Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation

Classic psychedelics (5-HT2A receptor agonists) show promise for treating addictions, including tobacco use disorder. Historical research from the 1950s–1970s linked these substances to addiction recovery across various drugs. Anthropological reports and epidemiological studies also support anti-addiction efficacy. Modern studies using psilocybin for alcohol and tobacco use disorders report high success rates. The general anti-addiction effect across different addictive drugs suggests psychedelic therapy amplifies psychotherapeutic processes, leading to lasting positive behavior change. Future research should explore treatments for other substance use disorders and additional psychedelics. Given societal costs, public funding for this research is critical.

Study at a glance

Abstract

This manuscript reviews research suggesting that classic psychedelics (5-HT2A receptor agonists) are effective in treating addictions including tobacco use disorder. I review historical research from the 1950s to 1970s suggesting that classic psychedelics are associated with addiction recovery across pharmacologically distinct drugs of addiction. I then review anthropological reports about ceremonial use of classic psychedelics and epidemiological studies that are consistent with anti-addiction efficacy. I review modern research using psilocybin in the treatment of alcohol use disorder and tobacco use disorder. Both lines of research show high success rates in preliminary studies. General anti-addiction efficacy across a variety of classes of addictive drugs is consistent with the notion that the persisting positive behavior change prompted by psychedelic therapy is due to amplification of psychotherapeutic processes. Future research should examine classic psychedelic treatment of additional substance use disorders including for opioids, cocaine, methamphetamine, and cannabis, and other disorders broadly characterized as addictions (e.g., obesity, problem gambling, hypersexual disorder). Future research should also explore addiction treatments with other classic psychedelics including LSD, mescaline, DMT, 5-MeO-DMT, and yet-to-be-discovered compounds. Experimental research is also needed to test different protocols for the delivery of classic psychedelic therapy for addictions. Given the staggering society costs of substance use disorders, including the mortality caused by tobacco smoking, it is critical that public funding be made available for scientists to follow up on promising early findings of classic psychedelics in addiction treatment. The costs and risks of not conducting such research are too great.