bwhen John Costas was 25, he was desperate to beat his alcohol dependence. He had started drinking at the age of 13 and had gone through various treatments – going to Alcoholics Anonymous meetings, taking pharmaceutical drugs and trying hospital rehab – but nothing helped. However, since 2015, when he participated in a clinical trial that combined talk therapy and psilocybin – psychedelic active ingredient in magic mushrooms—Kostas has stopped drinking. “I am forever grateful and indebted,” he says. “It saved my life.”
A randomized clinical trial published Aug. 24 in the journal JAMA Psychiatryfound that in combination with psychotherapy, psilocybin helped treat alcohol use disorder. Analyzing a group of 93 patients with the disorder – Costas among them – over 32 weeks, researchers found that patients who received psilocybin plus psychotherapy (48 in total) reduced their drinking by 83% within eight months of their first dose, compared with 51% among those who received placebo. Almost half of the people treated with psilocybin stopped drinking altogether, compared to less than a quarter of those who received only the placebo.
“If these effects are replicated, I think it would really be a breakthrough,” said Dr. Michael Bogenschutz, director of NYU’s Langone Center for Psychedelic Medicine and senior author of the study. “The effects seem to be ongoing. And the effects are greater than any of the treatments that are currently available,” which includes methods such as inpatient rehabilitation, talk therapy and medication.
Read more: Inside ibogaine, one of the most promising and dangerous addictive psychedelics
A more effective treatment for alcohol dependence could have profound consequences for society as a whole. About 95,000 Americans die of alcohol-related causes every year inclusive alcoholic liver disease and car accidents, according to US Centers for Disease Control and Prevention. Federal from 2021 analysis of Americans before the pandemic found that while about 5 percent of U.S. adults—about 14.1 million people—had an alcohol use disorder in the past year, only 7 percent of them received any treatment, and just under 3 % were treated with drugs. Even when people do receive treatment, however, they have only been shown to have approved drugs such as naltrexone limited effectiveness.
The new research adds to the strongest evidence yet that psilocybin may be a promising treatment for substance use disorders. Another preliminary study by Bogenschutz and other researchers in 2015 found that psilocybin therapy appeared to treat alcohol addiction in a small test group of patients. And a small one study published in 2014 by Bogenschutz and some of the same researchers found that psilocybin combined with talk therapy can help people quit smoking. Last year, the team received the first federal psychedelic treatment grant in more than 50 years to extend this research with a three-year, multisite study.
Psilocybin’s effectiveness may be related to how it affects the brain, Bogenschutz says. Research shows that psilocybin promotes neuroplasticity, which allows people to change the way they think and behave. Researchers have also found that psilocybin helps treatment of depression—which often co-occurs with substance use disorder. One of the things that makes psilocybin such a promising treatment, says Bogenschutz, is that unlike drugs that have to be taken again and again, psilocybin has a long-lasting, powerful effect after just a few doses. “It really suggests that we’re treating the underlying disorder, not just treating the symptoms,” Bogenschutz says.
Read more: How COVID-19 opened the door to a new era in psychedelic medicine
Although the results of this study are encouraging, there is still a long way to go before psilocybin can be used to treat a wider population. Fewer than 50 patients received psilocybin during the clinical trial, which means more research needs to be done on a larger and more diverse population. Also, the placebo used in the trial, diphenhydramine—an antihistamine—is not a perfect substitute for psilocybin, as psychedelic drugs produce unique hallucinogenic effects. Bogenschutz adds that people should not experiment with psilocybin outside of clinical settings because it may be riskier in an uncontrolled setting, in part because patients’ experiences can feel extreme. For example, some patients experience severe anxiety while under the influence of the drug.
The study also did not include the full range of people who could benefit from treatment using psilocybin. Bogenschutz noted that, on average, the participants had a lower intensity of drinking than people who typically join clinical trials for the condition. (According to Bogenschutz, this is likely because the experience may have appealed to people who were already dealing with their disorder.) The researchers also intentionally excluded patients with other mental disorders, such as depression, to ensure that they could determine whether psilocybin -assisted therapy treats alcohol addiction, not some other underlying condition.
However, Bogenschutz says it’s possible that patients with more severe disease could benefit even more from treatment, especially if psilocybin can address the problems that underlie not only alcohol use disorder but also mental health problems. health like depression and anxietyand even other types of substance use disorders. “People with co-occurring disorders and addictions may be an ideal population for this type of treatment because they can benefit from both disorders at the same time,” he says. Their hope is that “this more flexible pattern of brain function allows people to change their thoughts and behaviors in ways that allow them to be happier, healthier people.”
More must-see stories from TIME