Psilocybin Therapy: Potential For Treating Alcoholism Examined In APA Publication

The peer-reviewed journal Psychology of Addictive Behaviors published by the American Psychological Association (APA) released a new analysis by Fluence, NYU and UC-SF of a clinical trial of psilocybin-assisted psychotherapy for the treatment of Alcohol Use Disorder (AUD.) 

What triggered the analysis? Study authors state that theories on psychological processes involved in psychedelic therapy “remain underdeveloped,” and that regulatory agencies such as the FDA and its European equivalent EMA focus on safety and efficacy rather than on specific psychological mechanisms of action when deciding which treatments to approve.

Thus, a deeper understanding of the psychological mechanisms and coping processes will be key to future efforts in therapists’ training and improving protocols in psychedelic-assisted psychotherapy.

Titled “Reports of Self-Compassion and Affect Regulation in Psilocybin-Assisted Therapy for Alcohol Use Disorder: An Interpretive Phenomenological Analysis,” the paper is believed to be the first to uncover the therapeutic mechanisms that make the treatment effectively work, going beyond safety and efficacy assessments by providing details on the links between subjective and clinical effects of psilocybin therapy for AUD.

Researchers analyzed qualitative data from semi-structured interviews with 13 volunteers who participated in the 2022 double-blind randomized clinical study; they assessed two doses of psilocybin in 93 patients with AUD or Substance Use Disorder (SUD). The results were published last August in JAMA Psychiatry.

They organized thematic findings into temporal categories. Before treatment, patients reported self-medicating with alcohol to go into “pilot mode” and for avoiding common emotions like shame and self-criticism, using the substance as a surrogate for connection.  

During and after, they found:

• Psilocybin-assisted therapy prompted enduring improvements in self-awareness, self-compassion, emotional regulation and feelings of interconnectedness by allowing patients to cope with difficult emotions and stress related to painful past events. 

• Patients described the psilocybin sessions as foundational for the development of emotional regulation (being “mindfully present”) facing future stressors and cravings as well as for improvement in their close relationships.

The results support the belief that psilocybin increases the malleability of self-related processing and diminishes shame-based and self-critical thought patterns while improving affect regulation and alcohol cravings by encouraging adaptive coping responses during ongoing recovery. 

Further, they suggest psychosocial treatments that integrate self-compassion training with psychedelic therapy may serve as a useful tool for enhancing psychological outcomes in the treatment of AUD.

The article is authored by co-founder of the psychedelic therapies educational platform Fluence, Elizabeth Nielson Ph.D.; UCSF’s Gabrielle I. Agin-Liebes Ph.D. and Alexandra Haas MA; NYU’s Dr. Michael P. Bogenschutz, Dr. Michael Zingman, Dr. Katherine Kim, Lindsey T. Owens MA, and Ursula Rogers Ph.D.

Dr. Nielson said that qualitative research allows for “a direct understanding of the lived experience of psychedelic therapy clinical trial participants, from their perspective and in their own words,” and that the study “complements existing quantitative clinical research, adding detail and nuance to the picture of how the treatment unfolded and what future clinicians might encounter in their work with patients.”

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