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, 2017, 43, (1), 55–60
http://dx.doi.org/10.3109/00952990.2016.1170135
Abstract
Background : A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone.
Objectives : To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration.
Methods : The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. Results: All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16–57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives.
Conclusion : These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.
Keywords : addiction, Hallucinogen, mystical experience, nicotine, psilocybin,, psychedelic, smoking cessation, spirituality, tobacco
Introduction
With almost 6 million tobacco-related deaths per year worldwide, and that number projected to rise to an estimated 8 million annual mortalities by 2030, smoking remains among the leading public health concerns of the 21st century (1). At present, the most successful available smoking cessation treatments fail to promote long-term abstinence in the majority of individuals who use them (2,3), underscoring an urgent need to explore innovative treatment approaches.
The authors recently reported on a novel intervention for smoking cessation combining two to three administrations of psilocybin, a naturally occurring serotonin 2A receptor (5-HT2AR) agonist, with CBT. Initial results showed that 80% of participants in this open-label pilot study (N = 15) were biologically verified as smoking abstinent at the 6-month follow-up (4). Pilot results demonstrated safety and feasibility in this sample, with physiological adverse effects limited to mild post-session headache, and modest acute elevations in blood pressure and heart rate (4). Six volunteers (40%) reported acute challenging (i.e., fearful, anxiety-provoking) psilocybin session experiences. However, these effects resolved by the end of drug session days via interpersonal support from study staff, without pharmacologic intervention or persisting deleterious sequelae (4). The current report presents long-term follow-up data from this trial, including abstinence outcomes at 12 months and an average of 30 months post-treatment, as well as data on persisting psychological effects at 12-month follow-up.
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