Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction
In an open-label 15-week pilot with 15 nicotine-dependent smokers, moderate and high doses of the 5-HT2A agonist psilocybin administered alongside structured cessation support yielded an 80% biochemically-confirmed seven-day point-prevalence abstinence rate at six months, substantially higher than typical rates (<35%). While the uncontrolled design prevents definitive efficacy claims, the study suggests psilocybin may be a promising adjunct to smoking cessation treatment and provides a framework for future controlled research.
Authors
- Albert Garcia-Romeu
- Roland Griffiths
- Matthew Johnson
Published
Abstract
Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction.
Research Summary of 'Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction'
Introduction
Earlier research from the 1950s–1970s suggested therapeutic potential for 5-HT2AR agonist hallucinogens in treating substance use disorders, but many of those studies lacked modern methodological rigour and the field was largely abandoned amid controversy and regulatory restrictions. More recent experimental work with psilocybin in healthy volunteers and in patients with advanced cancer has reported mystical-type experiences and enduring positive behaviour change well beyond the acute drug effect, suggesting a possible mechanism relevant to addiction treatment given associations between increased spirituality and recovery outcomes. Johnson and colleagues therefore conducted an open-label pilot study to assess the safety and feasibility of psilocybin as an adjunct to a structured smoking cessation intervention. The study aimed to establish whether a psilocybin-facilitated protocol could be delivered safely, and whether preliminary cessation rates would justify proceeding to a randomized controlled trial; no control condition was included in this first-step evaluation.
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Study Details
- Study Typeindividual
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- Compound
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- APA Citation
Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P., & Griffiths, R. R. (2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology, 28(11), 983-992. https://doi.org/10.1177/0269881114548296
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