Pilot study of the 5-HT 2A R agonist psilocybin in the treatment of tobacco addiction

Summary & key facts

Researchers ran a small, open study to see if psilocybin could help people stop smoking. Fifteen otherwise healthy long-term smokers took part in a 15-week program and received one moderate and one higher dose of psilocybin during supervised sessions. Six months after the program, 12 of the 15 people were confirmed not smoking, which is much higher than quit rates usually seen with current treatments. Because everyone knew they were getting psilocybin and the group was small, the study cannot prove it works, but it suggests bigger controlled trials are worth doing.

Key facts:

• The study involved 15 psychiatrically healthy people who had been smoking for decades and had tried to quit several times before.
• Participants received two supervised psilocybin sessions during a structured 15-week smoking-cessation program: a moderate dose of 20 mg per 70 kg body weight and a higher dose of 30 mg per 70 kg.
• Smoking status was checked with biological tests and self-reports. Twelve of the 15 people, or about 80%, were abstinent from smoking at six months.
• Typical success rates for behavioral or drug-based smoking treatments are usually under 35%, so the 80% rate in this small study is much higher than expected.
• The study was open-label, meaning participants and researchers knew what was given. That design and the small number of people limit how confidently we can say psilocybin caused the quit results.
• The authors describe the work as a pilot study. They say the results justify doing larger, well-controlled trials to test if psilocybin really helps people stop smoking and to study how it might work.

Abstract

Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction.

Topics

Cannabis and Cannabinoid Research Neurotransmitter Receptor Influence on Behavior Psychedelics and Drug Studies

Categories

Clinical Psychology Psychology Social Sciences

Tags

Abstinence Addiction Craving Hallucinogen Medicine Nicotine Pathology Psilocybin Psychiatry Psychology Smoking cessation

Substances

Psilocybin

Conditions & symptoms

Addiction Substance abuse disorder Addiction or harmful habbits