In a small qualitative study of the first randomized controlled trial of psilocybin-assisted psychotherapy for alcohol use disorder, participants reported that the treatment helped them process emotions tied to painful past events, fostered self-compassion, self-awareness, and feelings of interconnectedness. The acute drug sessions laid the groundwork for more self-compassionate regulation of negative affect. Participants also described newfound belonging and improved relationship quality. The findings suggest psilocybin increases the malleability of self-related processing, reduces shame and self-critical thoughts, improves affect regulation, and lowers alcohol cravings, indicating that integrating self-compassion training with psychedelic therapy may enhance AUD treatment outcomes.
Classic psychedelics like psilocybin may help people change their behavior in substance use disorders. This paper describes the protocol for a multi-site, double-blind, randomized controlled trial that tested psilocybin-assisted psychotherapy in 96 alcohol-dependent volunteers. Participants received either psilocybin or an active placebo (diphenhydramine) during two dosing sessions, alongside a structured 12-week psychotherapy platform. The primary outcome was the proportion of heavy drinking days over 32 weeks after the first dose. Secondary outcomes included safety, abstinence, craving, and self-efficacy. The primary results are reported elsewhere; this paper focuses on the rationale and design decisions.