Psychedelics for addiction: promise, limits and caution
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.
What is the overall verdict on psychedelics for addiction? Show answer
There is real promise, but only as a guided, supervised and still experimental treatment inside therapy.
What results does Matthew Johnson describe for psilocybin? Show answer
One to three high-dose sessions with preparation and integration producing effects a year or more later, including in smokers.
What are the four steps of the Hopkins model? Show answer
Screening, preparation, a monitored dosing session and integration afterward.
How does Johnson explain the lasting effect? Show answer
Persisting changes in self-representation, such as revising the label of smoker or failure.
What two main risks does Johnson name? Show answer
Destabilizing people prone to psychosis or mania, and bad trips, which about a third of participants report at some point.
What does the evidence say about microdosing? Show answer
Double-blind studies found anything from no effect to slight impairment, with no gains in mood or creativity.
Why is Anna Lembke cautious about psychedelics for addiction? Show answer
Addiction is chronic and relapsing, the studies are small and short, and she doubts a quick fix.
Can psychedelics be addictive, according to Lembke? Show answer
Yes. She has patients addicted to MDMA and to microdosing.
What did the MDMA trial for PTSD find? Show answer
67 percent of the MDMA group no longer met criteria for PTSD, and many participants' substance problems also resolved.
What does Huberman say about MDMA alone? Show answer
Taken on its own it does not cure PTSD. It augments talk therapy.
What is the main danger of street drugs? Show answer
Widespread contamination with fentanyl.
What should you do right after a psychedelic session? Show answer
Avoid big decisions for about two weeks and take the integration work seriously.