There is a substantive clinical literature on classical hallucinogens, most commonly lysergic acid diethylamide (LSD) for the treatment of alcohol use disorder. Chemically related to serotonin, LSD was initially hypothesized to produce a psychosis like state. Later, LSD was reported to have benefits in the treatment of addictions. However, widespread indiscriminate use and reports of adverse effects resulted in the classification of LSD as an illicit drug with no accepted medical use.
- LSD was the subject of numerous research studies in the 1950s and early 1960s. These studies included investigating the therapeutic potential of the “psychedelic” experience in treating chronic alcoholism and mental illness, and in helping patients with terminal illnesses to accept death. LSD also captured the attention of the CIA, who tested its potential for use in psychological warfare.
Given the evidence for a beneficial effect of LSD on alcoholism, it is puzzling why this treatment approach has been largely overlooked. With that said, our goal is to delve into this area of research to develop a more profound understanding as to what current literature has to say!
What is LSD?
Lysergic acid diethylamide or LSD is a semisynthetic compound with strong psychoactive properties. Additionally, LSD is a potent hallucinogen—that is, a drug that can alter a person’s perception of reality and vividly distort the senses. LSD was originally derived from “ergot,” a fungus that grows on rye and other grains.
- The hallucinogenic effect of LSD was first discovered in 1943 by Dr. Albert Hofmann, a Swiss research chemist working at a pharmaceutical company. Early studies exploring potential use of the drug focused on what insight it might offer into certain kinds of mental illness. In the 1950s, intellectuals such as Aldous Huxley experimented with the drug for its alleged ability to induce a state of “cosmic consciousness.”
The effects of LSD include the following:
- Visual effectsinclude brightened, vivid colors, blurred vision, distorted shapes and colors of objects and faces, and halos of light.
- Changes related to touchinclude shaking, pressure, and light-headedness.
- Mood changescan lead to a sense of euphoria, bliss, peacefulness, dreaminess, and heightened awareness, or despair, anxiety and confusion. There may be rapid mood swings.
- Impact on thinkingcan lead to a distorted perception of time, either fast or slow, accelerated thoughts, unusual insight or terrifying thoughts, and a sense of transcendence.
An Overview of Alcohol Dependence
Alcohol-related disorders accounted for approximately 88,000 deaths annually and one in ten deaths in working age adults in the US from 2006 to 2010. Moreover, alcohol is said to cause more overall harm than any other drug. Alcohol contributes to about 4% of total mortality and about 5% of disability adjusted life-years to the global burden of disease. Despite the often extreme individual and social consequences of alcohol misuse, many users find it challenging to stop drinking. Alcoholism, also called alcohol dependence, continues to be difficult to treat, and many patients do not achieve recovery from existing treatments.
Numerous clinical investigators have claimed that treating alcoholics with individual doses of lysergic acid diethylamide (LSD), in combination with psychosocial interventions, can help to prevent a relapse of alcohol misuse, for example, by eliciting insights into behavioural patterns and generating motivation to build a meaningful sober lifestyle. Based upon a review of the literature, it has now been concluded that further research into LSD’s potential as a treatment for addictions is warranted.
- LSD is well-known for inducing spectacular and profound effects on the mind. It has previously been used in standard treatment programs for alcoholism at many clinics.
Although many people find a drink stimulating, alcohol is actually a depressant. The active ingredient in any alcoholic drink, ethyl alcohol, is quickly absorbed via the stomach and intestines into the bloodstream. It is then distributed throughout the body and quickly acts to depress the central nervous system (CNS). Although alcohol affects many neurotransmitter systems, its effect on receptors in the brain’s Gamma Aminobutyric Acid (GABA) system are particularly noteworthy.
- GABA is the brains primary inhibitory neurotransmitter, so by increasing GABA firing, alcohol inhibits other brain activity – which is why alcohol is called a depressant.
Continued drinking leads to a slowing, or depression or more accurately a suppression of the:
- Central nervous system (CNS)
- Impairing motor coordination
- Decreasing reaction times
- Impaired memory
- Poor judgment
- Visual and auditory disturbances
Findings Pertaining to LSD and Alcoholism
Recent research pertaining to this area of research has demonstrated the following promising findings:
- In a pooled analysis of six randomized controlled clinical trials, a single dose of LSD had a significant beneficial effect on alcohol misuse at the first reported follow-up assessment, which ranged from 1 to 12 months after discharge from each treatment program. This treatment effect from LSD on alcohol misuse was also seen at 2 to 3 months and at 6 months but was not statistically significant at 12 months post-treatment. Among the three trials that reported total abstinence from alcohol use, there was also a significant beneficial effect of LSD at the first reported follow-up, which ranged from 1 to 3 months after discharge from each treatment program.
- Regarding the effects of the LSD experience, investigators of one trial noted, ‘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’. Investigators of another trial noted, ‘It was not unusual for patients following their LSD experience to become much more self-accepting, to show greater openness and accessibility, and to adopt a more positive, optimistic view of their capacities to face future problems’
- The findings from randomized controlled trials of a sustained treatment effect of a single dose of LSD on alcohol misuse, which may fade within 12 months, are consistent with many reports of clinical experience and with data from most non-randomized controlled and open-label studies of LSD for alcoholism. In particular, a quasi-randomized trial reported beneficial effects of LSD on alcohol misuse at 3 months post-treatment.
- Additionally, four non-randomized controlled studies reported beneficial effects of LSD on alcohol misuse at follow-up periods ranging from 6 to 18 months.
- The effectiveness of a single dose of LSD compares well with the effectiveness of daily naltrexone, acamprosate, or disulfiram – medications that are commonly prescribed, for reducing relapse in alcohol dependence.
Despite these promising findings, more work will be necessary to determine whether there are particular characteristics of the LSD experience that are predictive of therapeutic benefit in alcohol use disorder.