Psylocybin in the treatment of alcoholism

Alcoholism is a difficult-to-treat mental disorder that takes a heavy toll on public health. It destroys not only the patient, but also his or her close environment and affects society as a whole. Existing therapies have moderate efficacy, with high relapse rates. Preliminary research suggests that quite a bit of potential may exist for psilocybin in the treatment of alcoholism. It is a psychedelic substance that is contained in the magic mushroom psilocybe cubensis. Therapy sessions involving psilocybin can effectively induce meaningful experiences that promote recovery from addiction.

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Effects of psilocybin


Psychedelics, including psilocybin, have the ability to effectively induce profound changes in consciousness and self-identity. Psilocybin, which is a serotonin agonist, induces profound changes in sensory, emotional and cognitive perception, mainly by interacting with the serotonin 2A (5-HT2A) receptor.

Clinical evidence suggests that psilocybin and other psychedelic substances, such as LSD, mescaline and ayahuasca, may have therapeutic potential in the treatment of various psychiatric disorders, including major depressive disorder, treatment of refractory depression, anxiety and depression in cancer patients, and smoking cessation therapy. It has a low risk of toxicity and does not show tendencies leading to addiction or compulsive use in humans. This is why psilocybin in the treatment of alcoholism can be crucial. The potential for abuse is low and there is no increased risk of mental problems such as psychotic disorders. In clinical settings, with appropriate psychological support, psilocybin is considered safe. The mystical, or spiritual, experience a patient goes through can change his or her life.

Treatment of alcoholism with psilocybin – research.

Magic mushrooms can promote positive changes in drinking behavior when used in a therapeutic context and under the care of professionals. Recent studies suggest that psilocybin alters the brain’s prefrontal and limbic circuits in alcohol use disorders.

Unlike current pharmacological options, the response to psilocybin therapy is rapid, noticeable as early as 8 hours after the first dosing session. The effect is long-lasting, as the benefits of the therapy last from 6 months to as long as 4.5 years after the last dosing session.

Clinical trials – psilocybin in the context of alcoholism

Early research, still from the 1950s, does not meet the standards of modern science. A contemporary meta-analysis of six randomized, controlled trials (involving 536 participants) conducted between 1966 and 1970 showed significant efficacy of a single administration of psychedelics. One dose was able to help treat alcoholism and achieve abstinence. In recent years, interest in psychedelic substances has resurged, and psilocybin, a naturally occurring compound present in psilocybe mushrooms, is gaining prominence in psychiatry.

Research in the area of executive functioning (the set of skills needed to control and self-regulate behavior) has shown that psychedelic substances increase cognitive flexibility and control, attentional skills, and the ability to psychologically separate from thoughts and emotions. It has also been found that in patients with alcohol use disorder, psilocybin promotes increased self-efficacy and improved behavioral control. The results suggest effects on mood (e.g., reducing neuroticism and depression, increasing positive feelings), reducing substance use cravings, and increasing openness and conscientiousness. Psychedelics can also enhance metacognition. This was noted in the tests by shifting values and moving from automatic action mode to more conscious processing of experiences.


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Course of study

Participants were randomly assigned to a group receiving psilocybin or active placebo in combination with psychotherapy sessions. Therapeutic care was aimed at enhancing psychological insight and emotional processing facilitated by psilocybin.

Prior to the session, participants underwent preparatory therapy sessions that included motivational interviewing and cognitive-behavioral strategies. A key goal of this phase was to set expectations, build trust and provide coping strategies for future psilocybin experiences.

The foundation of the methodology was an MRI performed on the patients three days before and two days after the procedure. Through these scans, the researchers were able to observe changes in brain activity when participants were exposed to images associated with alcoholic beverages and images that elicited positive, negative and neutral emotional responses.

Significant changes were observed in patterns of brain activity in response to alcohol-related and emotional stimuli. These changes suggest that there have been changes in neural processing in areas of the brain associated with feelings of hunger, emotion regulation and decision-making.

Psilocybin therapy led to increased activity in areas of the medial and lateral prefrontal cortex and the left caudate nucleus – areas responsible for higher-order cognitive functions. That is, such as goal-focused behavior, decision-making and emotion regulation.

Decreased activity was observed in the insular, motor, temporal, parietal, occipital and cerebellar cortex. These areas are often linked to feelings of hunger, automatic behavioral patterns and sensory processing. This suggests that psilocybin may reduce the intensity of alcohol-related signals.

The researchers also expected to see changes in areas of the brain that are associated with reward during the MRI. Here, however, there was another surprise, these “reward” areas were unawakened, which is an additional plus in favor of psilocybin.

Summary

Psylocybin in the treatment of alcoholism could be a huge breakthrough in the treatment of addicts. Unfortunately, the amount of research is still insufficient. Science does not fully understand the mechanisms of action of psilocybin. It is also important to eliminate all potential side effects. Environment and therapeutic support are key. The safety and effectiveness of the therapy depend on various factors, such as the quality of the substance, the therapeutic setting and the individual response of the patient. New scientific findings point to a promising future for psychedelic therapy. Public acceptance of psychedelics is beginning to shift in their favor. More and more countries are moving toward decriminalizing these substances. Despite promising results, psilocybin therapy remains controversial, mainly because of its legal status. Psylocybin in the treatment of alcoholism in Poland is still an unattainable topic. However, we firmly believe that the coming years will change this.

Footnotes:

https://www.nature.com/articles/s41598-024-52967-8

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577917/

https://reach4.biz/inwestowanie/psylocybina-moze-przyniesc-przelom-w-leczeniu-alkoholizmu-to-branza-o-wartosci-475-mld-usd/

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2795625?guestAccessKey=e1328a7a-6e79-43f8-ad04-143fd8134839&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=082422

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