five and the second on week seven. The patients also received therapy and prepared for their psychedelic trip in the first four weeks.
In the fifth week, the patients quit cigarettes and received their first (low-dose) of psilocybin. The next few weeks included additional therapy sessions followed by one high-dose on week seven.
Six months later, the researchers checked in with the patients to see if they had stayed abstinent from smoking. They found that twelve of the fifteen participants, or 80%, were indeed still living cigarette-free.
In their final, long-term follow-up to the study, researchers found that ten of the participants had abstained from smoking after a period of one year.
In another small-scale study in 2015, Dr. Michael Bogenschutz sought to test psilocybin's effect on treating alcoholism. This study gathered ten participants who met the criteria for alcohol dependence and reported having multiple heavy drinking days per week on a regular basis.
The study lasted twelve weeks, with psilocybin treatment given in the fourth and eighth weeks. Throughout the rest of the study, participants received behavioral therapy and psilocybin preparation.
After the two doses of psilocybin, researchers found that all participants had significantly reduced their drinking and reported that “gains were largely maintained at follow-up to 36 weeks.”
Researchers noted the most significant results in those who experienced more intense psilocybin experiences. As Dr. Bogenschutz notes:
“Strong correlations were observed between measures of intensity of the acute drug effects and clinical outcomes...change in drinking was correlated with the mystical quality of the experience...”
Although these studies are incredibly promising, they are both small-scale pilot studies. While these and other studies are beginning to pave the way for more extensive and comprehensive research, a phase II trial began in 2021 to test the effects of psilocybin on alcohol dependence in a larger, more controlled study.
So, what have the studies actually revealed about psilocybin and addiction? Why does a powerful psychedelic experience help people abstain from using substances they’ve been dependent on for so long?
While researchers themselves aren’t fully certain about how the process works, they do have some informed ideas based on existing studies.
First and foremost, researchers have observed that some of the participants who demonstrated the greatest benefit from psilocybin were those who had a mystical experience. This mystical experience is, in essence, a spiritual one.
Spiritual experiences can help people transcend a limited sense of self and remember that they are and have always been part of something greater than themselves. This is also found in the 12-step process, specifically Step 2: “Came to believe that a power greater than ourselves could restore us to sanity.”.
What does this spiritual or mystical experience have to do with addiction? As it turns out, a lot. As these experiences help people access a sense of meaning, purpose, and connection with the world, the short-term pleasures of substance use become increasingly less satisfying.
As Dr. Garcia-Romeu and Dr. Johnson from the 2014 nicotine addiction study observed:
“the high degree of personal meaning attributed to participants’ psilocybin session experiences is associated with subsequent decrease in temptation to use tobacco, and increase in self-efficacy to abstain from smoking.”
Psilocybin experiences can lead us to seek more meaningful relationships and careers. They can help us recognize where we fall short and how we might live in greater harmony.
Psychedelics help us understand our challenges, whether they’re related to a specific relationship, a traumatic experience, or a deeply rooted pattern that follows us like a shadow.
These experiences give us a peek into our subconscious mind, opening us to subtle truths we might not recognize otherwise.
The mystical experiences and personal insights we experience on psychedelic journeys may also be effective in helping reduce anxiety, depression, and possibly PTSD. As discussed earlier, addiction is often related to these underlying mental health challenges.
Psilocybin can function in multiple ways to help treat addiction; first, by helping us become aware of our underlying problems, and then by helping us develop stronger resolve and a sense of purpose to end the addiction and its associated behaviors.
Researchers also believe that a dose of psilocybin can make us more open and compassionate, potentially contributing to a greater willingness to accept difficult truths and take more initiative to care for ourselves and others. In others, a psychedelic experience may occasion a shift from self-destructive behavior and a lack of connection to others to a desire for better self-care and empathy for others.
Psychedelics such as psilocybin are not a quick fix for all of our problems. While some are tempted by the idea that a few doses of psilocybin will cure us forever, the reality of psilocybin treatment is much more complex.
The psychedelic experience is often just one of the first steps along the path of spiritual awakening. We must still live in our bodies and deal with our issues. As the Zen Proverb says, “Before enlightenment, chop wood, carry water. After enlightenment, chop wood, carry water.” After a psilocybin experience, we may be able to approach life with more compassion and wisdom.
Psilocybin can help us come to powerful realizations about our lives, and often floods us with profound feelings of gratitude and fulfillment. It also may help us understand the causes and effects of addiction and create possibilities for healthier, more loving attitudes toward ourselves and the world. Such realizations undermine the negative thoughts, feelings, beliefs and behaviors that once fueled addiction.
While these insights can be life-changing, the journeyer must act upon and integrate them into daily life in order to effect lasting change. It takes courage to let go of old ways of thinking and acting, and to take active steps to heal and grow.
For example, the psychedelic experience might help someone see the ways their addiction is emotionally harmful for their loved ones. The openness and compassion experienced through psilocybin can help them make a resolution to quit once and for all.
Another person might realize that their untreated anxiety or depression is leading them down the path of addiction. With this awareness, they can take steps to address and heal underlying conditions. They may decide to visit a therapist, meditate, and make more meaningful connections with the people around them.
Psilocybin helps us access the initial stage of awareness, but we must be willing to take action to improve our lives. Working with and through our addictions and mental health issues requires us to face the truth and make a conscious and sustained effort toward change.
Psilocybin motivates us to seek more compassionate, open, and positive emotional and psychological states. Psilocybin connects us to ourselves, others, and to the natural world in ways that facilitate healing. Perhaps that’s the true beauty and healing power of psilocybin in treating substance addiction.