Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation

This book chapter (2022) reviews the use of psilocybin in the treatment of addiction with a specific focus on smoking (tobacco use disorder, TUD). After exploring the historical use of psychedelics to treat addiction, modern research on the topic is reviewed. The anti-addiction properties of psychedelics differ but are consistent with the notion that the persisting positive behaviour change prompted by psychedelic therapy is due to the amplification of psychotherapeutic processes.

Abstract

“This manuscript reviews research suggesting that classic psychedelics (5-HT2A receptor agonists) are effective in treating addictions including tobacco use disorder. I review historical research from the 1950s to 1970s suggesting that classic psychedelics are associated with addiction recovery across pharmacologically distinct drugs of addiction. I then review anthropological reports about the ceremonial use of classic psychedelics and epidemiological studies that are consistent with anti-addiction efficacy. I review modern research using psilocybin in the treatment of alcohol use disorder and tobacco use disorder. Both lines of research show high success rates in preliminary studies. General anti-addiction efficacy across a variety of classes of addictive drugs is consistent with the notion that the persisting positive behaviour change prompted by psychedelic therapy is due to the amplification of psychotherapeutic processes. Future research should examine the classic psychedelic treatment of additional substance use disorders including for opioids, cocaine, methamphetamine, and cannabis, and other disorders broadly characterized as addictions (e.g., obesity, problem gambling, hypersexual disorder). Future research should also explore addiction treatments with other classic psychedelics including LSD, mescaline, DMT, 5-MeO-DMT, and yet-to-be-discovered compounds. Experimental research is also needed to test different protocols for the delivery of classic psychedelic therapy for addictions. Given the staggering societal costs of substance use disorders, including the mortality caused by tobacco smoking, it is critical that public funding be made available for scientists to follow up on promising early findings of classic psychedelics in addiction treatment. The costs and risks of not conducting such research are too great.”

Author: Matthew W. Johnson