Psychedelics for addiction: promise, limits and caution
September 29, 2026 · 20 min read
Matthew Johnson reports psilocybin trials helping addiction, Anna Lembke sees promise but urges caution, and Huberman's MDMA episode weighs benefits against crashes and neurotoxicity. The field offers hope for compulsive behaviors but isn't a shortcut.
The rules, numbers and steps worth keeping in front of you.
- Results come from therapy plus the drug, in a clinical setting.
- Johnson: one to three guided psilocybin sessions can bring change lasting a year or more.
- Johnson: ketamine given as psychedelic therapy helped heroin and alcohol addiction in older trials.
- The model: screening, preparation, a monitored dosing day and integration.
- Johnson: lasting change may come from a revised sense of self.
- About a third of trial participants have a bad trip at some point.
- People prone to psychosis or mania are excluded.
- Microdosing showed no benefit in double-blind studies.
- Lembke: addiction is chronic and relapsing, and the studies are small and short.
- Lembke: solo use for a spiritual awakening almost never works out well.
- Lembke: she treats patients addicted to MDMA and microdosing.
- Huberman: in the PTSD trial, many participants' substance problems also resolved.
- Street drugs are often contaminated with fentanyl.
- Talk with a physician or addiction specialist before considering any of this.
This is the short form. The full insight has every expert's reasoning, their own words and the sources.