LSD and psilocybin for alcohol use disorder

Domain VII · Transpersonal, psychedelic & altered states · Bogenschutz, Forcehimes · 2015

What it is

Important framing. This is a research protocol, not an approved treatment. None of the sources cited here reports psilocybin as approved for alcohol use disorder (AUD) anywhere (as of June 2026). The drug component is run only inside regulated trials or licensed programmes, by medical staff. This…

Format

• Overall format (NYU/UNM double-blind trial). About 12 weeks of manualised outpatient psychotherapy, with two day-long medication sessions at weeks 4 and 8. Each medication session has its own preparation beforehand and a debriefing the next day. The control condition was an active placebo with the…
• Week-by-week calendar (protocol schedule and text). Week 0 is the start of the psychosocial treatment; randomisation happens just before the first medication session. Week numbers follow the protocol's schedule figure and text; minor errors are possible.

Who practises it, and how they are trained or regulated

• Therapists hold at least a master's degree (or are training for one), and at least one team member is a physician.
• Why research stopped (per the authors): underpowered trials, unrealistic expectations that discounted modest effects, and the political history of LSD, which made regulatory approval harder.
• Important framing. This is a research protocol, not an approved treatment. None of the sources cited here reports psilocybin as approved for alcohol use disorder (AUD) anywhere (as of June 2026). The drug component is run only inside regulated trials or licensed programmes, by medical staff. This guide gives no drug quantities, routes, schedules or administration details. What a psychotherapist can use now: (a) the…

Evidence status, as the guide reports it

• Historical LSD trials: history only, not for use. Krebs and Johansen (2012) pooled six randomised trials run between 1966 and 1970 (536 adults, mostly male inpatients). Sites were Toronto; VA hospitals in Palo Alto, Topeka and Sheridan; Mendota State Hospital; and the Maryland Psychiatric Research…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• consent to touch given only to please the therapist. If in doubt, treat the answer as no.
• pressure to get a "bigger" experience; fear after a difficult first session. Declining is always allowed.
• values chosen to please the therapist. It is working when the person names a specific gap in their own words.
• the participant splitting the two therapists ("the good one"). The authors note that the roles overlap in practice.
• psychedelic use as a substitute for other treatment; a person who meets exclusion criteria; new or increased substance use.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.