Psilocybin for Addiction and Substance Use Disorders

## The Short Answer Psilocybin has produced the most impressive addiction treatment results of any substance in modern clinical research. A Johns Hopkins pilot study found **80% smoking abstinence at 6-month follow-up** — compared to 35% for varenicline (Chantix), the best available pharmaceutical. Psilocybin also shows significant results for alcohol use disorder and is being studied for opioid addiction. The mechanism appears to be a combination of neuroplasticity, default mode network disruption, and profound shifts in self-perception and values. ## The Smoking Cessation Data The Matthew Johnson-led Johns Hopkins study (2014, published in *Psychopharmacology*) enrolled 15 smokers who had failed multiple previous quit attempts. After 2–3 psilocybin sessions with cognitive behavioral therapy: - 80% were abstinent at 6-month follow-up - 67% remained abstinent at 12-month follow-up - Participants described the experience as "one of the most meaningful of their lives" For comparison, varenicline (Chantix) achieves approximately 35% abstinence at 6 months. ## Alcohol Use Disorder A 2022 RCT published in *JAMA Psychiatry* found that psilocybin-assisted therapy significantly reduced heavy drinking days compared to placebo. Participants in the psilocybin group reduced heavy drinking by 83% from baseline, compared to 51% in the placebo group. ## Why Psilocybin Works for Addiction Addiction involves rigid neural patterns — the same default mode network hyperactivity seen in depression and OCD. Psilocybin disrupts these patterns, creating a window of neuroplasticity during which new behavioral patterns can be established. Many participants describe a shift in their relationship with the substance — it simply loses its appeal. [See the protocol →](/research-checkout) *This article is for informational purposes only and does not constitute medical advice.*