Psilocybin, the active compound in “magic mushrooms,” has seen a surge in medical research over the past few years, particularly for its potential in treating psychiatric and neurological conditions like depression and post-traumatic stress disorder.
It’s also been part of trials for addiction treatments. A recent study in Denmark looked at whether a single dose of this psychedelic drug could help people reduce their alcohol intake – and the results from the small single-group trial are actually quite promising. However, it’s important we exercise greater scrutiny to accurately determine their efficacy.
Mathias Ebbesen Jensen, a researcher at the Neuropsychiatric Laboratory at Psychiatric Center Copenhagen, authored the paper that appeared in the Journal of Psychopharmacology in February. Following his own research into how the blood sugar regulating hormone GLP-1 could impact alcohol use disorder, as well as learning about the concept of quantum change, Jensen decided to look into what psilocybin could do for heavy drinkers.
Quantum change, a concept described by psychologist William Miller, refers to “sudden, dramatic, and enduring transformations that affect a broad range of personal emotion, cognition, and behavior.” It can be thought of as a sudden fundamental shift in one’s values and priorities, rather than a gradual development.
PsyPost noted that this was key to Jensen’s work, with the postdoc explaining that “the phenomenology of quantum change experiences bear a striking resemblance with the psilocybin-induced experiences, and I thought, perhaps we can occasion quantum changes with psilocybin and thereby radically change their drinking behavior.”
The study involved 10 participants with a median age of 44 years, who all had several alcohol use disorders and had never been treated for it before.
The treatment involved five sessions, including pre-dosage therapy, a single session in which a high dosage of psilocybin was administered before the participants listened to a six-hour music program, and post-dosage sessions. Twelve weeks later, participants reported their number of heavy drinking days had reduced by an average of 37.5%. They’d also reduced their alcohol intake by a median of 3.4 drinks. The cravings began to decrease just one week after treatment and remained lower three months after.
These findings are certainly encouraging, but Jensen himself offered a major caveat. “We only included 10 participants, of which only two were women, and everybody knew they were going to get psilocybin i.e., there was no control group,” he said. “It is likely that the effects we observed are inflated by high expectations. The results need to be replicated in larger placebo-controlled trials.”
And while this was the first study to investigate the effects of a single dose of psilocybin on alcohol use dependence, it’s not the first of its kind.
A larger trial with 93 subjects was conducted in 2022 by a team at New York University over several months, and it showed great results: 48% of those in the psilocybin group had stopped drinking completely, and those in this group reduced their heavy drinking days by 83% compared to a 51% reduction in the placebo group.
The trouble was that nearly all the participants broke blind, i.e. they guessed correctly whether they were in the experiment group or control group. That realization tends to color behavior, and taints the findings.
So with both studies, you’ve got questionable methodology and not-exactly-empirical results. As such, it’s worth exploring whether there are better ways to devise these studies in the first place, and if we can frame them such that readers aren’t misled as to their results. The prospect of psychedelics-led treatments proving effective for challenging psychiatric conditions is exciting, but it can’t be championed at the cost of accuracy and reliability.
For its part, Jensen’s team will prepare a more stringent, randomized placebo-controlled trial this fall. The idea is to assess “psilocybin’s effects on the neurobiology measured both with brain imaging techniques and blood markers of neuroplasticity.” Hopefully we’ll see more rigorous experimentation – and possibly even credible breakthroughs in psychedelics-based treatments in the near future.
Source: Copenhagen University Hospitals via PsyPost