This first systematic review of psychedelic-assisted treatments for alcohol, tobacco, and other substance use disorders examined 37 studies involving 2,035 participants. The best evidence of efficacy came from a phase 2 randomized controlled trial of psilocybin for alcohol use disorder and a phase 2 trial of ketamine for alcohol use disorder. Psilocybin-assisted treatment for alcohol use disorder appears to have the strongest evidence among all major psychedelic-assisted treatments. No serious adverse events were reported across any study. The review recommends that future research report all safety events, identify contraindications, mitigate participant blinding, use factorial designs, and develop a core outcome set.
A single 10 mg intranasal dose of the psychedelic drug BPL-003 (a formulation of 5-MeO-DMT) combined with cognitive behavioral therapy was safe and tolerable in people with moderate-to-severe alcohol use disorder. Over 12 weeks, the average percentage of abstinent days increased from 33.2% at baseline to 80.8%, and heavy drinking days dropped from 56.2% to 13.2%. Half of the 12 participants who completed the study were continuously abstinent, a quarter had meaningful reductions in drinking, and a quarter showed little change. Measures of craving, well-being, and quality of life also improved. The findings support larger controlled trials.