Psilocybin could be a therapeutic breakthrough for addiction

To the uninitiated, psilocybin – the substance that gives ‘shrooms’ their psychedelic properties – could be dismissed as a recreational drug. Like many psychedelics, it has been banned by the US government as a Schedule 1 substance, meaning it has a high potential for abuse and does not currently accept medical use in treatment. For many medical science researchers, however, psilocybin is much more: a promising treatment for a range of health problems. Experts in particular are increasingly seeing the chemical as a potentially effective, low-risk drug to help patients break their dependence on other substances. Given that more than 100,000 people died in the US last year after overdosing on opioids and other drugs, it’s an understatement to say there’s an urgent need to find new, effective treatments for substance use disorders.

The research supporting the use of psilocybin in this context has been growing for some time. One of the most recent such studies, published in Scientific Reports on April 7, looked at data from 214,505 U.S. adults in the National Survey on Drug Use and Health (NSDUH) from 2015 to 2019, and found an association between psilocybin use in the past: at any point in their lives – and a reduced risk of an opioid use disorder. The researchers looked at 11 criteria scientists use to diagnose opioid use disorders (for example, spending a significant amount of time getting and using drugs), and found that past use of psilocybin was significantly correlated with lower probability of seven items on the list, and with marginally reduced odds of two others.

There is an important caveat to this study: Because it looked at correlations, it found no definitive evidence that psilocybin use alone reduces the risk of opioid use disorders. While the researchers controlled for things like education level, annual family income and age, there may be social or personal characteristics that make psilocybin users different from people who didn’t decide to take the drug, says Grant Jones, a graduate researcher at Harvard. University who co-authored the study. “Maybe there are different psychological profiles that make” [some people] more immune to developing substance use disorders; we don’t know,” Jones says.

Nevertheless, the study adds to growing evidence that psilocybin is worth investigating as a treatment for substance use disorders. For example, a 2017 Johns Hopkins University pilot study co-authored by Albert Garcia-Romeu found that the majority of 15 participants were able to quit smoking for at least 16 months after receiving two to three moderate-to-high doses of psilocybin. † A similar proof-of-concept study of alcohol use disorders in 2015, led by Michael Bogenschutz, a professor of psychiatry at New York University Grossman School, found that abstinence among addicts increased significantly after taking psilocybin. Observational studies, including the Jones report and additional research by Garcia-Romeu, have also shown that psilocybin is associated with a reduced risk of using substances such as cocaine, marijuana and opioids.

Read more: Inside Ibogaine, One of the Most Promising and Dangerous Psychedelics for Addiction

Additional research has revealed another potential therapeutic use of psilocybin: to relieve depression. For example, a small randomized clinical trial published in 2020 in JAMA found that psilocybin therapy caused a rapid reduction in symptoms of major depression symptoms, and that the effects remained statistically significant at least four weeks later. Another study, published this year in the Journal of Psychopharmacology, found that of a small group of participants with depression who received two doses of psilocybin with supportive therapy, 75% still had some response to treatment and 58% were in complete remission. from depression. In another study, co-authored by Jones, published earlier this year in the Journal of Psychopharmacology, he and colleague Matthew K. Nock reviewed NSDUH data and found that psilocybin use was associated with a reduced risk of major depressive episodes.

Despite all that, Jones acknowledges that there is still a lot to learn about psychedelics. “What always strikes me about psychedelic research is that while there’s a tremendous amount of excitement and a lot of attention, and a lot of financial support pouring into the space, the actual body of literature is still very scarce,” Jones said. “I think we’re exploring the boundaries of wellness benefits.”

Why Can Psilocybin Help Treat Addiction?

Several clinical studies focusing on mental illnesses such as depression have shown that psilocybin appears to boost patients’ mood even weeks after taking the drug. How exactly remains uncertain, but researchers have a few ideas. For example, psilocybin appears to increase the brain’s neuroplasticity — the ability of neural networks to shift and rewire. For example, in a study published April 11 in Nature Medicine, researchers found that psilocybin helped broadly build more connections between different parts of the brain, while simultaneously reducing the interactions between brain areas linked to depression, and, in terms of results, the use of psilocybin was reduced. appeared to reduce patients’ depressive symptoms. In research in both humans and animals, psilocybin appears to make it easier to break habits and become more adaptive, Bogenschutz says. “It increases the brain’s ability to change, and thus to change thinking and behavior.”

In addition, evidence from animal studies suggests that psilocybin’s effect on mental well-being may be related in part to its ability to reduce inflammation — an immune response in the body’s tissues to hazards ranging from stress to physical injury, which researchers have determined to be linked to psychiatric disorders. disorders such as depression.

Biological mechanisms aren’t the only reason scientists are excited about psilocybin and other psychedelics — there’s also the psychological experience of taking the drugs. “The kind of experiences people often have with these drugs can be very meaningful, insightful, and sometimes spiritual in nature,” Garcia-Romeu says. “If you ask them, those experiences are the reason they make these better choices, and they make these behavioral changes.”

The unique benefits of psilocybin

Researchers point to two features that make psilocybin a particularly attractive potential treatment for mental illness. First, while it can cause some dangerous side effects if not used in a controlled environment, it is usually non-addictive. Second, psilocybin can have long-lasting effects, meaning people only need to take it occasionally, putting them at less risk of side effects. “That’s a huge benefit in terms of safety… compared to taking a pill every day, and that side effect profile will haunt you for months, possibly years, depending on how long you take it,” said Matthew Johnson, a professor of psychedelics and awareness at Johns Hopkins University.

In many ways, research into the potential of psilocybin is just beginning. Almost all research on psychedelics in the US came to an abrupt halt after the US stepped up regulation of pharmaceutical research in the 1960s and criminalized the production and possession of psilocybin and other psychedelics. Scientists are still “reopening the books” on psychedelics to make up for decades of stalled research, Garcia-Romeu says. To date, relatively few clinical studies have been published on psilocybin as a treatment for any type of substance use disorder, many of which involved a very small number of participants.

But the resulting evidence is mounting, generating increasing scientific attention for the drug’s capabilities, including, last fall, the first federal grant to study a psychedelic treatment in 50 years for a double-blind randomized trial in psilocybin as smoking cessation aid. In the words of Bogenschutz, science has reached a “first tipping point where there is now enough evidence” [that] it’s really hard not to take the potential of psychedelics seriously.”

Read more: How COVID-19 opened the door to a new era in psychedelic medicine

Scientists studying addiction science eagerly await the results of this and other burgeoning research into the potential of psychedelics in their field. Substance use disorders are chronically undertreated and few have highly effective treatment options. For example, only a minority of Americans with alcohol addiction – the most common substance use disorder in the US – receive treatment; a nationwide study conducted by the Washington University School of Medicine in St. Louis estimated the proportion of alcoholics receiving the care they needed from 2015-2019 at only about 6%.

According to Bogenschutz, the psychology and physiology underlying addiction to one substance have much in common with addiction to other such dependencies. And that, he says, is what makes psychedelics so promising as substance abuse therapy — it seems, he says, to be some sort of panacea for addiction. “Something about psychedelic treatment for addiction that’s exciting is that the way the mechanisms that we hope will work aren’t really specific to any particular addiction,” he says. †[These drugs] could represent a therapeutic breakthrough for alcohol use disorders, other addictions, mood and anxiety disorders – a whole host of conditions.”

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