Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction

In an open-label pilot study, 15 smokers received 2 or 3 doses of psilocybin alongside cognitive behavioral therapy for smoking cessation. Twelve of 15 participants (80%) had biologically verified smoking abstinence at 6-month follow-up. Those who quit scored significantly higher on a measure of psilocybin-occasioned mystical experience than those who relapsed, while general drug intensity did not differ between groups. Nine of 15 participants (60%) met criteria for a complete mystical experience. Smoking cessation outcomes correlated with measures of mystical experience on session days and with retrospective ratings of personal meaning and spiritual significance. The results suggest mystical experience may mediate psychedelic-facilitated addiction treatment.

Study at a glance

Abstract

Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment.