Preliminary research suggests that there may be significant potential for psilocybin in the treatment of alcoholism. Psilocybin is a classic psychedelic compound found in so-called “magic mushrooms”, especially species such as Psilocybe cubensis. In controlled, clinical conditions, psilocybin-assisted therapy can induce profound, meaningful experiences that support recovery from alcohol use disorder (AUD).
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Effects of psilocybin
Psychedelics, including psilocybin, have the ability to induce profound changes in consciousness, perception and self-identity. Psilocybin is a serotonin 2A (5-HT2A) receptor agonist, which leads to characteristic changes in:
- sensory perception (visual and auditory alterations),
- emotional processing,
- cognitive patterns and self-reflection,
- the sense of connection with self, others and the environment.
Clinical evidence indicates that psilocybin and other classic psychedelics such as LSD, mescaline or ayahuasca may have therapeutic potential in the treatment of several psychiatric conditions, including major depressive disorder, treatment-resistant depression, end-of-life anxiety in cancer patients, and smoking cessation. In controlled settings psilocybin shows a low physiological toxicity and does not typically lead to addiction or compulsive use.
This is why psilocybin is increasingly discussed in the context of alcohol addiction treatment. The potential for abuse appears low, and studies do not suggest a systematic increase in psychotic disorders in carefully screened populations. In a medical setting, with appropriate psychological support, psilocybin is considered relatively safe. The deep, sometimes mystical or spiritually framed experiences reported by patients can become a turning point in their recovery journey.
Treatment of alcoholism with psilocybin – current research
When used in a therapeutic framework and under professional supervision, psilocybin mushrooms may support positive changes in drinking patterns and help reduce or stop alcohol use. Recent studies suggest that psilocybin can modulate prefrontal and limbic brain circuits involved in alcohol use disorder.
Unlike many standard pharmacological treatments, the response to psilocybin-assisted therapy can be relatively rapid — meaningful psychological effects may appear within hours after a dosing session. Even more importantly, follow-up data indicate that the benefits may be long-lasting, persisting from several months up to 4.5 years after the last psilocybin session, especially when combined with psychotherapy and lifestyle changes.
Clinical trials – psilocybin and alcohol use disorder
Early studies from the 1950s and 1960s do not fully meet current scientific standards, but they already hinted at potential benefits. A later meta-analysis of six randomized, controlled trials (536 participants) conducted between 1966 and 1970 showed that a single psychedelic dose could significantly support treatment of alcoholism and help many patients achieve abstinence.
In recent years, interest in psychedelic-assisted therapy has returned. Psilocybin, a naturally occurring compound in psilocybin mushrooms, is one of the central focus points of modern psychiatric research.
Studies on executive functions — the skills we need to regulate behaviour and make deliberate choices — have shown that classic psychedelics may:
- increase cognitive flexibility and psychological insight,
- improve attentional control,
- support emotional self-regulation,
- help people step out of automatic, habitual patterns of thinking and acting.
In patients with alcohol use disorder, psilocybin has been associated with increased self-efficacy, better behavioural control and reduced craving. Improvements were also observed in:
- mood (lower neuroticism and depressive symptoms, more positive affect),
- openness and conscientiousness,
- the ability to “step back” from thoughts and emotions (metacognition).
Course of the study
In modern clinical trials, participants are usually randomly assigned to receive either psilocybin or an active placebo, always in combination with structured psychotherapy. The therapeutic process is designed to deepen psychological insight and support emotional processing facilitated by psilocybin.
Before the dosing session, participants attend preparatory meetings that include motivational interviewing and cognitive-behavioural strategies. This phase aims to:
- clarify intentions and expectations,
- build trust in the therapeutic team,
- provide coping tools for challenging moments during the psychedelic experience.
A key element of some studies is the use of MRI scans conducted both three days before and two days after the dosing session. These scans allow researchers to observe changes in brain activity when participants are shown:
- alcohol-related images,
- positive and negative emotional pictures,
- neutral stimuli.
Significant changes were observed in patterns of brain activity in response to both alcohol-related and emotional cues. These findings suggest altered neural processing in regions involved in craving, emotional regulation and decision-making.
Psilocybin therapy was associated with increased activity in the medial and lateral prefrontal cortex and the left caudate nucleus — areas linked to higher-order cognitive functions such as goal-directed behaviour, planning and emotion regulation.
At the same time, decreased activity was observed in the insular, motor, temporal, parietal, occipital and cerebellar cortex. These structures are related to interoception (body signals and craving), automatic behavioural patterns and sensory processing. This pattern suggests that psilocybin may help reduce the intensity of alcohol-related cues and break automatic response loops.
Interestingly, researchers expected to see changes in classic reward-system areas as well, but in some studies these “reward hubs” remained relatively unaltered. This may indicate that psilocybin does not simply replace one addictive stimulus with another, but instead modulates deeper regulatory networks.
Summary
Psilocybin in the treatment of alcoholism could become a major breakthrough in addiction medicine. However, current evidence is still limited and we do not fully understand the mechanisms underlying its effects. It is also crucial to identify and minimise all potential side effects, both psychological and physiological.
Therapeutic outcome depends strongly on the set & setting: the patient’s mental state, the therapeutic environment, the quality and dose of the substance, and the experience of the clinical team. Psychedelic-assisted treatment must always take place under medical supervision and is not a tool for self-medication.
New scientific data point towards a promising future for psychedelic therapy, and public attitudes towards psychedelics are gradually shifting. Some countries and regions are moving toward decriminalisation or tightly regulated medical use. Despite this, psilocybin remains a controlled substance in most jurisdictions, and therapy with psilocybin is still controversial, primarily because of legal and ethical questions.
In Poland, psilocybin treatment of alcoholism is currently not available as a legal medical option. We can only hope that carefully conducted research and evidence-based discussions will lead to more rational, health-focused regulations in the future.
The content on the psychodelicroom.pl website is educational and research-based and expresses personal opinions that should be approached with caution. We do not encourage the use of consciousness-altering substances, all of which can both heal and cause serious harm. In particular, we advise against cultivating mushrooms from growkits in countries where it is illegal – including Poland – because it involves criminal liability. We recommend that growkits purchased from us be disposed of within 72 hours of receipt.
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