Frontiers in Psychiatry
March 14, 2023
Jonathan Brett, Elizabeth Knock, Paul Liknaitzky et al.
16 citations
Methamphetamine use disorder is a chronic condition with high relapse rates and limited effective treatments. Contingency management and psychotherapy show modest efficacy, while pharmacological options have little to no benefit. Psilocybin-assisted psychotherapy is emerging as a promising approach for substance use disorders, though no studies have yet examined it for methamphetamine use disorder. This review presents the rationale for using psilocybin-assisted psychotherapy to treat methamphetamine use disorder and describes practical considerations from early experience designing and implementing four clinical trials on this approach.
Frontiers in Psychiatry
December 6, 2024
Jonathan Brett, Elizabeth Knock, Kathy Watson et al.
7 citations
A daily methamphetamine user, a 36-year-old transwoman, achieved sustained abstinence and improved mental health after a single session of psilocybin-assisted psychotherapy following inpatient withdrawal management. She reported increased self-esteem, mindfulness, and distress tolerance over three months. The case suggests that psilocybin-assisted therapy may offer a scalable, safe, and effective approach for treating methamphetamine dependence, though further research is needed to confirm generalizability.
Addiction
September 20, 2025
Elizabeth Knock, Krista J. Siefried, Gillinder Bedi et al.
4 citations
A single 25 mg dose of psilocybin combined with psychotherapy was safely delivered in an outpatient setting to 15 people seeking treatment for methamphetamine use disorder. No serious adverse events occurred; mild side effects included headache, nausea, and noise sensitivity. Methamphetamine use dropped from a median of 12 days in the prior month at screening to 0 days at 28 days and 2 days at 90 days after dosing. Craving decreased while quality of life, depression, anxiety, and stress scores improved at follow-ups. A larger randomized trial is needed to confirm efficacy.
BMJ open
February 10, 2025
Kathryn Fletcher, Nadine Ezard, Krista J Siefried et al.
1 citation
A pilot study will test the safety and feasibility of combining subanaesthetic ketamine with cognitive behavioural therapy for adults with methamphetamine use disorder. Twenty participants seeking to reduce or stop methamphetamine use will receive three subcutaneous ketamine doses (0.75 to 0.9 mg/kg) at weekly intervals and four therapy sessions over four weeks. The study will measure recruitment time, eligibility rates, treatment completion, retention, and acceptability over eight weeks, and explore changes in methamphetamine use, cravings, withdrawal, quality of life, and treatment satisfaction over 24 weeks. No pharmacological treatments currently exist for this condition, and psychotherapy alone is only moderately effective.
Addiction
December 22, 2025
Jonathan Brett, Toby Lea, Elizabeth Knock et al.
People with methamphetamine use disorder who took part in psilocybin-assisted psychotherapy reported that the treatment was acceptable and often transformative. Before treatment, participants held tempered hopes for positive outcomes. During the psychedelic sessions, many confronted challenging emotional or psychic obstacles by deliberately 'leaning into' them, a process that led to new understandings of themselves, their personal histories, and their relationships. Resolving these obstacles was associated with a reduced importance of methamphetamine in their lives. The therapeutic relationship—characterized by concentrated attention and deep interpersonal intimacy between participant and therapist—was seen as critical to these positive changes.