Alcohol Dependence Treatment with Psilocybin
Classic (5HT2A agonist) hallucinogens may have clinically significant impacts on alcohol and drug addiction, according to a number of lines of research. There have been recent research on the effects of psilocybin in different populations, but none have looked at how well it treats alcohol dependence.
The results of this investigation, however, strongly support the need for controlled studies with larger samples to look into causes and efficacy. After said that, let’s take a close look at recent findings in this field of study.
A Brief Overview on Psychedelics and Psychiatric Treatment
There was a lot of study done on the use of LSD and other traditional (5HT2A agonist or partial agonist) hallucinogens to treat addiction, existential anguish in terminal patients, pain, and other conditions from the 1950s through the early 1970s. However, over the past ten years, interest in potential clinical uses of the well-known psychedelic psilocybin has rapidly increased.
LSD, psilocybin, DMT, and mescaline have undergone extensive clinical testing, which has proven their relative safety when used in clinical research settings with thoroughly selected, monitored, and followed-up participants.
- The six reported randomised trials of LSD treatment for alcoholism were recently the subject of a meta-analysis. 211 patients underwent control treatment whereas 325 received active LSD therapy. The odds ratio for improvement at the initial post-treatment follow-up (varying from 1 month to 12 months) was 1.96, favouring LSD (95% confidence interval 1.36-2.84, Z= 3.59, p = 0.0003).
- In a recent pilot trial, the use of psilocybin as a supplement to nicotine replacement therapy produced astoundingly high rates of abstinence (80%-point abstinence at 6-month follow-up).
Psychological Models of Psychedelic Treatment
The essential significance of the altered state of consciousness experienced during the acute effects of the drug has been stressed in clinical work with traditional hallucinogens. There are now two different “psychedelic treatment” paradigms in use.
The first is the “psycholytic” paradigm of therapy, which placed emphasis on the use of traditional hallucinogens to speed up the course of psychodynamic psychotherapy by facilitating access to unconscious content.
- The “psychedelic” therapeutic style, on the other hand, placed more emphasis on using relatively large doses of traditional hallucinogens (often LSD) to cause a “peak-psychedelic” or mystical experience of ego loss, which is frequently compared to psychological death and rebirth.
Most clinical research employing LSD to treat addiction or existential anxiety in the dying carried out in North America followed the latter strategy. The idea of a single transformative event resulting in long-lasting behaviour change is congruent with traditional descriptions of religious conversion and spontaneous Quantum Change experiences.
- Recent research has shown that in normal volunteers who have taken psilocybin, the self-reported “mystical” aspect of the experience (feelings of unity, sacredness, ultimate reality, transcendence of time and space, deeply felt positive mood, and ineffability) significantly predicts the lasting personal significance of the experience and personality change.
The evidence outlined above offers a strong case for researching whether a traditional hallucinogen can enhance treatment response in people with alcoholism. Despite mounting evidence that psilocybin has clinically significant effects and is safe when used under strict supervision, psilocybin has not been studied in the past for use in treating alcoholism.
In order to evaluate results both before and after treatment, the current study’s objectives are to quantify the psychoactive effects and tolerance of oral psilocybin in alcohol-dependent subjects.
Utilizing fliers and adverts in the local media, participants were sourced from the local community. They were males and females between the ages of 25 and 65 who had been diagnosed with active alcohol dependence using the Structured Clinical Interview for DSM-IV (SCID), had at least two days of binge drinking within the previous 30 days, expressed concern about their drinking, and were not receiving treatment at the time.
The 12-session psychosocial intervention included three preparation sessions, two debriefing sessions, and seven sessions of Motivational Enhancement Therapy (MET), a structured method based on the concepts of motivational interviewing.
- Before the first psilocybin session, between the first and second psilocybin sessions, and after the second psilocybin session, there were four sessions.
The psilocybin sessions were conducted in a room that had been deliberately set up to resemble a living room. The morning of the session, the research pharmacist manufactured customized doses of psilocybin (depending on participant weight) and put them in a single gelatin capsule. The psilocybin capsule was taken by the participants, then they drank 4 ounces of water.
- They were told to lie on a couch while donning headphones with a pre-programmed soundtrack and an eyeshade, and to focus on their inner experience. Following psilocybin treatment, participants were monitored for at least 8 hours. Throughout the entire session, both therapists were there. The participants were engaged in supportive and non-directive interactions.
- A dose of 0.3 mg/kg of psilocybin was administered to participants during the first session. For
Findings & Conclusion
Large pre-post effect sizes indicate that participants’ drinking levels significantly improved. They also had significant changes in drinking-related psychological markers. Importantly, the majority of the improvement happened after the psilocybin was given, by which time the subjects had already received 4 weeks of psychosocial therapy and 4-6 hours of evaluation.
Additionally, there were significant connections between clinical outcomes and assessments of the acute pharmacological effects’ intensity. Although the amount of alcohol consumed changed with time, this association held true for ratings of other acute effects as well.
- At all follow-up intervals after the initial psilocybin session, the percentage of heavy drinking days and the percentage of drinking days are significantly lower than the baseline.
- Compared to the baseline, the percentage of heavy drinking days dropped between weeks 5 to 12.
To ascertain whether there are specific aspects of the acute psilocybin experience that are indicative of therapeutic effectiveness in alcohol consumption disorder, more research will be required.
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