Attitudes and perceptions of psychedelic therapy among clinical trial participants with alcohol use disorder: a mixed-method study

Most people with alcohol use disorder (AUD) are aware of psychedelic research and would be willing to try psychedelic therapy, but their openness depends heavily on expecting it to succeed. In a mixed-method study of 112 participants from two non-psychedelic clinical trials and 10 patients from addiction outpatient services, 62.5% knew about psychedelic research and 64.3% were willing to join a psychedelic therapy trial. Willingness was strongly linked to higher expectations of research success, not to age or knowledge alone. Interviews revealed a spectrum of attitudes shaped by perceived therapeutic potential, fears of addiction or loss of control, personal and societal experiences with substances, and media exposure. Expectation of benefit was central to openness.

Study at a glance

Abstract

BACKGROUND: Alcohol use disorder (AUD) remains a major global health concern, with high morbidity and mortality and limited long-term treatment success. Psychedelic therapy has re-emerged as a potential novel intervention for AUD, yet little is known about how affected individuals perceive such treatments. METHODS: This mixed-method study explored attitudes and perceptions of psychedelic therapy among individuals with AUD participating in two non-psychedelic clinical trials (n = 102) and from addiction outpatient services (n = 10). Quantitatively, 112 participants completed a four-item questionnaire assessing knowledge of psychedelic research, expectations of research promise, and willingness to participate in a psychedelic therapy trial, and, if willing, preferred setting (group therapy, individual therapy, or no preference). Binary logistic regression examined predictors of willingness to participate. Qualitatively, semi-structured interviews with 10 patients from addiction outpatient services were thematically analyzed to identify factors shaping attitudes toward psychedelic therapy. RESULTS: Quantitatively, 62.5% of participants were aware of psychedelic research and 64.3% were willing to participate in a psychedelic therapy trial. Willingness was significantly associated with higher expectations of research success (OR = 3.30, p < .001), but not with age or knowledge alone. Qualitatively, participants expressed a spectrum of attitudes with positive, neutral, and negative salience shaped by perceptions of therapeutic potential, fears of addiction or loss of control, personal and societal experiences with substance use, and media exposure. Expectation of benefit emerged as a central factor influencing openness to psychedelic therapy. CONCLUSIONS: Patients with AUD already participating in clinical trials generally demonstrate awareness and conditional openness toward psychedelic therapy, primarily determined by their expectations of research promise. Limitations of this study include participation bias in the clinical trial sample as well as the lack of measurement of bias through prior psychedelic use. Nonetheless, thorough informed consent addressing expectations and misconceptions about risk and addiction potential remains crucial for ethically and effectively conducting future psychedelic clinical trials in AUD populations.