title: Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction.
abstract: Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA mwj@jhu.edu.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Johnson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Garcia-Romeu
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Cosimano
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Roland R
authors.initials: RR
authors.lastname: Griffiths
mesh_terms: D001290:Attitude; D016739:Behavior, Addictive / Q000188:drug therapy; D015415:Biomarkers / Q000378:metabolism / Q000652:urine; D002248:Carbon Monoxide / Q000378:metabolism*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy / Q000009:adverse effects; D003367:Cotinine / Q000652:urine*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use; D010865:Pilot Projects; D011562:Psilocybin / Q000009:adverse effects / Q000627:therapeutic use*; D017366:Serotonin Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018722:Nicotinic Agonists; D017366:Serotonin Receptor Agonists; D011562:Psilocybin; D002248:Carbon Monoxide; D003367:Cotinine
keywords: Hallucinogen; addiction; nicotine; psilocybin; psychedelic; smoking cessation; tobacco