Alcohol Use Disorder (AUD)Tobacco/Nicotine Use Disorder (TUD)Substance Use Disorders (SUD)Public Health, Prevention & Behaviour ChangeMescalinePsilocybin

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.

Authors

  • Matthew Johnson

Published

Current Topics in Behavioral Neurosciences
meta Study

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.

Available with Blossom Pro

Research Summary of 'Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation'

Introduction

Johnson frames tobacco smoking as a major global public‑health problem with very high mortality and limited long‑term success for existing behavioural and pharmacological cessation aids. The introduction defines "classic psychedelics" as drugs whose primary mechanism is agonism at the 5‑HT2A receptor (for example psilocybin, LSD, mescaline, and DMT) and situates renewed interest in these compounds as potential anti‑addiction medicines given historical reports and recent pilot data. The paper sets out to review multiple lines of evidence relevant to the hypothesis that classic psychedelics can facilitate recovery from substance use disorders, with a special focus on psilocybin for tobacco smoking cessation. Johnson outlines the plan to cover mid‑twentieth century clinical research, anthropological and epidemiological studies, modern clinical trials for alcohol and tobacco use disorders, and to highlight future research priorities and gaps.

Expert Research Summaries

Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.

Study Details

References (40)

Papers cited by this study that are also in Blossom

A Prehistoric Mural in Spain Depicting Neurotropic Psilocybe Mushrooms?

Akers, B. P., Ruiz, J. F., Piper, A. et al. · Economic Botany (2011)

Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study

Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A. et al. · Journal of Psychopharmacology (2015)

Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences

Carbonaro, T. M., Bradstreet, M. P., Barrett, F. S. et al. · Journal of Psychopharmacology (2016)

Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study

Carhart-Harris, R. L., Bolstridge, M., Rucker, J. et al. · Lancet Psychiatry (2016)

1174 cited
Trial of Psilocybin versus Escitalopram for Depression

Carhart-Harris, R. L., Giribaldi, B., Watts, R. et al. · New England Journal of Medicine (2021)

927 cited
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder

Davis, A. K., Barrett, F. S., May, D. G. et al. · JAMA Psychiatry (2021)

1015 cited
Report on psychoactive drug use among adolescents using ayahuasca within a religious context

Doering-Silveira, E., Grob, C. S., Dobkin de Rios, M. et al. · Journal of Psychoactive Drugs (2005)

114 cited
90 cited
A narrative synthesis of research with 5-MeO-DMT

Ermakova, A. O., Dunbar, F., Rucker, J. et al. · Journal of Psychopharmacology (2021)

Show all 40 references
Assessment of addiction severity among ritual users of ayahuasca

Fábregas, J. M., González, D., Fondevila, S. et al. · Drug and Alcohol Dependence (2010)

222 cited
Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction

Garcia-Romeu, A., Griffiths, R. R., Johnson, M. W. · Current Drug Abuse Reviews (2015)

Cessation and reduction in alcohol consumption and misuse after psychedelic use

Garcia-Romeu, A., Davis, A. K., Fire Erowid et al. · Journal of Psychopharmacology (2019)

211 cited
Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey

Garcia-Romeu, A., Davis, A. K., Griffiths, R. R. et al. · Frontiers in Psychiatry (2020)

121 cited
Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases

Gasser, P., Holstein, D., Michel, Y. et al. · Journal of Nervous and Mental Disease (2014)

594 cited
Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer

Grob, C. S., Danforth, A. L., Chopra, G. S. et al. · JAMA Psychiatry (2011)

Evidence of health and safety in American members of a religion who use a hallucinogenic sacrament

Halpern, J. H., Sherwood, A. R., Passie, T. et al. · Medical Science Monitor (2008)

Potential Therapeutic Effects of Psilocybin

Johnson, M. W., Griffiths, R. R. · Neurotherapeutics (2017)

Human hallucinogen research: guidelines for safety

Johnson, M. W., Richards, W. A., Griffiths, R. R. · Journal of Psychopharmacology (2008)

Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction

Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P. et al. · Journal of Psychopharmacology (2014)

Long-term follow-up of psilocybin-facilitated smoking cessation

Johnson, M. W., Garcia-Romeu, A., Griffiths, R. R. · The American Journal of Drug and Alcohol Abuse (2016)

562 cited
An online survey of tobacco smoking cessation associated with naturalistic psychedelic use

Johnson, M. W., Garcia-Romeu, A., Johnson, P. S. et al. · Journal of Psychopharmacology (2017)

117 cited
Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function

Johnson, M. W., Hendricks, P. S., Barrett, F. S. et al. · Pharmacology and Therapeutics (2019)

Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials

Krebs, T. S., Johansen, P. Ø. · Journal of Psychopharmacology (2012)

Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness

Maclean, K. A., Johnson, M. W., Griffiths, R. R. · Journal of Psychopharmacology (2011)

Psychedelics and Psychotherapy

Nayak, S., Johnson, M. W. · Pharmacopsychiatry (2020)

Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

Noorani, T., Garcia-Romeu, A., Swift, T. C. et al. · Journal of Psychopharmacology (2018)

The association of psychedelic use and opioid use disorders among illicit users in the United States

Pisano, V. D., Putnam, N. P., Kramer, H. M. et al. · Journal of Psychopharmacology (2017)

Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression

Roseman, L., Nutt, D. J., Carhart-Harris, R. L. · Frontiers in Pharmacology (2018)

Increased Activation of Indirect Semantic Associations under Psilocybin

Spitzer, M., Thimm, M., Hermle, L. et al. · Biological Psychiatry (1996)

90 cited
Set and Setting: A Randomized Study of Different Musical Genres in Supporting Psychedelic Therapy

Strickland, J. C., Garcia-Romeu, A., Johnson, M. W. · ACS Pharmacology and Translational Science (2020)

Psychedelics and health behaviour change

Teixeira, P. J., Johnson, M. W., Timmermann, C. et al. · Journal of Psychopharmacology (2021)

Cited By (4)

Papers in Blossom that reference this study

Psilocybin or Nicotine Patch for Smoking Cessation A Pilot Randomized Clinical Trial

Johnson, M. W., Naudé, G. P., Hendricks, P. S. et al. · JAMA Network Open (2026)

Psychedelics for acquired brain injury: a review of molecular mechanisms and therapeutic potential

Allen, J., Dames, S., Foldi, C. J. et al. · Molecular Psychiatry (2024)

Set and setting predict psychopathology, wellbeing and meaningfulness of psychedelic experiences: a correlational study

Borkel, L. F., Rojas-Hernández, J., Henríquez-Hernández, L. A. et al. · Expert Review of Clinical Pharmacology (2023)

Mechanisms and molecular targets surrounding the potential therapeutic effects of psychedelics

Jaster, A. M., González-Maeso, J. · Molecular Psychiatry (2023)

Your Personal Research Library

Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.

Classic Psychedelics in Addiction Treatment: The... — Research Summary & Context | Blossom