Smoking cigarettes is a huge problem all over the world. The WHO reports that over 7.2 million smokers worldwide die as a direct result of cigarettes every year and that smoking decreases lifespan by 10 years. All in all, tobacco kills half of the people who end up using it regularly.
What’s more, smoking is extremely addictive. Judging by data collected in 2018, 55% of adult smokers make an attempt to quit each year but only 7.5% are successful.
Psilocybin, the active ingredient in most psychedelic drugs, has only recently come into the spotlight as a potentially game-changing way to help smokers kick the habit. Although it is too new on the scene to make any definite conclusions about, it seems that, when used in a well-facilitated setting, psilocybin’s abstinence rates in early trials appear to exceed those of varenicline, the most effective currently approved medication. Psilocybin is not habit-forming, either, in contrast to most existing treatments for smoking addiction.
Pros and Cons of Psychedelic Smoking Cessation
Before going any further, let’s look at some general draws and downsides of taking psilocybin-based substances for smoking cessation.
Pros
The pros listed below are, for the most part, based on commonly-reported effects of psilocybin from psilocybin therapy programs:
- Treats a wide variety of mental health issues.
- Sharpens focus when studying, working, etc. This effect mimics the increased clarity many smokers claim to derive from a nicotine high, making it easier to quit.
- Promotes healthier habits and routines in addition to discouraging bad ones.
- Not habit-forming, a sentiment reflected by the FDA.
- A ton of other positive mental effects, such as increased cognitive function, higher levels of empathy, and much more.
- Lack of any notable side effects (usually, see “cons” section below).
Cons
These side effects are not universal, but they are worth considering:
- Adverse physical effects, such as heightened heart rate.
- Problems with measuring out the correct dosage. A precision scale helps with this.
- Anxiety about acquiring an illegal substance, especially in regards to sourcing or quality.
- Increased anxiety
- Residual tiredness.
- Concern about developing dependence.
- Triggering of underlying mental health problems, especially in certain individuals. Be sure a qualified medical professional approves before you try psilocybin.
Psilocybin Smoking Cessation Programs
Psilocybin-facilitated smoking cessation programs have been growing increasingly popular in recent years. The programs can range in setting from a series of individual sessions in a therapist’s office to a clearing in the woods where well-trained shamans lead a mystical experience for a group. It is up to each individual to decide what kind of trip setting they are most comfortable with. Whatever the setting, though, the goal remains the same: to guide the participants through a psychedelic experience that will zero in on their smoking addiction and try to temper it as much as possible.
Are the Programs Effective?
Because of the greatly enhanced senses of empathy and unbiased reasoning that many report psilocybin to unlock, people often find it much easier to identify and minimize the root of their smoking addiction when aided by psychedelics.
“While the drug is active, the brain is operating in a dramatically, qualitatively different fashion… They know what’s going on [during the experience and] they can observe their life and themselves from a much different vantage point, a much broader vantage point.”
Although the research is admittedly limited, it appears that psychedelic-assisted smoking cessation is much more effective than traditional programs for quitting smoking would be.
Pubmed reports that just three professionally-administered doses of psilocybin and subsequent counseling caused 9 out of 15 people to quit smoking in the long term. But traditional smoking cessation programs that last 6 months, complete with counseling and pharmacotherapy, only have a 20-30% success rate in getting participants to quit smoking for good.
Varenicline, which is widely regarded as the most effective smoking cessation drug, has a success rate of roughly 25-35 percent (with a meta-analytic average around 27%) in getting people to abstain from smoking for a minimum of 6 months. In the Johnson et al. pilot study (n=15, open-label, no control group), the abstinence rate was 80% at 6 months and 67% at 12 months. While these results are promising, the small sample size and lack of a control group mean larger trials are needed to confirm efficacy. That said, psychedelics appear to show potential for helping people kick the habit, especially considering that Varenicline comes with a lengthy list of side effects.
“It’s really because the psilocybin, plus the therapy that’s being paired with it, is acting to reset people’s mental behaviors and habits and thought patterns around their addictive substance or behavior of choice; whereas the traditional therapies are really only dealing with cravings, with physical withdrawal symptoms, these sorts of things.”
Where to find programs near you
Unfortunately, due to psilocybin’s illegality in many areas, programs that specifically use it to target smoking addiction are nearly impossible to find even in the areas where the drug is unregulated. You could always use the databases at MAPS Trials or Psychedelic.support to search for ongoing programs near you and, if you’re incredibly lucky, you might find one that looks at smoking cessation. If you do, it’s likely to be held in either Oregon or Colorado, since those are the states where psilocybin is legalized for controlled therapeutic use as of December 2022.
Programs focused on psychedelic-assisted smoking cessation will likely become much more widespread in the near future if the NIS-funded John Hopkins study on the subject that is due to be completed in 2023 (more info on that below) shows promising results.
Studies on Psilocybin Smoking Cessation
By far the most well-known study on the effects of psilocybin on smoking cessation was completed at John Hopkins University in 2014. In the study, the participants were given just three doses of psilocybin-containing magic mushrooms at the 0, 2, and 8 week marks, and 80% of participants had quit smoking at the 6-month mark, dropping to 67% at 12 months and 60% at long-term follow-up. That result is clearly impressive for a pilot study, but there are important caveats.
First of all, the psilocybin itself wasn’t solely responsible for the results. They likely had a lot to do with the professional counseling given after the dose was administered. Matthew Johnson, the head researcher on the study, explained that “quitting smoking isn’t a simple biological reaction to psilocybin, as with other medications that directly affect nicotine receptors. When administered after careful preparation and in a therapeutic context, psilocybin can lead to deep reflection about one’s life and spark motivation to change.” In other words, the psilocybin was, most likely, responsible for making people more open to counseling. The counseling was instrumental in causing the desired effect, though. Because of that, simply taking psilocybin probably won’t help much with smoking cessation.
The second caveat is that the study was only conducted on 15 people, so that 60% of participants who seemingly quit smoking only consisted of nine people. That’s not really a large enough sample size to draw reliable conclusions.
Despite the caveats, though, the study’s results made huge waves in the world of smoking recovery and spurred NIH (the US National Institute of Health) to fund a larger study on the topic that’s due to complete in 2023.The study will be spread over the campuses of three universities: Johns Hopkins University in Baltimore, New York University, and University of Alabama at Birmingham. NIH awarded the universities a total of $4 million for the studies, making them the first federally-funded research on psychedelic therapy in half a century. It will also use magic mushrooms in similar doses, but it will focus on a much larger sample size.
“This is a groundbreaking study that opens the door to further study of psychedelic compounds. These compounds could be game-changers for the future of mental health and addiction care.”
We will definitely update this post once the results of the study are made available.
Although we’ve seen a lot of studies in recent years that strongly indicate psilocybin’s power to get people to kick deep-seated habits and addictions like smoking, no other major studies specifically looking at smoking cessation have been conducted recently.
Will Psychedelics be Legalized?
If we’re talking about small amounts of psychedelics being taken in a regulated, therapeutic environment, the answer is almost certainly yes. We are already seeing psilocybin being legalized for supervised use in certain states.
It has been decriminalized in an even greater number of places, which means that small doses of psilocybin are overlooked in the eyes of the law, and you can even get different types of products in cities like Oakland, CA and many other cities in the US and Europe, as well as in some entire countries like Jamaica and the Netherlands.
Some advocates argue psilocybin may follow a similar trajectory to cannabis, pointing to decriminalization in Oregon, Colorado, and several cities.
The medical establishment also seems to be taking psychedelics much more seriously as of late. In August 2022, the world’s first commercial firm dedicated to psychedelics research opened in London. And then there’s the NIH-funded study being conducted in the next few months. And there are countless other studies released recently that speak volumes about the as-of-yet nascent power of psychedelics to change the pharmaceutical world.
Looking to the Future
The NIH-funded Johns Hopkins trial, expected to conclude in 2023, is the largest psilocybin smoking cessation study ever conducted. If it replicates the 2014 pilot results at scale — with a control group — it would provide the strongest evidence yet for psilocybin’s role in addiction treatment.
Dustin Kemp
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