Can a psychedelic help people overcome addiction? It sounds surprising, yet researchers have been asking this question since the 1950s. Today, a new generation of studies is testing psilocybin for addiction, especially for alcohol and tobacco. This article explains what those studies found, how psilocybin might help, and why the evidence is still at an early stage.
This article is for general information only. It is not medical advice. If you are struggling with alcohol, tobacco or other substances, please contact a doctor or a local addiction service.
A Short History of Psychedelics and Addiction
In the 1950s and 1960s, doctors in Canada, the United States and parts of Europe gave LSD to people with alcoholism. Some reported encouraging results. However, these early studies often lacked proper control groups, and research stopped almost completely once psychedelics were banned. Interest only returned in the 2000s, this time with psilocybin and more rigorous methods.
Psilocybin for Addiction to Tobacco
In 2014, researchers at Johns Hopkins University ran a small pilot study with 15 long-term smokers [1]. Each participant received two or three psilocybin sessions as part of a structured 15-week program that also included cognitive behavioral therapy. Six months later, 12 of the 15 participants were not smoking, according to biological tests. That is a much higher rate than is typical for standard quit-smoking treatments.
In a later follow-up, most participants were still not smoking more than a year after treatment [2]. Nevertheless, the study was very small and had no control group, so it cannot prove that psilocybin caused the results. Larger randomized trials are now under way.
Psilocybin for Alcohol Use Disorder
Alcohol is the most studied area of psilocybin for addiction research. First, a 2015 proof-of-concept study gave psilocybin to 10 people with alcohol dependence, alongside motivational therapy [3]. On average, their drinking fell after the psilocybin sessions.
Then, in 2022, a larger double-blind trial at New York University and the University of New Mexico compared psilocybin with an active placebo in 95 adults with alcohol use disorder [4]. All participants also received psychotherapy. Over the following eight months, the psilocybin group had heavy drinking days on about 10% of days, compared with about 24% in the placebo group. Importantly, there were no serious adverse events among participants who received psilocybin.
In Europe, researchers in Denmark have designed a placebo-controlled trial to test whether psilocybin-assisted therapy can reduce drinking in people with alcohol use disorder [5]. Results from trials like this will help show whether the earlier findings hold up. Note that this research is very different from drinking while using mushrooms, which our guide to psilocybin and alcohol explains.
How Might Psilocybin Help With Addiction?
Scientists do not yet know exactly why psilocybin might help. Several ideas are being studied:
- Breaking rigid habits: psilocybin seems to temporarily loosen fixed patterns of brain activity, which may make it easier to change entrenched behavior. Our guide to psilocybin and the brain explains this in more detail.
- Meaningful experiences: in several studies, participants who had stronger mystical-type or deeply personal experiences tended to have better outcomes.
- A new perspective: many participants describe seeing their addiction, their values and their relationships in a new light.
- Therapy: every successful study combined psilocybin with structured psychological support, which is likely to play a major role.
Limits of the Research So Far
Although these results are encouraging, the research on psilocybin for addiction has clear limits. Most studies were small, several had no control group, and participants were carefully screened. In addition, because psilocybin has strong effects, it is hard to keep participants from guessing which treatment they received. Finally, little research has looked at other drugs, such as cocaine or opioids, so the results cannot be applied to all forms of addiction.
Risks and Important Warnings
Psilocybin has a low risk of physical addiction, but it is not without risks. It can cause intense anxiety or confusion, and it is not suitable for people with a personal or family history of psychosis or bipolar disorder. Combining psilocybin with alcohol or other drugs can also be dangerous and unpredictable.
Above all, using magic mushrooms on your own is very different from a clinical trial. The studies above used precise doses, medical screening, trained therapists and long-term follow-up. If you want to change your drinking or smoking, start by talking to a doctor or an addiction service. For more on supervised treatment, read our guide to psilocybin therapy.
Frequently Asked Questions
Is psilocybin itself addictive?
Psilocybin is not considered physically addictive. Tolerance builds very quickly, which makes frequent use less effective. Learn more in our guide to psilocybin effects and safety.
Is psilocybin approved for treating addiction?
No. In Europe and most other places, psilocybin for addiction is only available through clinical trials.
Does microdosing help with addiction?
There is no good evidence for this yet. The studies described here used full doses in supervised sessions, not microdoses.
Conclusion: Early Promise for Psilocybin for Addiction
Research on psilocybin for addiction has produced some of the most striking early results in psychedelic science, particularly for alcohol and tobacco. However, the studies are still few and mostly small, and psilocybin is not an approved treatment. If you are affected by addiction, reach out to a professional, and follow the larger trials in Europe and around the world as their results come in. For related research, see our articles on psilocybin for depression and psilocybin for anxiety.
Sources
- Johnson MW, et al. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology. 2014. doi:10.1177/0269881114548296
- Johnson MW, et al. Long-term follow-up of psilocybin-facilitated smoking cessation. The American Journal of Drug and Alcohol Abuse. 2016. doi:10.3109/00952990.2016.1170135
- Bogenschutz MP, et al. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. Journal of Psychopharmacology. 2015. doi:10.1177/0269881114565144
- Bogenschutz MP, et al. Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder. JAMA Psychiatry. 2022. doi:10.1001/jamapsychiatry.2022.2096
- Jensen ME, et al. Psilocybin-assisted therapy for reducing alcohol intake in patients with alcohol use disorder: protocol for a randomised, double-blinded, placebo-controlled 12-week clinical trial (The QUANTUM Trip Trial). BMJ Open. 2022. doi:10.1136/bmjopen-2022-066019
