Alcohol use disorder (AUD) is a widespread problem that can be successfully managed. Men and women with alcoholism have the opportunity to recover and live a healthier life. The journey toward successful recovery requires a strong support system and well-structured treatment.
But can psychedelics help those suffering from alcoholism? Or is that just a Reddit conspiracy theory?
In this post, we discuss an alcohol treatment with psychedelics and their potential efficacy. Read on to learn more about this important subject.
How Many People in The US Have Alcoholism?
Actually, the number of people in the US with alcoholism is unclear and even impossible to determine. The reason is simple – there is no official diagnosis of alcoholism.
As of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association in 2013, drinking problems have been diagnosed as alcohol use disorders (AUDs). The severity of AUD ranges from mild to moderate and severe.
Before this manual, alcohol-related problems were classified as alcohol abuse and alcohol dependence.
That being said, numbers show alcohol use disorder is a prevalent and serious problem in the United States. According to the National Institute on Alcohol Abuse and Alcoholism:
- 1 million US adults (5.6% of the population) had an AUD in 2019.
- The total number of adults with AUD includes 9 million (7.3% of male adults) were men, and 5.2 million (4.0% of female adults) were women .
- 9% of adults with AUD in 2018 received treatment, i.e., 8.0% of men and 7.7% of women .
- 95,000 people (about 68,000 men and 27,000 women) die from alcohol-related causes annually in the US. This makes alcohol the third leading preventable cause of death in the country, right after tobacco and poor diet/physical inactivity.
- Over 10% of the US children live with a parent with an alcohol problem.
How People Become Addicted to Alcohol
The path to addiction develops in several stages, such as:
- Stage #1 – occasional abuse and binge drinking, i.e., experimentation with alcohol
- Stage #2 – increased drinking
- Stage #3 – problem drinking due to frequent, uncontrolled abuse
- Stage #4 – alcohol dependence
- Stage #5 – alcohol addiction and alcoholism
The above-mentioned phases of developing an alcohol use disorder are quite familiar to most people. But before we discuss the treatment of AUD and the role of psychedelics, it’s important to address the mechanisms behind the development of addiction to alcohol.
Evidence shows the development of alcohol dependence is a complex and dynamic process. Various environmental and neurobiological factors influence a person’s motivation to drink. Prolonged and heavy consumption of alcohol leads to several neuroadaptive changes in the brain’s stress and reward systems. The chronic presence of alcohol produces a constant challenge to regulatory systems that attempt, but ultimately fail, to defend a normal balance of various internal processes.
To function properly, the human brain needs to maintain a balance of neurotransmitters. The neurotransmitters are messengers, i.e., small molecules that participate in the brain’s communication system and help regulate the body’s function and behavior.
Alcohol intoxication alters the delicate equilibrium among different types of neurotransmitters and leads to drowsiness, euphoria, loss of coordination, and other problems. For instance, the brain balances the activity of inhibitory and excitatory neurotransmitters. Inhibitory neurotransmitters delay or stop nerve signals while their excitatory counterparts accelerate those signals.
Alcohol slows down the transmission of signals in the brain, thus causing the symptoms of intoxication mentioned in this paragraph.
The ongoing exposure to alcohol forces the brain to adapt to these chemical changes. The long-term presence of alcohol in the brain, e.g., with chronic heavy drinking, pushes the brain to compensate for its effects. This is when the function of certain neurotransmitters starts to change in an effort to restore balance and allow the brain to function more normally.
Even as the brain becomes adapted to the effects of alcohol, other changes may affect a person’s sensitivity to alcohol’s chemical impacts. For example, a desire for alcohol may transition into a pathological craving for its effects. A strong craving for alcohol is associated with dependence.
Currently Approved Treatments for AUD
Let’s talk about the approved treatments for alcohol use disorders first. The FDA-approved treatments for AUD are presented in the table below.
Besides the above-mentioned treatments, benzodiazepines can be used in persons who are experiencing alcohol use withdrawal. They help to curb the brain’s excitability during detox and alcohol withdrawal symptoms. As a result, the brain may restore its natural balance of neurotransmitters.
The exact treatment option and medications depend on the severity of the addiction, the quantity of alcohol consumed, whether a person has an addiction to other substances, and other factors. Upon enrolling in the best alcohol rehab center near Dallas – Fort Worth, you will get the most suitable treatment plan based on your unique condition.
What Are Psychedelics?
Psychedelics, also known as hallucinogens, are a class of psychoactive substances that induce changes in processes of cognition, perception, and mood. These drugs affect all the senses and thereby alter a person’s thinking, emotions, and sense of time. Additionally, psychedelics can make a person hallucinate, i.e., see or hear things that do not exist.
Some psychedelics are extracted from plants or mushrooms, whereas others are synthetic or laboratory made. Not all psychedelics are the same. They can be divided into two groups:
- Classic psychedelics such as LSD
- Dissociative psychedelics such as PCP
The most common classic hallucinogens include:
- 251-NBOMe – synthetic psychedelic similar to both LSD and MDMA.
- DMT (N, N-dimethyltryptamine): A powerful chemical found in some Amazonian plants. These plants are used for Ayahuasca tea. DMT can also be produced synthetically. A synthetic form of DMT is known as Dimitri.
- LSD (d-lysergic acid diethylamide): One of the most potent mind-altering substances. It appears as a clear, white, and odorless material found in a fungus that grows on grains such as rye. It is also known as acid or mellow yellow.
- Peyote (mescaline): A small, spineless cactus with the main ingredient called mescaline. Also known as cactus or mesc.
- Psilocybin (4-phosphoryloxy-N, N-dimethyltryptamine): Obtained from certain types of mushrooms found in tropical and subtropical regions of the United States, Mexico, and South America. Also known as magic mushrooms or shrooms.
When it comes to psychedelics, LSD has been one of the most popular choices for many. decades. The drug was synthesized in 1938 by a chemist working for Sandoz Laboratories in Switzerland. Five years later, in 1943, the psychedelic properties of LSD were found.
Psilocybin is also used in many studies where scientists evaluated the role of psychedelics in the treatment of AUD.
But how do these hallucinogenic drugs compare?
One study, unrelated to alcoholism, found that the effects of psilocybin didn’t persist as long as those of LSD. In fact, LSD was 100 to 150 times as potent as psilocybin. The table below compares some of the most prominent characteristics of these two psychedelics side by side.
Do Psychedelics Work for AUD Treatment?
The use of psychedelics for the treatment of alcohol use disorder may seem like a novel concept to many, but it is not. In fact, scientists have explored this subject for decades. The earliest use of hallucinogens, LSD to be more precise, in the treatment of alcoholism was recorded in 1953 in the Canadian province of Saskatchewan.
Psychiatrist Humphry Osmond (who coined the term “psychedelic”) and a biochemist Abram Hoffer hypothesized that the LSD reaction was similar to the experience of delirium tremens (DT) as described by patients with alcoholism. Their previous research suggested that the often overwhelming and frightening experience of DT was the catalyst for many patients to seek help. They theorized if LSD could mimic the effect of DT, but without painful physical effects associated with “hitting rock bottom”, perhaps the drug could help people with alcoholism.
To test their theory, Osmond and Hoffer treated two patients suffering from chronic alcoholism with LSD. Their experiment included one male and one female patient with a single dose each of 200mcg of LSD. They chose a high dose to induce stronger reactions. Both treatments were considered successful. The male subject stopped drinking immediately after the trial with LSD. On the other hand, the female patient stopped drinking alcohol six months after the trial.
Osmond and Hoffer are not the only ones who used LSD for the treatment of alcoholism in the same province. Psychiatrist Colin Smith carried out a trial on 24 subjects. After a three-year follow-up, he published the results in 1958. Subjects had already been diagnosed with chronic alcoholism and agreed to a two- to a four-week hospital stay.
During the first part of their stay, Smith encouraged patients to talk about their drinking and explained the objectives of his trial. In the final days of their stay, participants received either a single dose of LSD ranging from 200 to 400mcg or 0.5g of mescaline. Subjects remained in a hospital for a few days after the treatment, and Smith encouraged them to continue or renew membership with AA once they leave.
Smith’s study showed none of 24 patients got worse after the psychedelic treatment. More precisely, 12 patients remained unchanged after the treatment, whereas six were described as “much improved” and six “improved.” Much improved here refers to complete abstinence from alcohol. The term “improved” refers to a significant reduction of alcohol intake and positive lifestyle changes.
Over the years, there have been several attempts to uncover the effectiveness of psychedelics in the treatment of AUD.
For example, one review searched databases such as PubMed for relevant studies from 1943 to 2010. Eligible studies were randomized controlled trials of LSD, compared to any treatment, including active control doses of up to 50mcg of LSD in patients with alcoholism. Six studies with a total of 536 patients were eligible for the review. These are the findings:
- LSD led to significant benefits for alcohol use and misuse at the first available follow-up, at two or three months after treatment, and at six months follow-up. There were no significant benefits of LSD for alcohol misuse at 12 months.
- LSD had significant benefits for maintenance of abstinence from alcohol use at the first reported follow-up and at short-term follow-up, but not at medium-term follow-up.
The authors of the review explained LSD had significant benefits at the short-term follow-up, but these benefits were not present at longer follow-up. In other words, the review concluded effects of LSD in alcoholism treatment are temporary and do not last long. The positive news here is that despite varying dosages from trial to trial, LSD had positive effects in all of the studies they analyzed.
In January 2015, the Journal of Psychopharmacology published a study that explored psilocybin-assisted treatment for alcohol dependence. The study included ten subjects with alcohol dependence who received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy as well as therapy sessions dedicated to preparing for and debriefing from psilocybin. In the first four weeks of treatment, when subjects didn’t receive psilocybin, the abstinence did not increase.
However, with psilocybin administration, the abstinence increased significantly. Gains were largely maintained at the follow-up to 36 weeks. The study also showed the intensity of effects in the first psilocybin session was a strong predictor of decreases in cravings and increases in abstinence during week five. Subjects did not experience adverse reactions to the treatment.
In February 2018, Frontiers in Pharmacology published an open-label pilot study of the psilocybin-assisted treatment of alcohol dependence. Participants experienced various positive effects with the use of this hallucinogen for the treatment of their alcohol problem. Some of these positive effects include:
- Internal/external unity
- Positive mood
- Changes in perception of time and space
- Changes in the personal relationship to alcohol
- Motivational enhancement
- Consistent commitment to change
September 2019 issue of the Journal of Pharmacology published a study that evaluated the effectiveness of psychedelics in AUD treatment. Researchers carried out an anonymous online survey of persons with prior AUD reporting cessation or reduction in alcohol use after the psychedelic use in a non-clinical setting. A total of 343 responders completed the survey. Of these, 89% were white, 78% male, and 60% from the United States.
The average length of problematic alcohol use prior to the psychedelic experience was seven years. About 38% of participants took a moderate-to-high dose of LSD, whereas 36% took psilocybin. The use of hallucinogens was followed by a significant reduction in alcohol drinking.
In fact, after the treatment with psychedelics, 83% of subjects no longer met the criteria for AUD. Scientists concluded the study confirming the naturalistic use of psychedelics might lead to cessation or reduction in problematic alcohol use, but further research on this subject is necessary.
How Do Psychedelics Treat Alcoholism?
As seen above, studies confirm the effectiveness of psychedelics in the treatment of alcoholism. While their efficacy is scientifically confirmed, the mechanism of action that helps people abstain from alcohol is still largely unclear. We can expect more studies about this subject in the near future.
It was common for patients who received LSD to report significant insights and perspectives into their problems. The subjects in the studies often felt as if they had received a new lease on life. This helped them decide to quit drinking. Remember, one of the studies above also confirmed the subjects felt more motivated to stop drinking alcohol.
It wasn’t unusual for patients who received LSD to become more self-accepting, demonstrate greater openness, and adopt a more positive or optimistic perspective of their capacities to face problems.
The effects of psychedelics such as LSD are, possibly, down to their primary mechanism of action – they interact with a specific type of serotonin receptors in the brain. Serotonin is a neurotransmitter associated with many aspects of mood, pleasure, and memory.
Basically, the psychedelics bind the same receptor sites in the brain as serotonin, but that’s where the similarity between them ends. You see, hallucinogens may elicit chemical cascades different from other compounds that bind at the same receptor. Moreover, LSD acts at other receptors too.
As a result, they may stimulate new connections and open the mind to new possibilities and perspectives. While LSD, for example, is not addictive or toxic to the body, it has a major impact on perception, imagination, and memories. It can elicit periods of intense confusion and anxiety.
The complicated nature of psychedelics is the reason, for now, studying human behavior responses to the drugs is easier than analyzing underlying mechanisms. For instance, a theory is that psychedelics for alcoholism probably work by making the brain function more chaotically for a certain period of time.
They may weaken reinforced brain connections and dynamics. Psychedelics oftentimes give a boost to distinctive and insightful experiences that can produce enduring positive changes in mood, behavior, and attitude.
The table below demonstrates biological and emotional mechanisms of action of psychedelics on AUD treatment side by side.
Why Won’t We Hear Much About Psychedelic Treatment for Alcoholism?
Since multiple studies and trials have confirmed the positive influence of psychedelics on AUD treatments, it’s impossible not to wonder why we don’t hear much about this subject. This treatment approach is overlooked for several reasons:
- Small sample sizes in the studies make it difficult for scientists to confidently conclude LSD has a beneficial effect on AUD treatment
- Trial authors often expected unrealistic results and were quick to dismiss or discount moderate or short-term effects
- Earlier non-randomized clinical trials reporting promising results had methodological problems. This led to the misunderstanding that well-designed studies didn’t exist, or they failed to find a beneficial effect of psychedelics in AUD treatment
- The complicated social and political history of psychedelics such as LSD often makes obtaining regulatory approval for clinical trials a difficult and demanding process
Side Effects of Psychedelics
Physical stimulation resulting from psychedelics may cause a person’s pupils to dilate. Blood pressure, temperature, and heart rate increase too. Short-term effects of psychedelics include:
- Reduced appetite
- Dry mouth
Keep in mind the potency of psychedelics is unreliable, and people react differently to them. Several factors influence the effects of psychedelics, including:
- User’s mindset
- Stress levels
- Mood at the time the drug is taken
People often experience feelings of wellbeing, enhanced insight towards creativity, problem-solving, a perception of being outside one’s body, discovering a purpose, among other things. Remember, all these effects are important for patients with alcoholism. This way, psychedelics could help a person with AUD find strength and motivation to quit drinking.
However, some people may have a bad trip. A bad trip is similar to psychosis, and a person may experience extreme fear, paranoia, separation from self, or even feeling as if they’re going to die. Disturbing anxiety, panic attacks, and pain may also happen during a bad trip.
Self-Administration Not Recommended
While studies have shown the positive influence of psychedelics on the treatment of alcoholism, these substances are largely illegal to buy, use, and sell recreationally. While the content above may seem like quitting drinking is easy with psychedelics, the process is still demanding and requires a well-structured approach.
For that reason, the best way to overcome AUD is to get into the best alcohol medical detox in North Texas, where you will receive support to go through withdrawal symptoms and adopt healthier coping mechanisms for a healthy lifestyle. You also get supervision to ensure a safe recovery.
In other words, trying to think of a way to use psychedelics for the treatment of AUD is not a good idea and most certainly not recommended.
Throughout this post, we discuss a psychedelic approach to treating alcoholism. Can you cure alcoholism with LSD? A growing body of evidence confirms the effectiveness of the substances. These compounds act on serotonin receptors. Also, they allow a person to experience openness, change the perception of how they see their life, and boost their strength and motivation to quit drinking alcohol. A lot more research on this subject is necessary to learn more, especially the long-term effects of psychedelics in the treatment of AUD.
John Eckelbarger is a Business Development Representative for Stonegate Center. With a BSA in Chemistry from the University of Texas at Austin, he has an interest in the neurobiology of addiction as well as the pharmacology of drugs. He hopes to bolster Stonegate Center’s status at the forefront of addiction medicine through bold, innovative content creation. He is currently pursuing his MBA in Finance from Texas Christian University.