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In recent years, psilocybin, the active ingredient in some hallucinogenic mushrooms, has been gaining popularity as a potential therapy for various mental disorders such as depression. Given the promising results, clinical trials have recently been conducted on people suffering from alcohol dependence. During tests comparing the molecule to placebo for the first time in this context, patients saw their addiction drop dramatically by 83%! Mandatory accompanied by psychological supervision, psilocybin treatment for alcoholism must soon undergo more rigorous and broader testing before it can be submitted to the FDA.
Extracted from certain hallucinogenic mushrooms, psilocybin is a mind-altering compound that alters the state of consciousness. As with LSD, effects usually appear 15–45 minutes after ingestion and are said to last between 4 and 6 hours, although these figures may vary by individual.
By acting directly on neural connections, the molecule is considered a promising treatment for some mental disorders, although the biomolecular mechanisms that cause these effects are not yet well understood. As for the idea of using psilocybin to treat alcohol abuse disorders, it goes back to the 60s and 70s.
Researchers at the Langone Center for Psychedelic Medicine (in New York) conducted clinical trials of the compound, along with psychological monitoring, for the treatment of alcohol dependence. Alcoholism is a disorder that affects not only the patient himself, but also the people around him. WHO estimates that it affects nearly 237 million men and 46 million women, with higher prevalence in Europe and the US, especially in high-income countries. Among alcohol-related deaths, 28% will be traumatic (traffic accidents, violence, etc.), 21% due to metabolic pathologies and 19% due to cardiovascular diseases.
In response to the medical and socioeconomic problems directly related to alcoholism, current solutions typically rely on psychology and detoxification programs. However, the risk of relapse remains high. “Our findings strongly suggest that psilocybin therapy is a promising treatment for alcohol use disorder, a complex disease notoriously difficult to manage,” said Michael P. Bogenschutz, lead author of the new study, published in the journal JAMA Psychiatry. director of psychiatry at the Langone Center for Psychedelic Medicine.
The new study recruited 93 men and women with a history of alcohol dependence, aged 25 to 65 years. Based on the standard definition of illness, these people are considered alcoholics because they consume an average of 7 drinks per day. Randomly, 48 of them received one to three doses of psilocybin, while the remaining 45 received a placebo. At the same time, everyone benefited from psychological support (up to 12 sessions) before, during and after the procedures.
To assess the effects of the drug, patients were asked to report the number of days of alcohol consumption during the 36-week clinical trial. Samples of nails and hair were also taken to confirm or disprove the declaration of alcohol use.
Result: Candidates who received psilocybin reduced their alcohol consumption by an average of 83%, and those who received placebo by 51%. In addition, eight months after the first dose, 48% of patients who received the active molecule stopped drinking completely, compared with 24% in the placebo group. Given this large discrepancy, most patients and researchers subsequently easily guessed who received the active substance. “I stopped drinking right after my first psilocybin session. It worked on me very quickly,” testified John Kostas, a study participant belonging to the psilocybin group. “It took away all my cravings,” he added.
However, the research team recorded several side effects, including headaches, nausea, and anxiety, which were more pronounced in the psilocybin group. However, the most severe side effects were observed in the placebo group and outside the testing laboratory. Patients also reported emotional and sensory changes commonly associated with the use of hallucinogens. In addition to these various effects, which can cause disabling psychological conditions, the molecule is also a cardiotonic agent, so it is necessary to carefully monitor (and psychologically prepare) patients when taking the drug.
How it works ?
Despite the impressive healing effects, the researchers behind the new study say they still don’t fully understand how the molecule affects the brain. A possible explanation could be a mechanism similar to LSD, in particular the activation of serotonin 2A receptors (5-HT2A) at the level of brain regions involved in cognitive functions such as introspection and the ability to perform actions.
Clearly, by activating these receptors, psilocybin can stimulate neuronal connectivity. For example, in depressed people, it would make the brain more pliable to loosen rigid and negative thought patterns. The molecule is likely to be able to “reboot” neural networks to make new learning possible, facilitating psychological therapy, according to Langone’s researchers.
“We can suggest that there is an increased potential for change, and in the context of therapy, psilocybin could increase people’s ability to make these changes,” suggests Bogenschutz. However, wider and deeper studies will be needed to understand the exact mechanisms, a program already planned by the research team.