As we find out more about Psilocybin and its potential treatment benefits, it is becoming less of the old question (Why would you use a classic hallucinogen for addiction?) and more of the new. Is Psilocybin the future of Smoking Cessation and Tobacco addiction? In 2013 Dr. Matthew Johnson PhD along with Albert Garcia-Romeu and Roland Griffiths PhD, spearheaded a pilot study on Smoking Cessation using Psilocybin. In this Johns Hopkins study that included 15 patients taking 2-3 high doses of Psilocybin achieved an 80% abstinence rate over 6 Months. While most pharmacotherapies for smoking cessation show only modest success rates around 6 Months, which is typically less than 35%. For example, verenicline which is widely considered to be the most effective smoking cessation drug available and has a 6 Month success rate that is approximately 35%.
Of the 15 Participants in the pilot study using psilocybin to treat tobacco addiction, 5 of whom were Women and 10 were Men. The average age of participants was 51 years old an on average consumed (1 pack) 19.9 cigarettes per day for 30 years and had repeatedly tried and failed to stop smoking. Out of the 15 participants 5 of which had prior use of hallucinogens the other 10 had minimal past use that reported back 25+ years before this study’s intake. The results from this study are coming from a specific controlled administration of psilocybin in the context of a treatment program involving cognitive behavioral therapy. Upon being informed what their experience might be like, the first dose of psilocybin was administered by pill the day each participant decided to quit smoking. Two subsequent sessions with higher doses of psilocybin were held 2 weeks and 8 weeks apart. Administering moderate (20mg/70kg) and high ( 30 mg/70 kg ) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Each session would last around 6-7 Hours, closely monitored by two members of the Hopkins research team in a comfortable home like setting. Most of the patients were wearing eyeshades, headphones that played music and were encouraged to relax and focus on their inner experiences. Data was collected via self reporting questionnaires 1-2 Weeks after quitting.
(Smoking self-report data. Mean (SEM) of Timeline Follow-back data at intake and 6-month follow-up for the entire study sample, N=15 (A), and for participants who tested positive for smoking at 6-month follow-up, n=3 (B). 6mo=6-month follow-up. Results shown are for 2-tailed paired t-tests comparing average daily smoking.) Link
In these self reported questionnaires there were 5 options given for participants to choose from as well as a “Write in“ section for your own personal experiences and the option that the psilocybin had zero effect. The 5 options in this questionnaire were.
• Changing ones Orientation toward the future, so that long term benefits outweighed immediate desires. (83.3%)
• Strengthening their own belief in there own ability to quit. (66.7%)
• Changing life priorities or values, such that smoking was no longer more important than quitting. (58.3%)
• Reducing stress involved with quitting (50%)
• Reframing quitting as a spiritual task (25%)
Not one of the participants responded that their psilocybin session was unhelpful in quitting smoking. Some of the additional write-in reasons provided by participants included.
• Increased awareness of the addictive process
• Increased determination to quit
• Greater distance or space between the desire to smoke and behavioral response
Smoking cessation measures. Median (interquartile range) of urinary cotinine (A) and breath CO (B) at all time points are shown. Prep Mtg=Preparation Meeting. TQD=Target Quit Date. Threshold values for determining non-smoking status are indicated at dotted line (<200 ng/mL cotinine; ⩽6ppm breath CO). Mean (SEM) of Questionnaire on Smoking Urges (QSU) scores (C), Wisconsin Smoking Withdrawal Scale (WSWS) scores (D), Smoking Abstinence Self-Efficacy (SASE) temptation (E) and confidence (F) scores at Prep Mtg 1, at 1, 3, 4, 5, 6, 7, 9, and 10 weeks post-TQD, and at 6-month follow-up are shown. C, The QSU contains 32 items (e.g. “Smoking would make me feel happier now”), rated on a 7-point scale ranging from strongly disagree, to strongly agree (Range=32-224). D, The WSWS contains 28 items (e.g. “I have been tense or anxious”) rated on a 5-point scale ranging from strongly disagree, to strongly agree (Range=28-140). E, The SASE assesses temptation to smoke and confidence in smoking abstinence (F) in 20 hypothetical situations (e.g. “At a bar or cocktail lounge having a drink”) rated on a 5-point scale ranging from not at all, to extremely (Range=20-100)
After completion of session 1, four patients went on to share their experience 1 week after consuming psilocybin.
“ I saw an image of my lighting a cigarette and saw that image duplicated many times over and tried to count all the cigarettes Ive had in my lifetime. I tried to remember specific ones but mostly I just kept coming back to that one image duplicated and saw that there’s no such thing as “just one” – one cigarette is never enough – 1,000 is never enough”
“I am confident and content to be who I am. I am confident and content… anything feels possible”.
“ With regards to smoking cessation, when the thought occurs that I’d like one now, it seems that craving/need can be easily overcome. That shifting my thoughts to the intense, vivid, enlightening experience during the session distracts me long enough to stop thinking about the cigarettes, also deep breaths and altoids”
“ After facing challenges within the session, (coping with intensely uncomfortable physical sensation and great anxiety) I was left feeling empowered to deal with any possible future cravings concerning smoking. During the session I felt as though I had already completed my withdrawal from smoking. I felt that all the work had already been accomplished. I felt amazed, grateful and giddy about everything being so simple”
A lot of the participants picked up chewing gum, carrot sticks, as well as altoids as you can imagine going from 1 pack a day for 30 years to not smoking can be quite jarring. As we can see from the data we are unable to pinpoint exactly why or how psilocybin has a great effect on smoking cessation. Dr. Matthew Johnson and Johns Hopkins were recently granted a Federally funded 4 Million Dollar research grant In 2021 to further explore how psilocybin can potentially be a breakthrough therapy in this field. Dr. Matthew Johnson is quoted stating “Quitting smoking isn’t a simple biological reaction to psilocybin, as with other medications that directly affect nicotine receptors”. Dr. Johnson was also quoted saying “When administered after careful preparation and in a therapeutic context, psilocybin can lead to deep reflection about ones life and spark motivation to change”. As you can see the desire to smoke is going from a smoker level to that of a non smoker essentially overnight upon their psilocybin session. As we head towards the future of Plant Medicine, I would love to know your thoughts. Is Psilocybin the future of Smoking Cessation and tobacco addiction??