Therapeutic effect of psilocybin in addiction: A systematic review

Summary & key facts

This systematic review searched for clinical trials of psilocybin for substance use disorders without date limits. It found four clinical trials (reported in six articles) including 151 patients, mostly for alcohol use disorder and tobacco use disorder. Psilocybin doses ranged from 6 to 40 mg and was given together with some form of psychotherapy. Small trials and one randomized controlled trial reported reductions in heavy drinking and high short-term smoking abstinence rates, but the evidence is limited and the authors call for larger randomized studies.

Key facts:

• The review included four clinical trials (six articles) with a total of 151 patients.
• Psilocybin doses in the trials ranged from 6 mg to 40 mg.
• Three trials targeted alcohol use disorder and one targeted tobacco (smoking) use disorder.
• In a double-blind randomized controlled trial (n = 95), the percentage of heavy drinking days over a 32-week double-blind period was 13.9 percentage points lower with psilocybin than with placebo (mean difference = 13.9, 95% CI = 3.0–24.7,
• In a small pilot alcohol study (n = 10), heavy drinking days decreased between baseline and weeks 5–12 by a mean of 26.0 percentage points (95% CI = 8.7–43.2, p = 0.008).
• In a smoking pilot study (n = 15), 7-day point-prevalence abstinence was 80% (12/15) at 26 weeks and 67% (10/15) at 52 weeks.
• In a single-arm alcohol study (n = 31) that included long-term follow-up, 32% (10/31) of participants were completely abstinent from alcohol over a mean follow-up of 6 years.
• All included trials combined psilocybin dosing with some form of psychotherapy; study designs and sizes varied widely, and only one was a randomized controlled trial.
• The authors conclude that all four trials indicated a beneficial effect of psilocybin-assisted therapy on substance use disorder symptoms, but they emphasize that larger randomized controlled trials are needed to confirm efficacy.

Abstract

Only one RCT and three small clinical trials were identified assessing the efficacy of psilocybin combined with some form of psychotherapy in patients with alcohol and tobacco use disorder. All four clinical trials indicated a beneficial effect of psilocybin-assisted therapy on SUD symptoms. Larger RCTs in patients with SUDs need to evaluate whether psilocybin-assisted therapy is effective in patients with SUD.

Topics

Chemical synthesis and alkaloids Neurotransmitter Receptor Influence on Behavior Psychedelics and Drug Studies

Categories

Clinical Psychology Psychology Social Sciences

Tags

Addiction Clinical psychology Clinical trial Hallucinogen Internal medicine Law Medicine MEDLINE Political science Psilocybin Psychiatry Psychology Systematic review

Substances

Psilocybin

Conditions & symptoms

Addiction Addiction or harmful habbits