In the early 1950s, Bill Wilson, creator of Alcoholics Anonymous, discovered that under the influence of LSD he had a spiritual experience. What attracted him to continue using the drug was that it catalyzed the same experience he had had detoxifying at Towns Hospital in December 1934—his famous “white light” spiritual experience. Although drinking two quarts of low-grade whiskey a day for years (Prohibition had made alcohol illegal in the United States until December 1933), Wilson never drank again after his spiritual awakening. The two events may have indeed been very similar. The concoction used at Towns Hospital to detoxify alcoholics contained belladonna, a hallucinatory drug.

Today, Johns Hopkins University, NYU, Imperial College London, and others are studying the efficacy of using psilocybin, LSD, ayahuasca, ibogaine, and other drugs to help those addicted to substances. These efforts are part of a growing research movement showing promising results using psychedelics (and drugs such as MDMA and ketamine) in the treatment of mental disorders, including anxiety, depression, and posttraumatic stress disorder (Weir, 2020).

The origin of psychedelic therapy for addiction stems from the 1950s in Weyburn, SK, Canada. From 1954 to 1960, psychiatrist Humphrey Osmond and his colleague, biochemist Abram Hoffer, gave LSD to 2000 alcoholics at the Weyburn Mental Hospital. Although Osmond initially used LSD to help the alcoholics “hit bottom”—an idea he got from Bill Wilson—he discovered that this didn’t happen. Instead, the patients reported having spiritual experiences. Results were impressive: 40 to 45 percent of the patients abstained from alcohol for at least a year, an outcome that was far superior to any treatment at the time (or today).

Modern psychedelic research has confirmed the Weyburn reports. Studies using the hallucinogen psilocybin as an aid to therapy for alcohol addiction have shown the drug reduces the mean number of drinking days and heavy drinking days by half (Bogenschutz, Forcehimes, Pommy, Wilcox, Barbosa, & Strassman, 2015). Using psilocybin to aid smoking cessation produced 80 percent abstinence at 6 months (Johnson, Garcia-Romeu, Cosimano, & Griffiths, 2014), a far better success rate than our current smoking cessation programs, which report less than 35 percent abstinence.

Of course, much more research is needed, but the collection of outcome studies thus far suggests that psychedelic therapy may, in fact, be superior to our mainstream addiction therapies.

So, what’s going on with this psychedelic-assisted therapy? Is it merely some effect of the drug on the brain? Scientists who reduce the impact of psychedelics strictly to brain chemistry offer us little help, mainly because they’re still unsure of the drugs’ effects. Even their hypothesized answers do not account for the profound influence of culture, environment, and mindset that are fundamental to the experience. Multicultural studies have shown, for example, that the experience of, say, an initiate in the Gabon Fang tribe using ibogaine is wildly different from the experience of a Dutch woman using the same drug (Rodger, 2018).

What is consistent in the research is that participants explain the agent of change as a spiritual experience. Sadly, many psychologists and neuroscientists still cringe at the mention of spirituality, preferring to see it as a tangential idea [construct] best left to new-age parapsychology or an epiphenomenon of no real value. But there is sufficient evidence that this spiritual experience seems to be at the core of the success rates in treatment, and participants report that the visionary experience is precisely why they volunteered to ingest the drug. Even the nicotine study mentioned above reported: “Smoking cessation outcomes were significantly correlated with a measure of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions.”

The precise nature of the experience remains a mystery, but its result is not. Regardless of the details of the experience, participants consistently report that during the experience, they changed how they made sense of themselves, the world around them, and their mental health. And, most importantly, they report that this change in perspective continued months and years after the therapy.

Pollen (2018) wrote the best-seller, How to Change Your Mind, which has become required reading for anyone interested in the science of psychedelic therapy. The book’s title reinforces that the result of the psychedelic experience is a change in mind, a change in perspective, a new way of making sense of oneself, one’s place in the world, and one’s mental health. Pollen described a single mom in her 30s who took part in the smoking cessation study mentioned above: “She had a ‘humbling’ realization that ‘everything in the universe is of equal importance, including me’…. ‘It put smoking in a whole new context. Smoking seemed very unimportant’.”  A 64-year-old woman who was part of a psilocybin trial for alcoholism reported that she had a vision of being a tiny kid in a helicopter flying around Jesus on the cross. “He just sort of gathered me up in his hands, you know, the way you would comfort a small child.” She felt this vision was teaching her to accept herself: “I spend less time thinking about people who have a better life than me. I realize I’m not a bad person.” The result was rather than go on frequent two-week binges on hard liquor, she only goes on a one-day binge on wine or beer once in a while.

We don’t know why this change in perspective takes place, only that it does. It seems to have something to do with helping the participant change perceptions and responses that were rigidly held (Rodgers, 2018). This idea is reminiscent of the LSD studies in the 1960s, in which professionals were invited to take LSD and then work on a business, scientific, mathematical, or engineering problem that had baffled them for months. Under the influence most professionals were able to see the problem and the data in a new way. Based on this new perspective, many problems were solved and patents secured (Harman, McKim, Mogar, Fadiman, & Stolaroff, 1966).

Clients I work with often ask me about psychedelic therapy for addiction. I tell them it’s very similar to the meaning-focused therapy they participate in at our facility. Our goal is to help them find new ways of making sense of themselves and relationships, and pursuing goals that resonate with their personal values. These appear to be the elements of the visionary experience. Perhaps what sets psychedelic therapy apart is that confronted with the hallucinations, participants experience a “reality” that feels more potent and real than normal waking life. Hendricks (2018) suggested the agent of change was developing a sense of “awe.” Like the astronauts who were profoundly affected by seeing the Earth at a distance—the first people to have this perspective—participants in psychedelic therapy seem to be profoundly changed when their thoughts/unconscious become visible.

 

References

Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A, Wilcox, C. E., Barbosa, P. C. R., & Strassman, R. J. (2015). Psilocybin treatment for alcohol dependence: A proof-of-concept study. Journal of Psychopharmacology, 29(3), 289–299. Doi: 10.1177/0269881114565144

Harman, W. W., McKim, R. H., Mogar, R. E., Fadiman, J., & Stolaroff, M. J. (1966). Psychedelic agents in creative problem solving: A pilot study. Psychological Reports, 19(1), 211–227. Doi: 10.2466/pr0.1966.19.1.211

Hendricks, P. S. (2018). Awe: A putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy. International Review of Psychiatry, 30(4), 331–342. Doi: 10.1080/09540261.2018.1474185

Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P., & Griffiths, R. R. (2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology, 28(11), 983–992. Doi: 10.1177/0269881114548296

Pollen, M. (2018). How to change your mind: What the new science of psychedelics teaches us bout consciousness, dying, addiction, depression, and transcendence. New York: Penguin.

Rodger, J. (2018). Understanding the healing potential of ibogaine through a comparative and interpretive phenomenology of the visionary experience. Anthropology of Consciousness, 29(1), 77–119. Doi: 10.1111/anoc.12088.

Tupper, K. W., Wood, E., & Johnson, M. W. (2015). Psychedelic medicine: A re-emerging therapeutic paradigm. Canadian Medical Association Journal, 187(14), 1054–1059. Doi: 10.1503/cmaj.141124.

Weir, K. (2020). Trip of a lifetime. Monitor on Psychology, 51(2). [online]. Washington, DC: American Psychological Association.