ADDICTION MEDICINE
Hitting Reset
When psychedelic medicines were first being studied in the 1950's, the majority of trials were looking at the beneficial effects conferred to people struggling with alcohol addiction. The founder of Alcoholics Anonymous, Bill Wilson, attributed his success with overcoming alcoholism to a psychedelic experience. Research has begun again with open label pilot trials showing very promising results.
ALCOHOL ADDICTION
Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study. Bogenschutz, Journal of Psychopharmacology, 2015
10 volunteers with DSM-IV alcohol dependence received psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration. Gains were largely maintained at follow-up to 36 weeks. The intensity of effects in the first psilocybin session (at week 4) strongly predicted change in drinking during weeks 5–8 and also predicted decreases in craving and increases in abstinence self-efficacy.
SMOKING
Long-term follow-up of psilocybin-facilitated smoking cessation. M Johnson, American Journal of Drug Abuse, 2016
A recent open-label pilot study (N = 15) found that two to three doses of psilocybin in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives.
PATIENTS EXPERIENCES
Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts. Noorani, Journal of Psychopharmacology, 2018
Participants reported gaining vivid insights into self-identity and reasons for smoking from their psilocybin sessions. Experiences of interconnectedness, awe, and curiosity persisted beyond the duration of acute drug effects. Participants emphasised that the content of psilocybin experiences overshadowed any short-term withdrawal symptoms. Preparatory counselling, strong rapport with the study team, and a sense of momentum once engaged in the study treatment were perceived as vital additional factors in achieving abstinence. In addition, participants reported a range of persisting positive changes beyond smoking cessation, including increased aesthetic appreciation, altruism, and pro-social behaviour
PSYCHEDELIC THERAPY FOR ADDICTION
The Drug Science Podcast
Tobacco and alcohol are the largest sources of preventable death in the world. Our current treatments are only 15% effective at best. However, psilocybin-assisted therapy has achieved an astonishing 80% success rate in clinical trials. Professor Matthew Johnson is paving the way for this new an innovative treatment to address one of the most damaging social burdens of modern society, drug addiction. It is important to note that Professor Johnson’s research is not looking at casual habitual smokers, but instead, long-term, treatment resistant tobacco users.
Matthew W. Johnson, Ph.D., Professor at Johns Hopkins, has worked with psychedelics since 2004. He published psychedelic safety guidelines in 2008, the first psychedelic treatment of tobacco addiction in 2014, and with colleagues published the largest study of psilocybin in cancer distress in 2016. His 2018 psilocybin review recommended Schedule IV upon medical approval. He is Principal Investigator on upcoming psilocybin studies treating opioid addiction and PTSD, and LSD research treating chronic pain.
Matt and the Johns Hopkins Psychedelic Research Unit are examining the long-term behavioural changes resulting from a single psilocybin session and cognitive behavioural therapy.
MDMA ASSISTED THERAPY
The Drug Science Podcast
The links between childhood trauma/PTSD and adult addiction are very apparent. It is now well documented that MDMA has a therapeutic potential to treat PTSD could that mean that patients suffering with PTSD-related addiction could benefit from this type of therapy? To do this, Dr. Sessa had to examine the childhood trauma, sexual abuse and the selectively impaired fear response.
Dr Sessa is a consultant child and adolescent psychiatrist working in adult addiction services and with custodial detained young people in a secure adolescent setting. Dr Sessa is currently a senior research fellow at Bristol, Cardiff and Imperial College London Universities, where he is conducting the UK’s first clinical studies with MDMA-assisted therapy for the treatment of PTSD and alcohol dependence syndrome. In the last ten years he has worked on several UK-based human pharmacology trials as study doctor or as a healthy subject administering and receiving test doses of LSD, psilocybin, MDMA and ketamine.