In contrast to occasional, recreational, or therapeutic use of a substance, continued use that impacts on a person’s physical and mental health, social situation, and/or responsibilities can be classified as misuse or addiction. According to the American Society of Addiction Medicine, addiction is defined as “a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviours.” Included in this definition are legal substances such as alcohol and tobacco, as well as currently illicit substances.
For many substances, current treatments are moderately effective at best, and many people continue to struggle with addictions and their consequences, having exhausted existing treatment options. Studies in the 50s and 60s investigated the effectiveness of psychedelics in overcoming addictions, but due to regulatory hurdles, these studies have been stopped for 30 years, despite their promising results. The need to find alternative treatment options is urgent. In addressing this need, our Programme investigates the effectiveness of:
A Beckley-sponsored pilot trial, conducted by Prof Roland Griffiths and Dr Matthew Johnson at Johns Hopkins University, was the first study in modern times to investigate the efficacy of the psychedelic psilocybin as an aid to psychotherapy (as part of a structured 15-week smoking cessation treatment protocol) in overcoming nicotine addiction. The results were extremely promising, with 12 of 15 participants (80%) showing abstinence at 6 month follow-up. This is a substantially higher percentage than commonly reported for any other behavioural or pharmaceutical intervention. Although the study was open-label (subjects knew they were getting psilocybin), it demonstrates the potential of psilocybin as an addition to smoking cessation programmes. A second, larger trial with a brain-imaging component to investigate the neurobiological effects of this approach is currently underway.
In collaboration with Dr Michael Bogenschutz, we are preparing a study to investigate the efficacy of LSD in the treatment of alcohol addiction, along with the associated neural mechanisms. The study will extend the clinical research carried out in the 1950s and 1960s, and will build on a recent pilot study by Dr Bogenschutz showing that 2 psilocybin sessions in the context of a 12-week treatment program decreased drinking and craving, and increased self-efficacy. Thus, administration of psychedelics can mobilise biological and psychological processes that are relevant to addictions and could produce therapeutic effects when administered in a safe environment and clinical setting designed to maximise the therapeutic effects of the experience.
A number of animal studies suggest that CBD (cannabidiol – a non-psychoactive cannabis constituent) may have therapeutic properties that may help treat opioid and psychostimulant addictions. Some preliminary data also suggest that it may be beneficial in cannabis and tobacco addiction in humans.
We are currently collaborating with Prof Celia Morgan at the University of Exeter on a study investigating whether CBD could help smoking cessation.
Observational studies on the sacramental use of psychedelics (e.g., peyote/mescaline or ayahuasca/DMT) suggest that these practices are associated with decreased substance misuse and few if any detrimental effects. Ayahuasca and ibogaine are used to treat addictions in many retreat centres and treatment programmess in Latin America and the Caribbean, however placebo-controlled clinical trials still need to be done.
Our Scientific Programme is working hard to fill in this gap in knowledge.
Psilocybin for Depression
Type of publication