Psychedelic-assisted addiction therapy
By Josh Genuth
For centuries, the science behind addiction and how it works has challenged researchers almost as much as creating effective and lasting treatments for them.
Addiction destroys families, creates heartbreaking situations of abuse and neglect, and often results in early death. According to the UN’s 2019 World Drug Report, about 35 million people suffer from drug use disorders. In 2017 alone, drug overdoses directly caused 167,000 deaths, with the highest rates occurring in the US.
And the addiction problem is a stubborn one. Medication and therapy are the chief treatment categories currently available, but both have considerable drawbacks. For example, side effects, prolonged treatment time, lack of access to health professionals or insurance, and low recovery rates are all deterrents to seeking help.
Psychedelic-assisted addiction therapy is showing dramatic success in overcoming these obstacles. These new treatments are lasting, inexpensive, and deeply engaging of core addiction issues.
Early Psychedelic Research
Early trials involving psychedelics showed real promise in addiction treatment, but the 1960s Day-Glo cultural revolution quickly overshadowed the research. Timothy Leary, the psychedelic evangelist dubbed “the most dangerous man in America”, had become a symbol of moral decline. As a result, the hippy spectacle doomed the nascent field of psychedelic-assisted addiction therapy almost from the start.
Long before Leary was urging the youth to “turn on, tune in, and drop out”, researchers in the Canadian province of Saskatchewan were quietly running trials on psychedelics’ impact on alcoholism, with remarkable results. Regarded for centuries as a moral failing, people were now seeing alcoholism as an unfortunate psychiatric condition. As such, alcohol addiction required treatment beyond shaming and moralizing. Instead, it called for a nuanced look at the individual, the acknowledgement of deeply established habits, and the power to change.
In 1935 Alcoholics Anonymous codified this approach, emphasizing personal responsibility, humility, and surrender to a higher power. A little-known chapter in AA’s history concerns its founder, Bill Wilson. Wilson experimented with LSD as a treatment for alcohol dependence and was so inspired by its power to treat addiction that he began advocating for its inclusion into the AA methodology. But by the late 1950s the stigma against LSD was already too strong, and Wilson himself was marginalized by the board of his own organization.
The federal prohibition on psychedelics that followed slammed the door on the legal use of psychedelics for any purpose. Today, psychedelic-assisted treatment research is again targeting addiction, and showing strong treatment efficacy. Scientists are employing modernized trial methods and clinical work, ensuring the research conforms to conventional standards.
How Does it Work?
What is the mystical experience behind LSD, psilocybin, ibogaine, ayahuasca, and other psychedelics that have so profoundly impacted psychiatric treatment? How are these substances bringing such hope to people with addiction, depression, PTSD, and other mental health issues?
Experts point to certain themes in patient experiences. These experiences are highly subjective, defy normative quantification, and borderline on the spiritual/transcendent. Of course, traditional science does not often factor such qualities. Yet, successful trials relying on precisely these variables are gaining serious traction at institutions as mainstream as Johns Hopkins University, NYU, and Imperial College London.
Catalysts for Behavioral Transformation
Michael Pollan, who literally wrote the book, put it this way: “Of all the phenomenological effects that people on psychedelics report, the dissolution of the ego seems to me by far the most important and the most therapeutic… It is this that gives us the mystical experience, the death rehearsal process, the overview effect, the notion of a mental reboot, the making of new meanings, and the experience of awe.”
In other words, there seems to be something so intensely transformative in the psychedelic experience that it can even disrupt a self-belief as deeply rooted as substance addiction.
Pollan continues: “When the ego dissolves, so does a bounded conception not only of our self but of our self-interest. What emerges in its place is invariably a broader, more openhearted and altruistic—that is, more spiritual—idea of what matters in life. One in which a new sense of connection, or love, however defined, seems to figure prominently.”
From this viewpoint, it’s easy to see why Bill Wilson saw such potential in psychedelics. For people trying to develop self-knowledge, spiritual transcendence, and surrender of ego, what could be more important?
Now, and Going Forward
Current treatment methods for addiction and other conditions like depression and PTSD are anything but perfect. For instance, 40% of people drop out of AA during their first year, and overall success rates stand around 10%. The relapse rate for substance disorders is between 40% and 60%.
Contrast this with the 80% tobacco cessation rate or 23% drop in heavy drinking days following respective psilocybin trials. Ibogaine, another natural psychedelic, has shown substantive effect in opioid detoxification.
In addition, psilocybin trials are currently underway for cocaine addiction, an especially important focus because there is currently no medication-based treatment for this addictive drug.
Psychedelics offer a holistic, rapid, non-addictive, and highly effective alternative to conventional treatments. As clinical trials with these wondrous old/new medicines continue to show strong results in treating addiction and other mental health disorders, government policymakers would do well to reconsider the prohibition policies levied decades ago. Investing in these powerful treatments will enable real action against globally increasing addiction numbers.