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October 2022

Does Psilocybin Reduce Heavy Drinking?

Buzz around psilocybin has been growing for several years. Questions about what it is, whether it’s safe, and what benefits it might offer continue to pour in. Now, new research takes a look at its effects on alcohol use disorder. What should you tell patients?

The latest study in people with at least 4 heavy drinking days each month shows that taking 2 doses of psilocybin along with psychotherapy – one at week 4 and one at week 8 – reduces the frequency and number of drinks compared with diphenhydramine. Additionally, after 32 weeks of follow-up, the participants in the psilocybin group had 29% total drinking days compared with 43% for those receiving diphenhydramine. Also, those taking psilocybin had a reduction in heavy drinking days to 10%, compared with 24% in those taking diphenhydramine. While these results are promising, blinding between treatment groups wasn’t effective, limiting the overall validity of these findings. Additionally, it’s not clear what benefits it might have in people with severe alcohol dependence.

If patients ask about using psilocybin for alcohol use disorder, explain that it’s still not clear if it really helps. Safety concerns appear to be manageable when it’s used in a controlled environment under medical supervision – short-term headache, increased blood pressure, and increased heart rate are among some of the most commonly reported side effects. But it’s not clear if taking psilocybin in an uncontrolled environment, either in treatment doses or micro doses, is safe or will offer the same benefits.

We’ll keep you updated as we learn more. For now, check out our recently updated monograph for more details.

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