Can psychedelics help smokers quit?
The National Institutes of Health wants to know the answer, and to find out, they’ve awarded a grant to scientists at Johns Hopkins University. It’s the first time in 50 years that a federal grant has been given to study a psychedelic drug as a possible treatment.
The study, a randomized controlled trial expected to start later this year, will investigate whether psilocybin, the psychedelic compound found in “magic mushrooms,” can help people quit smoking tobacco. Hopkins researchers will lead the trial, which will be done in collaboration with researchers at NYU Langone Health and the University of Alabama at Birmingham.
Until now, the lack of support from NIH on psychedelic research had been a major hurdle in the field, said Dr. Joshua Woolley, an associate professor of psychiatry at the University of California, San Francisco. Woolley is not involved with the new research.
“The fact that the NIH is now interested in these types of studies is a great thing,” said Dr. Charles Nemeroff, chair of the department of psychiatry and behavioral sciences at Dell Medical School at the University of Texas at Austin. “It’ll provide us with funding to be able to do these controlled studies.” Nemeroff is also not involved with the new study.
Psychedelics have garnered considerable attention as a potential treatment for mental health disorders including addiction, depression and post-traumatic stress disorder. In a study published in August, researchers found that psilocybin helped drinkers reduce alcohol cravings.
The upcoming trial aims to include up to 66 participants. Participants will receive either two doses of psilocybin or two doses of niacin, a type of B vitamin. Both groups will undergo talk therapy.
Typically in studies using psychedelics, participants receive the drug during a monitored session with a therapist, which can last hours. Results can be seen after just one session, experts say.
Matthew Johnson, a psychedelic researcher at Johns Hopkins Medicine who is leading the randomized controlled trial, chose to look at the effects on cigarette smoking cessation because of the lack of effective treatments available for people who want to quit.
Quitting smoking is extremely difficult, with fewer than 1 in 10 smokers who attempt it succeeding each year, according to the Centers for Disease Control and Prevention.
“There’s several existing treatments, both medications and other therapies, but they all have lots of room for improvement,” Johnson said. “None of the medications help a majority of the people long term. Even six months down the road, it’s pretty small success rates.”
Psilocybin has shown promise as a tool to quit smoking. A small pilot study from Johnson and his colleagues found that the compound helped 10 out of 15 people stop smoking for at least one year.
The group of researchers is also in the midst of a study looking at how effective psilocybin is for quitting compared with nicotine patches. The open-label trial — which means that patients and scientists know which treatment they are receiving — currently has findings on 61 participants. According to interim data provided by the researchers to NBC News, about half of the participants who received psilocybin hadn’t picked up a cigarette for a year, compared with 27% of those who were given nicotine patches. These numbers, the researchers noted, are expected to change once roughly 80 people have reached the one-year mark.
Anne Levine, 58, from Baltimore, was one of the participants in the open-label study. She said she had been smoking about a pack a day for nearly 40 years and had tried quitting a dozen times.
She was in the group that received psilocybin and said she hasn’t smoked or craved a cigarette since.
“I don’t crave cigarettes anymore, which is the craziest thing, because every time I’ve quit before, I’ve always craved a cigarette,” Levine said. “I don’t have that anymore. … I don’t have any of that physical desire to smoke or emotional desire to smoke.”
It remains unclear how psilocybin may be helping people with addiction.
“That’s really the million-dollar question that’s really hard to answer,” Johnson said. “I don’t think there’s any good answers in the field in terms of what’s different in the brain a year later or six months later.”
But some things are known psychologically, he said. When people are given psychedelics, they “have a shift in their personality, on average, towards being more open to new experiences and so that can be expressed with smoking in any number of ways.”
One of the theories, according to Woolley, is that psychedelics may help people ditch long-standing behaviors.
“Helping people get out of behavioral ruts … would have really big implications for mental health, addictive disorders and smoking in particular,” he said.
The behavioral change may stem from increased neuroplasticity, a condition where the brain can make changes, Nemeroff said. In theory, with psychedelics, new learning is possible and “behavioral change can occur where it hasn’t been able to occur before.”