Psilocybin-assisted psychotherapy may effectively treat alcohol use disorder

By Jules Murtha | Medically reviewed by Amanda Zeglis, DO, MBA
Published October 17, 2022

Key Takeaways

  • Patients with alcohol use disorder (AUD) may be able to significantly diminish their percentage of heavy drinking days with the help of psilocybin-assisted psychotherapy.

  • Under the Oregon model of psilocybin services, facilitators will have adequate training in both Western sciences and Indigenous plant medicines.

  • For now, doctors can treat patients with AUD with behavioral therapies and medications. Support groups can also encourage patients to maintain their sobriety.

Memory impairment, injury accidents, liver disease, and death: These are potential outcomes for patients with alcohol use disorder (AUD), according to NYU Langone Health.[]

But hope may be in sight. Psilocybin-assisted psychotherapy may reduce patients’ number of heavy drinking days, paving the way for treatment that merges traditional therapy with psychedelics.

The magic of mushrooms in curbing AUD

Clinical interest in the use of psilocybin to treat mental health disorders (including AUD) has grown considerably since the early 2000s—for good reason.

A study published in 2022 by JAMA Psychiatry found that psilocybin may play an important role in therapeutic approaches to patients with AUD.[]

The study was a double-blind randomized clinical trial in which 93 participants underwent 12 weeks of motivational enhancement therapy or cognitive behavioral therapy. Each participant randomly received either psilocybin or diphenhydramine during two “medication sessions” throughout.

Participants were adults between the ages of 25–65 who had a DSM-IV diagnosis of alcohol dependence and experienced at least 4 heavy drinking days in the 30 days prior to screening.

In the first session, those who received psilocybin took 25 mg/70 kg, while the placebo group took 50 mg of diphenhydramine. The doses increased in the second session, rising to 25–40 mg/70 kg of psilocybin and 50–100 mg of diphenhydramine.

The percentage of heavy drinking days for those who took psilocybin in the 32-week double-blind period was reportedly 9.7%, a 13.9% decrease compared with the placebo group, who experienced 23.6% of heavy drinking days. Those in the psilocybin group also had fewer average drinks per day.

This study, along with other research, points to the potential for psilocybin to effectively treat mental health conditions like AUD, depression, and more.[]

Michael P. Bogenschutz, MD, echoed this sentiment in an article published by NYU Langone Health.[]

"As research into psychedelic treatment grows, we find more possible applications for mental health conditions."

Michael P. Bogenschutz, MD

“Beyond [AUD], this approach may prove useful in treating other addictions such as cigarette smoking and abuse of cocaine and opioids,” Dr. Bogenschutz added.

Oregon model may lead the way

The success of psilocybin therapies may hinge on a specific collaboration, however.

An article published by Nature Medicine described how the state of Oregon is pursuing psychedelic therapy.[] The Oregon Health Authority (OHA) hopes to license trained facilitators who can administer psilocybin.

The Oregon model, as the authors call it, imagined licensed facilitators as a “new type of professional trained in Western scientific knowledge as well as Indigenous uses of plant medicines.” The Oregon Psilocybin Advisory Board will advise the OHA on appropriate protocols and procedures as the industry grows.

In this model, clients can seek out psilocybin services with or without a medical diagnosis. Those who don’t have one may still benefit from psilocybin, as have many clinical trial participants who’ve reported improvements in their well-being after taking it.

In this way, psilocybin services may be a preventive mental healthcare tool as well as a method of treatment.

Alternative treatments

As researchers test the efficacy of psilocybin in AUD treatment, patients may benefit from other forms of treatment.

According to an article published by the Cleveland Clinic, clinicians can use one or more of the following to treat patients with AUD.[]

Behavioral therapies. Psychologists and therapists can facilitate one of several types of behavioral therapies for patients with AUD. Cognitive behavioral therapy, motivational therapy, contingency plans, and 12-step facilitation could provide your patient with tools to adjust their behaviors and heal from AUD.

Western medications. Naltrexone and acamprosate are FDA-approved treatments for AUD. Other medications including gabapentin, topiramate, and disulfiram may help curb cravings and diminish obsessive thoughts pertaining to alcohol.

Support groups. Patients are more likely to stay sober if they have a community that understands their struggle. Alcoholics Anonymous, Celebrate Recovery, and Recovery Dharma are examples of support groups patients can regularly lean on. Each also provides a different spiritual focus.

As for psilocybin-assisted psychotherapy, further research is needed before clinicians are given the go-ahead to start using it.

The results look promising so far, though, so keep your eyes—and minds—open.

What this means for you

Psilocybin may be useful in treating a variety of mental health issues, including AUD. Psilocybin-assisted psychotherapy may help patients with AUD reduce heavy drinking days. Clinicians who facilitate therapies that include psilocybin may benefit from extensive training pertaining to both Western medical sciences and Indigenous uses of plant medicines—the crux of the Oregon model. In the meantime, consider prescribing behavioral therapies and medications to patients with AUD.

Read Next: Magic mushrooms: Can you trip your way to good health?
Share with emailShare to FacebookShare to LinkedInShare to Twitter