Clinical interpretations of patient experience in a trial of psilocybin-assisted psychotherapy for alcohol use disorder
This study describes the treatment trajectories of (n=3) participants administered with psilocybin (25-40mg/70kg) in a double-blind placebo-controlled clinical trial investigating the treatment of alcoholism (AUD). These participants experienced acute and lasting alterations in their perceptions of self, in the quality of their baseline consciousness, and in their relationship with alcohol. Increased mindfulness, and control over choices, were also reported following the treatment.
Authors
- Michael Bogenschutz
- Stephen Ross
- Susan Mennenga
Published
Abstract
After a hiatus of some 40 years, clinical research has resumed on the use of classic hallucinogens to treat addiction. Following completion of a small open-label feasibility study, we are currently conducting a double-blind placebo-controlled clinical trial of psilocybin-assisted treatment of alcohol use disorder. Although treatment effects cannot be analyzed until the study is complete, descriptive case studies provide a useful window into the therapeutic process of psychedelic-assisted treatment of addiction. Here we describe treatment trajectories of three participants in the ongoing trial to illustrate the range of experiences and persisting effects of psilocybin treatment. Although it is difficult to generalize from a few cases, several qualitative conclusions can be drawn from the data presented here. Although participants often find it difficult to describe much of their psilocybin experience, pivotal moments tend to be individualized, extremely vivid, and memorable. Often, the qualitative content extends beyond the clinical problem that is being addressed. The participants discussed in this paper experienced acute and lasting alterations in their perceptions of self, in the quality of their baseline consciousness, and in their relationship with alcohol and drinking. In these cases, experiences of catharsis, forgiveness, self-compassion, and love were at least as salient as classic mystical content. Finally, feelings of increased “spaciousness” or mindfulness, and increased control over choices and behavior were reported following the drug administration sessions. Ultimately, psilocybin-assisted treatment appears to elicit experiences that are extremely variable, yet seem to meet the particular needs of the individual.
Research Summary of 'Clinical interpretations of patient experience in a trial of psilocybin-assisted psychotherapy for alcohol use disorder'
Introduction
Bogenschutz and colleagues situate this work within a recent revival of clinical research into classic hallucinogens for psychiatric indications, noting that prior controlled trials of LSD for alcoholism and small contemporary open-label studies of psilocybin for addictions and mood disorders have suggested therapeutic potential. They describe psychotherapeutic models historically used with psychedelics (psychedelic-peak, psychedelic-chemotherapy, psycholytic) and note that recent addiction trials have typically combined a small number of high-dose psilocybin sessions with structured preparation and integration. The authors emphasise that standard quantitative measures used in recent trials tend to emphasise mystical, sensory/perceptual, and dysphoric acute effects and that these instruments may miss other experiential processes that participants report as therapeutically important. This paper aims to illustrate, via descriptive case reports drawn from an ongoing randomised controlled trial of psilocybin-assisted psychotherapy for alcohol use disorder (AUD), the range of acute and persisting psychological processes that participants experience. The stated goal is exploratory and formative: to describe change processes observed in participants so as to inform the design, measurement, and hypotheses of future trials rather than to make inferential claims about efficacy.
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Study Details
- Study Typeindividual
- Journal
- Compound
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- APA Citation
Bogenschutz, M. P., Podrebarac, S. K., Duane, J. H., Amegadzie, S. S., Malone, T. C., Owens, L. T., Ross, S., & Mennenga, S. E. (2018). Clinical interpretations of patient experience in a trial of psilocybin-assisted psychotherapy for alcohol use disorder. Frontiers in Pharmacology, 9. https://doi.org/10.3389/fphar.2018.00100
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