• Psychedelic Medicine

Alcohol Addiction | +80 articles

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Psilocybin-assisted treatment of alcoholism

Adam Halberstadt, ‎Franz Vollenweider, ‎David Nichols

C is a 59 year-old divorced mother of 2 who had struggled with alcohol since age 15. Her drinking had led to problems including recurrent physical violence, multiple arrests, poor work history, and intermittent homelessness. She had suffered severe abuse in the context of relationships with partners who also drank, including being beaten unconscious and suffering from intracranial bleeding on at least one occasion. She had made several past attempts to stop drinking, with little success. When she volunteered for the psilocybin trial, she had been sober for 11 days.

During the preparatory phase, C stated a goal of total abstinence, and rated the importance of abstinence and her readiness for abstinence as high, but her confidence in achieving it was low. She said that she wanted to understand why she drank, and hoped that this would help her stay sober. She indicated God's will, forgiveness, humility, (to be) loved, and self-control as her most important values, and saw clearly that her drinking was in conflict with these values.

During her first psilocybin session, she reported that she experienced powerful feelings of sorrow and remorse regarding the course of her life, and particularly concerning her perceived failures as a parent as a result of her drinking. This experience was quite painful, and she believed that she was sobbing uncontrollably during much of this time, although she was actually lying quietly on the couch at the time. After the session, she felt a sense of relief, and said that she had been able to let go of these feelings and experience a sense of forgiveness. She was hopeful that the experience would help her stay sober, and had no desire to drink after the session.

C remained sober between the first and second session. During the second session, she reported she experienced a visual image of a small child lying broken on the floor. She realized that this child was her, and experienced herself as a 3-year-old child, devastated by abandonment by her father, an issue that she had not discussed in the preparatory sessions. After this, she began to perceive a white light, which she called Gods healing light, and felt a profound sense of love. She felt that she had been healed by this experience, and that she now felt whole and worthy of love.

In discussing these experiences afterwards, C said that she thought her drinking had been an attempt to escape the painful feelings of being unworthy of love, as well as the painful feelings of shame and loss related to her life as an alcoholic. She had avoided these feelings, believing that she would fall apart if she faced them. Following the sessions, she now felt that she was strong enough to face these feelings, and that she was a whole person, worthy of love. At her most recent follow-up, 5 months after the first psilocybin session, she remained abstinent and continued to feel that her life had been transformed, in spite of the unexpected death of a close family member during the interim.

 
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Teri Krebs and Pal-Orjan Johansen

LSD treatment for alcohol addiction

The psychedelic drug LSD could help alcoholics give up drinking, according to studies performed in the 1960s. A study, presented in the Journal of Psychopharmacology, looked at data from six trials and more than 500 patients. It said there was a significant beneficial effect on alcohol abuse, which lasted several months after the drug was taken.

At present LSD is a class A drug in the UK and is one of the most powerful hallucinogens ever identified. It appears to work by blocking a chemical in the brain, serotonin, which controls functions including perception, behavior, hunger and mood.

For this new study researchers at the Norwegian University of Science and Technology analyzed earlier studies on the drug between 1966 and 1970. A total of 536 patients were taking part in alcohol treatment programs, but some were given a single dose of LSD of between 210 and 800 micrograms.

For the group of patients taking LSD, 59% showed reduced levels of alcohol misuse compared with 38% in the other group. This effect was maintained 6 months after taking the hallucinogen, but it disappeared after a year. Those taking LSD also reported higher levels of abstinence.

According to authors Teri Krebs and Pal-Orjan Johansen, "A single dose of LSD has a significant beneficial effect on alcohol misuse. Given the evidence for a beneficial effect of LSD on alcoholism, it is puzzling why this treatment approach has been largely overlooked." They suggest that more regular doses might lead to a sustained benefit.

"We were surprised that the effect was so clear and consistent, said Krebs. She said that "the problem with most studies done at that time was that there were too few participants, which limited statistical power. But when you combine the data in a meta-analysis, we have more than 500 patients and there is definitely an effect," she said.

Professor David Nutt, had earlier called on the government to allow more research on illegal drugs, and for this he was removed as the UK government's drugs adviser. He said, "Curing alcohol dependency requires huge changes in the way you see yourself. That's what LSD does. This is as good as anything we've got for treating alcoholism."

"Psychedelics were promoted by psychiatrists in the 1950s as having a range of medical uses, to treat conditions such as schizophrenia, for example, before political pressures in the United States and elsewhere largely ended the work. Alcoholism was considered one of the most promising clinical applications for LSD
," says Johansen. Alcoholics Anonymous co-founder Bill Wilson is said to have espoused the benefits of LSD in the book: The Story of Bill Wilson and How the AA Message Reached the World.

In the last decade, however, a new generation of researchers have been interested in harnessing the therapeutic benefits of illicit drugs, such as MDMA for post-traumatic stress disorder, ayahuasca for drug and alcohol dependency, and psilocybin, the active ingredient in hallucinogenic mushrooms, for smoking cessation.

Robin Carhart-Harris, a psychopharmacologist at Imperial College London who has researched how psilocybin could treat depression, says that psychedelics must work at both biological and psychological levels. "Psychedelics work by making the brain function more chaotically for a period, a bit like shaking up a snow globe - weakening reinforced brain connections and dynamics," he says.

"This is important work," says Matthew Johnson, a psychiatrist also at Johns Hopkins who is running a small trial looking at the effectiveness of psilocybin to treat nicotine addiction. "Although this meta-analysis does not replace the need to test the approach in new, well-designed and rigorous clinical trials, it puts some more muscle behind the interpretation that the older literature shows hints that psychedelic therapy might really help addiction."

However, Ken Checinski, a consultant addiction psychiatrist and independent researcher based in London, says that although the results are exciting, no pharmacological treatment should be seen as a magic bullet and that modern therapeutic techniques have improved. "The included LSD trials pre-date the use of psychological techniques such as motivational interviewing and cognitive behavior therapy," he says.

https://www.news-medical.net/news/20...ion-Study.aspx
 
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I lost my desire to drink after taking LSD

reset.me | 29 Apr 2019

I began struggling with alcoholism at the age of 18 during my senior year of high school. When I moved away from my hometown to attend college in a larger city in 1993, a combination of factors compounded my escalating drinking and drug abuse.

At last, I’d achieved a degree of freedom from my parents. I was raised in an upper-middle class family where external appearances were everything. My parents had complex and unresolved issues of their own, and my upbringing was often traumatic. Much later in life, I would learn that the years I spent with my parents and their emotionally-neglectful style of upbringing would result in my living with Complex-PTSD. I would also be diagnosed with anxiety disorder and substance use disorder, all the while living with high sensory-processing sensitivity, making me a “Highly Sensitive Person” per Dr. Elaine Aron’s book by the same name.

Free from the perpetual lock-down of my parents’ clenched reins, I exploded onto the college party scene. While marijuana was more my thing, I had initially begun coping with overwhelming feelings by using alcohol, because it was legal and more readily available. After only a year and a half at college, I went from being a high school honor student to one who rarely attended classes. I usually crawled into my dorm room bed at dawn. Between alcoholism, anxiety and depression, I could barely function.

I had begun experimenting with many different drugs. At the time, my attitude was that all these substances were created “equal,” that they all had certain risks, but were essentially party tools. In one way or another, they helped me to numb my emotional pain for a while.

I did not yet understand that not all “drugs” are created equal. I grew up in the era of Nancy Reagan wagging her finger to “just say no.” I did not yet understand the healing potentiality of psychedelics . . . nor did I respect their power.

Then one night, hanging out with a friend in a small trailer outside of town, I had my first life-altering psychedelic experience. My friend had spent a period of life living and traveling with a community of hippies at something he called “Rainbow gatherings.” We were kindred spirits – emotionally wounded, mischievous flower-children misplaced in the grunge era.

I dropped LSD that night in his trailer. I had done mushrooms with a different group of friends once before, but the experience yielded no more than a soft-focused sense of wonder and connection as I rambled through nature. This night was amazing.

Reality, as I had known it, turned sideways. I lost interest in participating in society in a whole new way. Everything man-made seemed petty, egotistic, pointless and even repulsive: politics, organized religion, consumerism, attending school. Since everyone close to me was interested in those things, I experienced a whole new sense of isolation from everyone and everything around me, except for Nature and my concept of Spirit. That feeling of disconnection from society led me to drop out of college. While that may sound like a negative consequence of my experience, in retrospect, school was not where I needed to be at that time. I felt like I was being taught much larger lessons that I would need later on in life. (I later returned to school and obtained my B.A. with highest honors.)

Another unexpected outcome of my psychedelic use was that I lost my desire to drink for 12 straight years. The urge had simply vanished. I did not attend AA once during that time. Eventually, I did relapse on alcohol, and when I attended AA and mentioned my 12-year sober stint that resulted from LSD, you can be sure that nobody in the program wanted to hear about it! I pointed out that even Bill Wilson, AA’s founder, had experimented with psychedelics and had positive things to say about them regarding his recovery. Nobody wanted to hear that, either. Fully immersed in the AA culture for nearly five years, I read all the recovery literature and was keenly interested by the concept of ego-death in recovery. Had LSD prompted such a temporary ego-death in me? Certainly, psychedelics command a degree of humility and surrender.

Always fascinated by metaphysics, over the years I began to research some of the bizarre physical sensations that I experienced back in my early days of psychedelic usage. The blossoming of the internet suddenly made answering odd questions easy. I read of something called kundalini energy and kundalini awakenings. Those seemed to be pieces in the puzzle, as kundalini is often described as a serpent-like energy that lies dormant in the root chakra at the base of the spine, climbing up the spine and activating the chakras as it induces spiritual awakening. Further, I learned this might sometimes be triggered not just by intense yoga practice, but also intense drug experiences. I knew nothing of chakras or this type of phenomena in the old days. Readings on qi and the Tao were also applicable and of interest.

I no longer drink alcohol or use other drugs. I stopped attending AA years ago for a variety of reasons. I continued embarking upon psychedelic journeys until my early 40’s, though in a more deliberate and spiritual context, several times as part of shamanic rituals. The same distress tolerance that psychedelics cultivated now helps me cope with chronic pain from fibromyalgia.

I will always have great reverence for the power of psychedelic medicines and hope they will continue to be explored for their healing potential.

 
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Understanding alcohol addiction and how Ketamine can help prevent relapse

by Cindy Van Praag, MD

Alcohol addiction is deadly, we know this. It does not just punish the addict, it punishes their family and society. For those who find sobriety alone or with help from a detox program, staying sober is a lifelong challenge. Relapse occurs when one resumes drinking and is a detrimental problem that deserves more attention.

Understanding some basics of alcohol addiction and how to help prevent relapse can be a bit complicated. In the next section we summarize an article on the neurobiology of addiction by Xavier Noel. It simplifies some popular thoughts about how and why addiction works in the brain. Then, we can see how to use ketamine to help prevent relapse.

Is alcoholism a choice?

The impulse/habit system:

How does the compulsion to drink develop? A part of our brain, called the amygdala-striatum neural complex, motivates us to achieve rewards. This area is driven by dopamine, a naturally produced neurotransmitter in our bodies that has many effects, including feelings of pleasure, or reward. Alcohol, and other addictive drugs, increase overall dopamine levels in our brain. Therefore, a link forms between automatic, repetitive behaviors, such as pouring a drink, and increased dopamine. These actions are saved in our brain as rewarding. And the brain loves rewards.

Increasing dopamine activity also accelerates the change between the first steps of choosing to have a drink and later craving a drink. New pathways in the brain form with repetitive behavior. Cues and memories in the environment to drink are noticed more quickly, like hearing glasses clink, or walking in the front door after work. These cues drive the compulsion to drink. The brain’s automatic response is to seek this reward, but can’t we control this behavior?

The control/decision making system:

The decision-making part of our brain is found in the prefrontal cortex. It is also known as the “reflective system”, or executive function system, where we can control impulses. This means we can trade short term rewards, like a drink, for possibly greater long-term goals, such as avoiding a DUI charge. One explanation is that there is a balance between a “cool” and “hot” system that works out how we respond to triggers or cravings. The “cool” refers to basic working memory and inhibition of impulses.

The “hot” involves numerous emotional responses that are possible. Damage to either of these systems may impair the ability to say “no” to situations, or drugs like alcohol, that can harm us. Either the impulse side or the emotional side wins when we lose a health balance.

When/How impulse overpowers control:

Poor decision making in alcoholics may also be explained by yet another system called the insular cortex. It responds to imbalance in our bodies from things like sleep deprivation, anxiety and stress. These stressors may hijack our impulse/habit system and increase cravings while promoting decisions to seek out alcohol. Repeated cycles of increased cravings can also essentially rewire brain circuits, reinforcing continued destructive behavior.

Addiction as a "pathology of choice"

Other studies support that “faulty brain connections related to decision-making can lead to addictive behaviors and relapse.” [ii] There is a definite shift from blaming addiction on cravings to finding abnormalities in decision making areas of the brain. Thus, the brain is not able to make the right decisions to ignore the craving.

NMDA receptors are at fault too?

Alcohol Treatment Depression Ketamine


Family history of alcoholism is a risk factor for developing alcohol addiction. A study by Petrakis et al showed one answer may lie in the NMDA (N-Methyl-D-Aspartate) receptor, which is vital to the glutamate system in the brain. Alcohol alters this receptor’s function, but if the receptor is not normal, that person may be more susceptible to alcohol abuse.[iii]

How can ketamine help?

Ketamine can play a key role in preventing relapse in those who have either completed a detoxification program or managed to stop themselves.

Over-write memories that drive addiction

It is possible a rewarding memory of taking a drink, for example, can be triggered repeatedly by seeing a glass of beer, going to a restaurant, or maybe returning home from work. These triggers lead to the urge to drink. Ravi Das from University College London explains why people often quit but return to drinking. “The main problem is the really high relapse rate after treatment,” said Das. “People can successfully quit using over the short term while they’re being monitored in the hospital … but when they return home they’re exposed to those environmental triggers again.”[iv] The good news, is that each time the brain accesses that rewarding memory, the neural connections that code the memory are destabilized. It is at this moment that ketamine, which blocks the brain receptor required for the formation of memories (NDMA), can help weaken or even erase the memory. In other words, ketamine will help break the power of that trigger.

The psychedelic experience

The benefits from the psychedelic experience while receiving a ketamine treatment may hold benefits. Dr. Tobias Stevens, in his presentation on ketamine as a treatment for alcohol use disorder, postulates the hallucinations and altered mental state from ketamine may help change lifestyle choices. He suggests the experience may alter perceptions and break routine behaviors.[v] Therefore, a combination of psychotherapy with ketamine, (ketamine psychotherapy or KPT) may prove helpful for some folks. KPT allows the psychedelic effects from ketamine to enhance a psychotherapy session and is shown to be effective helping those with addiction, including heroin and alcohol by Dr. Evgeny Krupitsky.[vi]

Ketamine allows learning

Ketamine Treatment Options Chicago


Psychotherapy is a vital mainstay of alcoholism recovery treatment, but why are relapse rates so high? Maybe, postulates McAndrew et al, the alcoholic brain simply can’t learn the new skills.[vii] There is a proven decrease in neural growth factors in the brain, BDNF, with alcohol addiction. With fewer connections between nerves, and less ability to make new connections, the brain cannot learn new skills. With ketamine and synaptogenesis, which happens to peak 24 hrs after a treatment, well timed psychotherapy can have a greater impact.

What does ketamine for relapse prevention look like?

Ketamine is not a solitary treatment for alcohol relapse prevention. To say so would oversimplify the disease. Current studies include interesting combinations with ketamine.

KARE – Ketamine for reduction of Alcoholic Relapse

KARE is a multi-site project running in England that is a clinical trial seeking to explore psychotherapy combined with low dose ketamine as a possible treatment for alcoholism.[viii] Participants who completed alcohol detoxification receive IV ketamine 3 times interspersed with 7 therapy sessions. The psychotherapy model, developed by Dr.s Rob Hill and Jen Harris included 3 key areas:

- Wellness promotion: planning weeks, problem solving, relaxation, and mindfulness
- Risk reduction strategies: Identify high risk situations, cope with cravings, or restructure unhelpful thinking
- Education: what is addiction, biological effects of alcohol both acute and chronic, alcohol and sleep, and how alcohol interacts with the brain

Combining ketamine with other medications?


Combining ketamine with other prescription drugs is debatable as there is conflicting evidence. For example, naltrexone is frequently used with alcohol dependence. It binds opioid receptors and is supposed to take away cravings for opioids and alcohol which can take away reward effects.[ix] In reality, it does reduce overall total alcohol consumption, but not necessarily abstinence. Nimodipine is a calcium channel blocker that is also studied for its’ ability to decrease alcohol-type effects from ketamine treatment.[x] Additionally, some providers prescribe Baclofen to help suppress cravings.

But, isn’t ketamine addicting?

Are we just trading alcohol addiction for ketamine addiction? This is not true according to several studies. A study by Krystal, et al in 1998 clearly showed ketamine did not increase cravings on recovering alcohol dependent patients.[xi] Recently detoxified alcoholics given ketamine did not go on to abuse the drug. Keep in mind, ketamine for alcohol abuse is given by trained providers in a medical setting at doses far less than what one may find on the street. The body does not become physically dependent on ketamine, meaning there are no physical withdrawal symptoms when one stops. However, there is always a possibility of mental dependence on a treatment that is helping. But, lets put this in perspective. Many people are dependent, or “addicted”, to a variety of activities, like exercise, weight loss, meditation, because these things reward them, (ie their brain).

Ketamine Infusions Alcoholics

Conclusion

Reducing alcohol dependence and relapse has far reaching benefits from decreased personal injury from liver disease, to depression and anxiety, to family relationships, to work stability, or to alcohol related death from accidents. Once detoxification is complete, ketamine can help people maintain sobriety when used in part with a comprehensive program. Alcoholics Anonymous (AA), psychotherapy, adjuvant medications and physician oversight can all help cut cravings and save lives.


A big thank you to @sdxyln for the headsup on this article!
 
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Bill Wilson, LSD and the Secret Psychedelic History of AA

by Don Lattin | LUCID News | 20 Oct 2020

Taking one mind-altering drug to free oneself from addiction to another mind-altering drug may sound counter-intuitive. But, like with all things psychedelic, this therapeutic approach is all about set and setting, intention and integration, what kind of drugs are consumed, how often and at what dose.

Those who preach that the only way to achieve lasting sobriety is through total abstinence from alcohol and all other drugs may be surprised to learn that the supposed patron saint of abstinence, Bill Wilson, the co-founder of Alcoholics Anonymous, was a firm believer in the ability of LSD to free some hardcore alcoholics from their addiction.

Bill Wilson’s enthusiasm for LSD as a tool in twelve-step work is best expressed in his correspondence in 1961 with the famous Swiss psychologist Carl Jung.

Jung was discussing how he agreed with Wilson that some diehard alcoholics must have a spiritual awakening to overcome their addiction. He pointed out that the Latin word for alcohol is spiritus. “You use the same word for the highest religious experience,” Jung wrote, “as for the most depraving poison.”

That letter of January 30, 1961 — in response to a long letter Wilson wrote to Jung — is fairly famous in AA circles. But in researching my book Distilled Spirits — Getting High, then Sober, with a Famous Writer, a Forgotten Philosopher and a Hopeless Drunk, I discovered a second Wilson letter to Jung. In that letter of March 29, 1961, Wilson writes at length about his experiments using LSD to help members of Alcoholics Anonymous have the spiritual awakening that is central to the twelve-step program of recovery.

“Some of my AA friends and I have taken the material (LSD) frequently and with much benefit,” Wilson told Jung, adding that "the powerful psychedelic drug sparks a great broadening and deepening and heightening of consciousness.”

Wilson told Jung that his first LSD trip in 1956 reminded him of a mystical revelation he had after hitting bottom in the 1930s and winding up in a New York City hospital ward for hardcore alcoholics. “My original spontaneous spiritual experience of twenty-five years before was enacted with wonderful splendor and conviction,” he wrote.

LSD was still legal in 1956, and in Wilson’s case initially taken under the medical supervision of UCLA researcher Sidney Cohen, and with the spiritual guidance of his Wilson’s friend, Gerald Heard, an Anglo-Irish mystic and early proponent of psychedelic spirituality. Wilson would go on to quietly form a bi-coastal psychedelic salon with various leading lights of that decade, including the writer Aldous Huxley.

Wilson’s earlier spiritual experience occurred in December of 1934, before LSD was even invented. It happened during Wilson’s fourth and final stay at a private New York City hospital that employed something called the Towns-Lambert Cure to treat their alcoholic clients. Many of these patients, including Wilson, were once-successful businessmen whose drinking had spun out of control during the Great Depression.

“Suddenly,” Bill would later recall, “my room blazed with an indescribably white light. I was seized with an ecstasy beyond description.”

That room was in a rehab center where doctors employed a potion which included two drugs derived from plants known to cause delirium and hallucinations. One of them is belladonna and the other henbane, was long associated with witchcraft and potions said to summon the spirits of the dead. (Warning to psychonaunts: both of these plants can be poisonous at high doses.)

So there’s a good chance that psychoactive plants played a role in what came to be known as the founding vision of Alcoholics Anonymous, even though the effects of the herbs used at Towns Hospital differ from other psychedelic plants and from the LSD Wilson would begin experimenting with two decades later.

Here’s how Bill W. would later describe his Towns Hospital vision:

“In the mind’s eye, there was a mountain. I stood upon its summit where a great wind blew. A wind, not of air, but of spirit. In great, clean strength it blew right through me. Then came the blazing thought, ‘You are a free man.’ ”

In my view, it doesn’t really matter if Bill’s vision was caused by psychoactive plants, divine revelation, or the hallucinations hardcore drunks sometimes experience when they hit bottom and stop drinking.

What matters is that the vision transformed his life and inspired a crusade to free other alcoholics from addiction.

One of the foundations of the twelve-step recovery program Wilson and company devised in the 1930s is the proposition that alcoholics and other addicts must undergo a “spiritual awakening” inspiring them to “turn our will and our lives over to the care of God as we understand Him.”

Those are the only words in the twelve steps that were printed in italics, indicating an openness in the early AA circles to finding God in the Judeo-Christian tradition, Eastern spirituality or, twenty years later, in a tab of acid. In fact, long before he discovered psychedelics, Wilson was a serious student of paranormal psychology and various forms of spiritualism, holding seances and other gatherings with some of the leading psychics of his time.

In his second letter to Jung, Bill Wilson told Jung that "many members of AA have returned to the churches, almost always with fine results. But some of us have taken less orthodox paths. Along with a number of friends, I find myself among the later.”

Wilson cited the Canadian research of Humphry Osmond, the man who turned Huxley onto mescaline in 1953. Osmond reported that 150 hardcore alcoholics were “preconditioned by LSD and then placed in the surrounding AA groups.”

Over a three-year period, they achieved “startling results” when compared to similar drunks who were not treated with psychedelics, but only got AA.

“My friends believe that LSD temporarily triggers a change in blood chemistry that inhibits or reduces ego thereby enabling more reality to be felt and seen,” Wilson told Jung.

Jung became seriously ill around the time he received Wilson’s second letter. He never answered that missive and he may not have even gotten a chance to read it before he died.

Jung died on June 6, 1961.

Bill Wilson died ten years later from diseases caused by the other addiction he could never shake — cigarettes.

In the end, not much came of Bill Wilson’s idea to introduce LSD into Alcoholics Anonymous. More cautious and conservative elements in the AA fellowship pushed back, questioning their founder’s unbridled enthusiasm for the drug.

In one letter, Wilson asserted that the powerful psychoactive compound was “about as harmless as aspirin.” But in another piece of correspondence, he acknowledged that "LSD does not have any miraculous property of transforming spiritually and emotionally sick people into healthy ones overnight.” Wilson also wrote that those opposing his LSD enthusiasm in AA were joking that “Bill takes one pill to see God and another to quiet his nerves.”

Meanwhile, by the mid-1960s, the notorious LSD evangelism of such counter-cultural icons as Harvard Professor Timothy Leary and Merry Prankster Ken Kesey had begun turning mainstream America against the idea of psychedelic therapy.

In recent decades, psychologists and neuroscientists have resurrected substance abuse research that began in the 1950s and was shut down during the “war on drugs” in the 1970s and 1980s. Clinical trials have, once again, shown the effectiveness of using psychedelic drugs, along with psychotherapy, to treat addiction to alcohol, cocaine and tobacco.

At the same time, there has been an explosion of interest in the ritualized use of ayahuasca, ibogaine and other plant medicines to help those addicted to various drugs of abuse.

In my book Changing Our Minds – Psychedelic Sacraments and the New Psychotherapy, I interviewed addicts, alcoholics, therapists, shamans and scientists doing this work.

Carroll Carlson, an alcoholic treated in a clinical trial at the University of New Mexico, said a vision she had of Jesus during psilocybin-assisted therapy enabled her to “forgive myself for the choices I had made.”

Gordon McGlothlin, a lifelong smoker approaching retirement, kicked his tobacco habit following a psychedelic clinical trial at Johns Hopkins University in Baltimore. Asked how his trip did the trick, he said, “You suddenly understand how your body and the universe are connected…I might want to have a cigarette, but now I know I don’t need it.”

Carson, a heroin addict I interviewed at a treatment center in Mexico and asked that his last name not be used, was treated with two psychedelic medicines — ibogaine and 5-MeO-DMT. Carson, a 31-year-old evangelical Christian from Dallas, said he felt “reborn” after the experience. “Since the ibogaine,” he told me, “the basic craving that I’ve had for opiates is gone for the first time in ten years.”

If this all sounds too good to be true, that’s because it sometimes is. Another heroin addict I interviewed for my book went to this same clinic and quickly relapsed after his miracle cure. He soon realized that he needed an ongoing support group and other lifestyle changes if he was to stay free from addictive thoughts and behaviors.

That’s exactly the point behind an emerging network of alcoholics and other addicts who have slightly rewritten Bill Wilson’s twelve steps and hold Zoom meetings under the banner “Psychedelics in Recovery.

As a recovering alcoholic and cocaine addict, I played a minor role in the formation of that online fellowship. I got sober in 2006, and did so without psychedelics. I tell that story in Distilled Spirits. In 2014, after eight years of taking nothing stronger than a double espresso, I started researching and reporting Changing Our Minds. Over the next few years, as part of that project and to satisfy my own curiously, I cautiously revived my own psychedelic experimentation. As a participant/observer, I explored the therapeutic and spiritual use of magic mushrooms, MDMA, ketamine, ayahuasca and 5-Meo-DMT.

So far, I have not touched alcohol and cocaine — nor have I fallen into the abuse of psychedelics. I still drink too much espresso.

Others have not been so lucky. My work with Psychedelics in Recovery showed me how easy it is for addicts like me to fool ourselves and fall back into addictive, abusive and harmful use of drugs that, in a therapeutic or spiritual setting, might help us at least temporarily dissolve the ego and examine our own self-centeredness.

“Defining our own sobriety” may work for some, but certainly not for all addicts and alcoholics. Honesty, openness and truly knowing ourselves, with the help of a supportive community, seems to be the best route to recovery — with or without a psychedelic assist.

 
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Ketamine helpful in treating Alcohol Use Disorder*

by Eugene Rubin M.D., Ph.D. | Psychology Today | 18 Nov 2020

Multiple studies have demonstrated that a single administration of ketamine can rapidly, but transiently, alleviate depressive symptoms as well as thoughts of suicide. Interestingly, ketamine’s effect may be more potent in depressed individuals with a family history of alcoholism. Can ketamine help individuals with problematic consumption of alcohol who do not exhibit depressive symptoms? Two recent studies addressed this question.

In an article published in the American Journal of Psychiatry, Elias Dakwar and colleagues describe a study utilizing a single 52-minute infusion of ketamine in conjunction with several weeks of motivational enhancement therapy. Individuals with alcohol use disorder who received the ketamine infusion had improved rates of abstinence, prolonged time to relapse, and fewer days of heavy drinking than individuals with alcohol use disorder who received an infusion of midazolam.

During the 21 days following the infusion, 41% of the midazolam group abstained from alcohol compared to 53% in the ketamine-treated group. During the same period, 41% of the midazolam group experienced a heavy drinking day compared to 18% in the ketamine group. (A heavy drinking day was defined as more than four drinks per day for men and more than three drinks for women.) The odds of a heavy drinking day increased with each day post-infusion for the midazolam group but did not change significantly for the ketamine group.

The authors acknowledge that this study is preliminary and has several limitations. The sample was small: 23 individuals were in the midazolam group (six of whom dropped out before the end of the study) and 17 in the ketamine group. The study was also of short duration; longer follow-up would have provided important information about the longer-term effectiveness of ketamine in preventing relapse.

In a second study published in Nature Communications, Ravi Das and colleagues used a single infusion of ketamine to interfere with memory reconsolidation related to drinking cues in a group of young adults (55 men and 35 women) with harmful/hazardous drinking patterns. Individuals with problematic substance use develop learned associations between environmental cues related to the substance and expectations of reward from consumption of the substance. For example, when individuals with histories of problematic drinking see pictures of alcoholic beverages, they recall prior experiences with alcohol and these memories reinforce their urge to drink. These retrieved memories can be modified by administering ketamine during the initiation of the memory retrieval process. This procedure is thought to make these memories less reinforcing.

In the Das et al. study, when ketamine was administered without initiating recall of alcohol-related memories, there was a decrease in alcohol use during the first week after the procedure and at all time points during the 9-month follow-up period. This result is consistent with the results of the Dakwar et al. study discussed above, although subjects in the Das et al. study did not meet the criteria for alcohol use disorder. When ketamine was administered in a manner that interfered with the reconsolidation of alcohol-related memories, the effect of ketamine was substantially larger. These results suggest that ketamine might help decrease the use of alcohol in those with problematic drinking through two different mechanisms.

The knowledge that recalled memories undergo a process of reconsolidation and that reconsolidation is susceptible to modification was gained from preclinical neuroscience research. Therapeutic application of this finding in studies such as those discussed here is an example of translating findings from basic science research into treatments. As more is learned about brain function, more science-based therapies will be discovered.

*From the article here :
 
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Psilocybin touted as Treatment for Alcoholism*

by Kyle Jaeger | 21 Sep 2021

A former Republican congresswoman is touting the therapeutic benefits of psychedelics, sharing the story of how a close family friend was able to recover from alcoholism with the help of psilocybin.

Former Rep. Mimi Walters (R-CA) gave the personal anecdote during a recent interview with Spectrum News. She was discussing a bill that’s temporarily stalled in the state legislature to legalize the possession of a wide range of psychedelics.

“Somebody who’s very close to our family was an alcoholic at the age of 15 years old, and he tried everything he could in order to overcome this disease and he wasn’t successful,” Walters, who also previously served as a California state senator and assemblymember, said. But then the person was invited to participate in a study at NYU “to help him kick his addiction of alcoholism.”

“He went through as one of the participants, actually got the psilocybin treatment and, after the first time he got the treatment, he lost all cravings for drinking,” she said. “This happened about six years ago, and he has not had a craving since.”

Walters left Congress in 2019, just a few months prior to a vote on an amendment meant to promote psychedelics research. That measure has failed both times it’s been introduced, though it garnered more support the last time it was on the floor this July.


A growing body of research has demonstrated that certain psychedelics may be effective in the treatment of conditions such as addiction, severe depression and post-traumatic stress disorder. Media attention to these studies is one of the reasons that National Institute on Drug Abuse Director Nora Volkow believes the U.S. is seeing an increase in psychedelic use among young adults, she told Marijuana Moment in a recent interview.

Oregon voters approved a historic initiative last year to legalize psilocybin for therapeutic use. A state panel charged with advising on the implementation of a legal psilocybin therapy program has cleared a team of researchers to produce a comprehensive report on the science, history and culture of the psychedelic as regulators prepare to license facilities to administer it.

In California, Sen. Scott Wiener’s (D) legislation isn’t singularly about the therapeutic use of psychedelics. Rather, it would broadly remove criminal penalties for possessing numerous psychedelics—including psilocybin mushrooms, DMT, ibogaine, LSD and MDMA—for adults 21 and older.

The bill cleared the Senate and two Assembly committees before being pulled by the sponsor to buy more time to generate support among lawmakers. The plan is to take up the reform during next year’s legislative session.

Wiener said during a psychedelics policy forum this month that it took significant compromise both internally and externally to advance the measure as far as it went, and he also noted that legalizing psychedelics possession is simply a first step toward comprehensively ending the drug war and decriminalizing all currently illicit substances.

The senator has spent significant energy building support for the reform proposal as it has moved through the legislature, including by holding a recent rally with military veterans, law enforcement and health officials.

Meanwhile, California psychedelics activists recently filed a petition for the 2022 ballot to make the state the first in the nation to legalize psilocybin mushrooms for any use. And a fiscal analysis of the proposal found that it would save the state millions in enforcement costs and also generate state and local tax revenue. The state attorney general issued a ballot title and summary for the measure last week, clearing advocates to begin collecting signatures.

The psychedelics effort in the California legislature, which Wiener first previewed back in November, comes as activists are stepping up the push to enact psychedelics reform locally in cities in the states and across the country.

In California, Oakland and Santa Cruz have already enacted psychedelics decriminalization. In Oakland, the first municipality in the U.S. where a city council voted to broadly deprioritize criminalization of entheogenic substances, lawmakers approved a follow-up resolution in December that calls for the policy change to be adopted statewide and for local jurisdictions to be allowed to permit healing ceremonies where people could use psychedelics.

Michigan senators introduced a bill this month to legalize the possession, cultivation and delivery of an array of plant- and fungus-derived psychedelics like psilocybin and mescaline.

Voters in Detroit will decide on a ballot measure to decriminalize psychedelics in November.

The Ann Arbor City Council approved entheogenic decriminalization last year—and in July, local lawmakers passed a resolution to officially designate September as Entheogenic Plants and Fungi Awareness Month. After the local decriminalization resolution passed, a county prosecutor announced that his office will not be pursuing charges over possessing entheogenic plants and fungi—“regardless of the amount at issue.”

Efforts are also underway in Grand Rapids to enact a policy change for the psychedelic substances.

Meanwhile, Denver activists who successfully led a 2019 campaign to make the city the first in the U.S. to decriminalize psilocybin possession have their eyes set on broader reform, with plans in the works to end the criminalization of noncommercial gifting and communal use of the psychedelic.

Massachusetts cities that have enacted the policy change are: Northampton, Somerville and Cambridge. In July, state lawmakers heard testimony about a bill to create a task force charged with studying the implications of legalizing psychedelics like psilocybin and ayahuasca.

The governor of Connecticut recently signed legislation recently that includes language requiring the state to carry out a study into the therapeutic potential of psilocybin mushrooms.

Texas also recently enacted a bill to require the state study the medical benefits of psychedelics for military veterans.

A New York lawmaker introduced a bill in June that would require the state to establish an institute to similarly research the medical value of psychedelics.

The Aspen, Colorado City Council discussed the therapeutic potential of psychedelics like psilocybin and proposals to decriminalize such substances at a meeting in May. But members said, as it stands, enacting a reform would be more better handled at the state level while entheogens remain strictly federally controlled.

Seattle lawmakers also recently sent a letter to members of a local task force focused on the opioid overdose epidemic, imploring the group to investigate the therapeutic potential of psychedelics like ayahuasca and ibogaine in curbing addiction. In response, the task force issued a recommendation for the widespread decriminalization of all drugs. The group said psychedelics in particular could represent a promising treatment to address substance abuse disorders and mental health issues.

Meanwhile, Portland, Oregon activists are mounting a push to have local lawmakers pass a resolution decriminalizing the cultivation, gifting and ceremonial use of a wide range of psychedelics.

In a setback for advocates, the U.S. House of Representatives recently voted against a proposal from Rep. Alexandria Ocasio-Cortez (D-NY) that would have removed a spending bill rider that advocates say has restricted federal funds for research into Schedule I drugs, including psychedelics such as psilocybin, MDMA and ibogaine. However, it picked up considerably more votes this round than when the congresswoman first introduced it in 2019.

Report provisions of separate, House-passed spending legislation also touch on the need to expand cannabis and psychedelics research. The panel urged the National Institute On Drug Abuse (NIDA) to support expanded marijuana studies, for example. It further says that federal health agencies should pursue research into the therapeutic potential of psychedelics for military veterans suffering from a host of mental health conditions.

When it comes to broader drug policy reform, Oregon voters also approved an initiative in November to decriminalize possession of all drugs. This year, the Maine House of Representatives passed a drug decriminalization bill, but it later died in the Senate.

In May, lawmakers in Congress filed the first-ever legislation to federally decriminalize possession of illicit substances.

*From the article here :
 
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LSD Therapy for Alcoholism

by Tom Hatsis on August 04, 2021

Beginning in the late 1950s, five hospitals in the Saskatchewan District of Alberta, Canada, offered a new kind of psychedelic therapy: treating alcoholism with LSD. Duncan Blewett, an Irish psychologist, played “an active role” as an LSD facilitator at Saskatchewan, administering LSD to numerous alcoholics who couldn’t tread the twelve steps. While there, in 1959 he wrote perhaps the world’s first medical manual for using LSD to treat alcoholism, The Handbook for the Therapeutic Use of Lysergic Acid Diethylamide-25: Individual and Group Procedures.

The use of a psychedelic to treat alcoholism actually had its origins in the early 1900s. Anthropologists working in 1907 reported on alcoholics among Native Americans, who had successfully given up the bottle in favor of peyote, the hallucinogenic cactus. Those who had made the transition from whiskey to dry whiskey became “successful, healthy and outstanding members” of their society. Consider the following testimonial: “Peyote cures us of our temporal ills as well as those of spiritual nature. It takes away the desire for strong drink. I myself have been cured of a loathsome disease too horrible to mention. So have hundreds of others.”

Modern clinical work in this area had started with Saskatchewan psychiatrist Dr. Colin Smith who tried to replicate the delirium tremens (DTs) often felt by alcohol withdrawal, which include running high fever, sweating profusely, nightmares, irritability, and hallucinations. Some severe cases can result in death. Smith hoped to “shock alcoholics into full awareness of their degradation and generate a desire to reform,” by using LSD to simulate DTs.

Others caught on quickly. Dr. Humphrey Osmond and Dr. Abram Hoffer both felt that alcoholics were prime candidates for LSD experimentation “because it is often easier to know whether they are improved or not.” Either they stopped drinking or they continued. And so they set out trying to find if LSD could effectively cure the “spiritual disease” of alcoholism. Osmond and Hoffer gave LSD to 500 alcoholics who had failed to sober up after receiving treatment from Alcoholics Anonymous and who had had no luck with traditional psychotherapy.

Psychosis or Gnosis?

Thinking at the time (1954) that LSD and related compounds rested in the psychotomimetic (“madness-mimicking”) family of chemicals, Osmond and Hoffer “conceived the idea that [LSD and mescaline] represented something very similar to delirium tremens — that a good many people who really give up alcohol do so on basis of the fact that they’ve had an attack of D.T.’s and been converted by them. We [thought] it might be a very good idea to give a person an ‘attack’ before he’d been completely destroyed.”

The plan backfired. Instead of experiencing DT, the patients were having “favorable personality changes … even though this was not the purpose of the experiment.” Where they had tried to trigger terror, they instead triggered “illuminating” experiences. Dr. Smith noted the change in alcoholics “resemble the state of religious conversion.” One patient sounded off about their “momentary oneness with God.” The drunks weren’t “scared” straight; quite the contrary, they were actually enjoying the numinous nature of LSD. “Those who have not had the transcendental experience are not changed. They continue to drink,” Hoffer reported at the Josiah Macy Jr. Conference in 1959. “The large proportion of those who had it are changed.”

Follow-up surveys conducted after the LSD treatment revealed surprising results: “roughly half the patients either improved or stopped drinking altogether,” a Saturday Evening Post article stated four years later. So promising was the success rate of recovering alcoholics with LSD therapy that Saskatchewan’s Bureau of Alcoholism called LSD “the most helpful remedy we’ve known.”

Not bad for a chemical that supposedly makes people crazy.


This excerpt is adapted from LSD The Wonder Child: The Golden Age of Psychedelic Research in the 1950s by Tom Hatsis (Park Street Press, 2021).

 
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Ibogaine and the treatment of alcoholism

ICEERS is working with researchers from the University of Sao Paulo, Brazil, to carry out a clinical trial studying the tolerability and efficacy of ibogaine in the treatment of alcoholism. Starting in early 2018, this study is the first in a series of clinical trials to study the efficacy of ibogaine in the treatment of different types of addictions. The study is being led by principal investigator Dr. Rafael Guimaraes dos Santos, along with senior investigator and study co-supervisor Dr. Jaime Hallak, and collaborator Dr. Jose Carlos Bouso, from ICEERS.

About 5% of the world’s adult population has some alcohol-related disorder, which are associated with 3% of all deaths in the world. Currently available medications have some efficacy for treatment, but the adverse effects and relatively long length of treatment are factors that may reduce patients’ motivation to continue taking the medication correctly. Therefore, it is necessary to conduct research with new drugs for the treatment of alcoholism.

Ibogaine is an alkaloid present in the bush Tabernanthe iboga (iboga), a plant from Central Africa traditionally used in countries such as Gabon and Cameroon. This study is using semi-synthesized ibogaine from voacanga africana.

Studies suggest that just one or a few doses of ibogaine significantly reduce withdrawal symptoms and the intensity of use of various drugs, including opioids, psychostimulants, and alcohol. However, until now there have been no controlled clinical studies that have explored these effects, since all studies published until the present are case reports, case series, and open-label studies. Moreover, previous reports described the use of ibogaine mostly in non-medical settings or in private clinics, and setting descriptions were often vague, thus seriously limiting the generalization of the results.

This new study was designed to overcome these limitations. It will evaluate the safety, tolerability and efficacy of increasing doses of ibogaine in 12 alcoholic patients after they have passed their abstinence syndrome in a controlled hospital setting. The setting is the Psychiatric Unit of the Clinics Hospital of the Ribeirao Preto Medical School (HCFMRP), in the University of Sao Paulo (USP), Ribeirao Preto, Brazil. USP is the largest Brazilian public university and one of Latin America’s most prestigious. Furthermore, our study is receiving financial support by some of the most important Brazilian agencies supporting education and research, such as CNPq (National Council for Scientific and Technological Development) and and FAPESP (the Sao Paulo Research Foundation).

Importantly, previous reports used doses ranging from 6 to 29 mg/kg. In our study each patient will be hospitalized for 20 days for safety and tolerability evaluation, and will receive 3 increasing doses of ibogaine. The first 3 of the 12 patients will receive oral doses of 20 to 400 mg of ibogaine in an open-label design. If the 3 higher doses (240, 320 and 400 mg) are well tolerated, the next 9 volunteers will randomly be provided either these doses or placebos in a double-blind design. With this design we will observe the safety and tolerability of increasing doses of ibogaine and its possible efficacy. Volunteers will also be evaluated 7, 14 and 21 days and 1, 3, 6 and 12 months after leaving the hospital to monitor their consumption of alcohol and other drugs. Furthermore, this study will be the first to explore the possible effects of ibogaine on endocannabinoid, brain-derived neurotrophic factor (BDNF), and interleukin plasma levels.

To the best of our knowledge, this seems to be the only ibogaine study using the most rigorous methodology. If we find that ibogaine administered in these doses is safe and effective in reducing alcohol consumption, we are planning further trials with larger sample sizes. Moreover, in parallel to this alcoholism study in Brazil, we are preparing an additional clinical trial that will study ibogaine for the treatment of methadone dependence in Spain. Together, we hope these studies may soon answer our questions regarding the safety and efficacy of ibogaine to treat drug dependence.

http://news.iceers.org/2018/03/new-r...of-alcoholism/
 
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Psilocybin reduces relapses for those with Alcohol Use Disorder

CIMH | Neuroscience News | 23 Nov 2021

Current research results uncover the unknown potential of psilocybin to restore molecular circuits in the brain and thus contribute to a reduction of relapses in alcohol dependence. This could lead to new therapeutic approaches.

Alcohol dependence is one of the most common neuropsychiatric diseases. In Germany, more than five million people are affected. The consequences are often severe physical and mental suffering and a high mortality rate. The average life expectancy of those affected is reduced by more than 22 years.

Despite the severity of the disease, whose chronic course is characterized by frequently recurring relapses into excessive alcohol consumption and great suffering pressure for those affected, we still know little about the causal mechanisms in the brain.

Cortical mGluR2 deficit as a pathological molecular mechanism of altered behavior in addiction

Mental processes that control behavior, attention and emotions are known as executive functions. In many psychiatric diseases, the ability to control one’s own thoughts and actions and to regulate emotions are disturbed, for example in attention deficit hyperactivity disorder (ADHD), autism, schizophrenia, borderline syndrome and also in addiction.

In a multidisciplinary, international collaboration led by Dr. Marcus Meinhardt, Prof. Dr. Rainer Spanagel and Prof. Dr. Wolfgang Sommer (all at the Central Institute of Mental Health in Mannheim), the molecular mechanism of altered executive functions and increased relapses in alcohol dependence have been investigated.

The research focuses on the role of the metabotropic glutamate receptor 2 (mGluR2). In the brain, this receptor works as an antenna for the neurotransmitter-glutamate and regulates its release in various brain areas.

In their current work, which has now been published in the journal Science Advances, the research team shows a causal link between a reduced mGluR2 function within the brain region of the prefrontal cortex in alcohol-dependent rodents and an impaired executive control as well as craving for alcohol. mGluR2 activation has thus been identified as a potential therapeutic mechanism in alcohol dependence.

Psilocybin restores the production of mGluR2

Hallucinogenic substances such as psilocybin—the active ingredient in the so-called magic mushrooms—or LSD act on serotonin 2A receptors (5-HT2AR) in the brain. These receptors are present in large numbers in the prefrontal cortex.

Previous research has shown that 5-HT2AR and mGluR2 can form a functional complex. This complex has been linked to the mechanism of action of psychedelics, but the molecular functions of this complex in addiction were previously unknown.

“We were able to show that psilocybin can restore mGluR2 levels which leads to a reduction in relapses to alcohol,” says Marcus Meinhardt. "Thus, this research opens up the possibility of developing new therapeutic approaches that focus on psilocybin as a driver of mGluR2."

Original Research: Open access.
Psilocybin targets a common molecular mechanism for cognitive impairment and increased craving in alcoholism” by Marcus W. Meinhardt et al. Science Advances
 
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Non-hallucinogenic DMT? Psilera Bioscience reports progress on ‘well-tolerated’ derivative

Further in vivo studies with PSIL-002 will evaluate its antidepressant, anxiolytic, and anti-addictive properties, specifically targeting alcohol consumption.

by Emily Jarvie | PSYCHEDELIC SPOTLIGHT | 9 Dec 2021​

Florida-based biotechnology company Psilera Bioscience believes it has created a safe and well-tolerated DMT derivative that maintains the psychedelic’s mood benefits while reducing hallucinations.

Results from the company’s in vivo preclinical study show the derivative, PSIL-002, achieved these benefits with no hallucinogenic effects at all administered dosages between 0.5mg/kg to 100mg/kg in mice.

The study used a head-twitch-response (HTR), which is a well-established and widely used method of assessing hallucinogenic effects in animals, to evaluate PSIL-002. A HTR is a rapid side-to-side rotational head movement that occurs in rats and mice after the administration of hallucinogens and other 5-HT2A agonists. This method is used in preclinical studies because there is evidence that HTR potencies in mice are correlated with hallucinogenic potencies in humans, meaning it can be a useful indicator as to whether a compound is likely to display hallucinogenic activity in humans.

Compared to the positive control, a psilocybin mimic called psilacetin, no dose of PSIL-002 induced a HTR. “Other psychedelics like psilocybin and DMT often produce the HTR at doses from 1mg/kg to 10mg/kg, or as low as 0.05mg/kg to 0.1mg/kg for LSD, further demonstrating the non-hallucinogenic potential of PSIL-002 and broader range for therapeutic dosing,” Psilera Bioscience explained.

There are several advantages of reducing the hallucinogenic effects of psychedelics such as DMT, for example, the development of therapeutics that can be administered outside of a clinical setting, such as medications that can be self-administered.

“Compounds like PSIL-002 have the potential to reach new patient populations in need with greater access than current models, especially for those suffering from conditions where hallucinations may be undesirable,” explained Psilera Bioscience CEO and Co-Founder Dr. Chris Witowski. “This biological data is key to our vision of reducing side effects such as hallucinations while further optimizing classical psychedelics into next-generation drugs.”

The company now plans to conduct further in vivo studies with PSIL-002 to evaluate its antidepressant, anxiolytic, and anti-addictive properties, specifically targeting alcohol consumption.

PSIL-002 is part of Psilera Bioscience’s patent-pending new chemical entity (NCE) library, all of which are compounds designed to maintain the positive effects of current psychedelics while eliminating hallucinations and other adverse effects such as cardiotoxicity. “New formulations tailoring the therapeutic effects of DMT will improve treatment scalability and patient compliance, further expanding addressable markets,” Psilera Bioscience said.

The company has selected its NCEs with the help of its proprietary BRAIN technology platform, which can be used to identify new compounds that may have a therapeutic effect on mood, cognitive, and substance-use disorders. This platform virtually screens and filers compounds for their psychedelic potential at multiple receptors, specifically the 5-HT2A receptor.

 
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MDMA proves a promising alcoholism treatment in world-first trial

by Rich Haridy | NEW ATLAS | 21 Feb 2021

A new study published in the Journal of Psychopharmacology is reporting on a landmark clinical trial exploring the potential for MDMA-assisted psychotherapy in treating subjects with alcohol use disorder. The small open-label trial is the first to test MDMA therapy as a treatment for addiction and the results suggest it is safe, well-tolerated and significantly more effective than any current treatment for alcoholism.

3,4-Methylenedioxymethamphetamine, or MDMA, was originally synthesized in Germany in 1912 but spent much of the 20th century as an unexplored footnote in chemistry journals. The drug was rediscovered by psychonauts in the 1960s, and psychotherapists quietly explored its therapeutic potential before its use spiraled into recreational circles, eventually becoming illegal in the early 1980s.

Over the past few decades, a small community of dedicated researchers has worked to legitimize the drug and re-establish its medical uses. Leading the way has been robust work showing the drug to be significantly effective treating PTSD. Now deep in Phase 3 clinical trials, MDMA-assisted psychotherapy for PTSD is just a year or two away from market approval in the United States.

For the last few years psychiatrist Ben Sessa and a team of UK researchers have been exploring the role of MDMA therapy in treating alcohol use disorder (AUD). In a newly published study the researchers report on the world’s first trial testing the novel treatment on patients suffering from addiction.

This small, proof-of-concept study recruited 14 subjects with AUD. The goal of this preliminary study was to establish a safety profile for the MDMA therapy in patients suffering from AUD, but an expansive nine-month follow-up period also allowed for a unique insight into the possible long-term efficacy of the treatment.

The trial used a protocol similar to that being explored by MDMA for PTSD research. The course of treatment spans eight weeks and comprises 10 psychotherapy sessions. Two of those sessions involve day-long MDMA treatments, while the other sessions are more traditional one-hour psychotherapy appointments.

In regards to tolerability and safety, the study reports no adverse responses to the drug were detected either during a treatment session or in the days following. In a fascinating side note, the study followed each subject’s acute mood state for seven days after each MDMA session.

Recreational MDMA users have for years frequently reported negative mood swings around two to three days after using the drug. Anecdotally referred to as "Terrible Tuesdays," pseudoscientific explanations have often suggested some kind of serotonin depletion can take hold in the days following MDMA use, causing a unique kind of depressive hangover.

The new research specifically addresses this anecdotal phenomenon and suggests when MDMA is delivered through a clinical therapeutic program this anecdotal post-drug hangover is not detected. Sessa hypothesizes this common recreational observation is more due to polydrug use and other confounding factors instead of the MDMA itself.

“No come-downs or post-drug affect drops for 7-days post MDMA,” Sessa notes on Twitter. “Blue Monday/Black Tuesday/so-called ‘Suicide Wednesday’ reported by ravers are myths due to confounding hangover factors; not MDMA.”

Although the primary goal of the trial was to understand safety issues with the MDMA therapy in AUD patients, the extensive follow-up period allowed for some compelling insights into how long-term drinking behaviors were affected.

Nine months after the trial only 21 percent of the cohort were drinking more than 14 units of alcohol per week. This compares to an average of 130 units of alcohol consumed per week by each patient before detox at the beginning of the study.

As this was not a placebo-controlled trial, the researchers did conduct a small adjacent study to look at how MDMA therapy compares to current gold-standard treatments for AUD.

Fourteen subjects were recruited and tracked for nine months following detox for this adjacent outcome study. A striking 75 percent were consuming more than 14 units of alcohol per week at the nine-month follow-up point. This data resembles the generally poor long-term outcomes for current AUD treatments, which register drinking relapse rates at around 60 percent one year after treatment and 80 percent three years later.
BIMA worked. Compared to the very best gold standard treatments modern medicine can offer alcoholics, open-label MDMA therapy if far superior at reducing drinking for 9-months post detox.
— Dr Ben Sessa MBBS (MD) BSc MRCPsych (@BenSessa) February 20, 2021

It is important to note this is still very preliminary research. A larger Phase 2b placebo-controlled trial run by burgeoning psychedelic biotech company Awakn Life Sciences is getting underway in the United Kingdom to more comprehensively explore the efficacy of MDMA therapy for AUD. Sessa, chief medical officer for Awakn, suggests this stage should take around three years.

In the meantime, prospective clinics around the world are preparing for MDMA/PTSD treatments to be approved, establishing the infrastructure necessary to administer multiple forms of psychedelic therapies for a variety of conditions, including psilocybin for depression. MDMA therapy for alcoholism may still be a few years away from clear clinical validation, but this proof-of-concept trial is as strong a first study as one could hope for.

The new research was published in the Journal of Psychopharmacology.

Source: Awakn Life Sciences
 
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Brain damage from alcohol may be reversed by using magic mushrooms, study

by Karla Tafra | Heling Maps | 30 Dec 2021

Can magic mushrooms really reverse brain damage from alcohol? Per a new study, there may be a connection between magic mushrooms and the part of the brain controlling alcohol cravings. This only increases optimism that the psychedelic may produce positive effects.

We highlight what this means in the present and future for those struggling with chronic brain damage from alcohol.

What are magic mushrooms?

The active psychedelic ingredient that makes magic mushrooms so magical is psilocybin. Researchers continue to study its therapeutic potential. In fact, there’s support claiming it helps everything from anxiety and depression to addiction and PTSD.

This occurs by binding to the receptors of serotonin — the so-called happiness hormone. By doing so, it creates an outstanding effect, improving mood, relieving feelings of anxiety, and helping let go of trauma.

With tobacco addiction, studies show that the cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies. This really is incredible news, as it showcases the potential alternative way of weaning off drugs to current medication.

Psilocybin is the first among psychedelics to actually become decriminalized in certain U.S. states, with approved therapies for treatment-resistant depression. They need to be performed under strict guidelines, but these treatments pave the way for the further use of psychedelics in the medical field.

What is alcoholism?

Also known as Alcohol Use Disorder (AUD), alcoholism is a mental health disorder which occurs when excessive drinking leads to distress and harm. Symptoms range from mild to severe, with the disorder gradually worsening without any treatment.

AUD usually shows up as strong alcohol cravings which lead to a complete loss of control combined with a negative and anxious emotional state when being deprived of a drink. Most people develop a high tolerance level for booze, which, long-term, may cause brain damage from alcohol.

The problem usually develops throughout the day as the drinks pile on, and the alcohol content in their bloodstream increases. The connection between alcoholism and violence is pretty strong too, as scientists repeatedly showcase the dangers. And it seems to be a two-way street: Alcohol consumption may promote aggressiveness, but victimization may lead to excessive alcohol consumption.

This often shows up with those battling AUD, and it’s one of the symptoms that’s not only dangerous and harmful for them, but for the ones living with them and interacting with them on the daily as well.

How does brain damage from alcohol occur?

Alcohol affects the body very quickly. It enters the bloodstream through the lining of the stomach and spreads to all cells and tissue. Effects of alcohol typically begin within 10 minutes.

Alcohol is metabolized through the liver. On average, it can process one ounce every hour. Intoxication occurs when your liver simply cannot process the amount of alcohol in your system, and excessive drinking overtime lowers its function, leading to disease.

The most common diseases include the following.​
  • Fatty Liver. Also known as hepatic steatosis, it shows up as excessive buildup of fat in the liver which makes it larger and inflamed. This is typically the earliest stage of alcohol-related liver disease.​
  • Alcoholic Hepatitis. Severe inflammation of the liver which makes it swell, destroying and killing liver cells. Although ranging from moderate to severe, hepatitis can be a life-threatening disease if left untreated.​
  • Cirrhosis. The late stage of scarring (fibrosis) of the liver which destroys cells and leads to loss of functionality. It’s an extremely serious condition which can lead to fatal liver failure or liver cancer.​
Brain damage from alcohol might be secondary, but it’s much more serious.

Alcohol interferes with the brain’s communication pathways, making your reaction time slower, as well as affecting your memory, coordination, and the way you process information. It also stimulates euphoria and excitement, which can lead to confusion, violence, inability to control your body, and in severe cases stupor, coma, and even death.

Long-term, heavy drinking can cause severe alterations in the neurons, even reducing them in their size. It can also lead to blackouts. These gaps in a person’s memory prevent the transferring of memories from short-term to long-term storage (memory consolidation).

How magic mushrooms may impact brain damage from alcohol

This new study from the journal Science Advances shows the connection between psilocybin and alcoholism and how they interact in the brain. Using rats, the study focuses on the “mGluR2” glutamate receptor in the brain — which excessive alcohol use damages.

After intoxicating them to induce brain damage from alcohol, the rats were split into three groups. One received a low dose of psilocybin, the other a high dose, and the third was the control group.

Both groups given psilocybin had their mGluR2 glutamate receptor regenerated. This led to a severe reduction of further addictive behavior. It also creates optimism that future studies in humans will produce similar results.

Both Mydecine and Johns Hopkins University are currently working together on research into psychedelic therapies and addiction. Their focus is on cigarette cessation in tobacco smokers, but with this new study coming into light, the researchers are hoping alcohol is the next in line.

Studies for psychedelics to treat mental health disorders continue. As research and funding becomes more available, studies may mirror the above relating to brain damage from alcohol.

This study is just one of the latest which emerged with such amazing results, all building a case for the approval of their use as alternative treatment methods in those disorders and illnesses which leave many people feeling helpless.

Today’s approved treatments for addiction, anxiety, depression, PTSD, eating disorders, and other mental health issues, aren’t always working. In case, the majority of people don’t seem to find them helpful. Psychedelics could really be the non-invasive solution everyone is hoping for.

 
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Ketamine trial for Alcohol Use Disorder delivers promising results

by Travis Reilly | PSYCHESELIC SPOTLIGHT | 22 Jan 2022

Awakn Life Sciences' Head of Ketamine-Assisted Therapy, Professor Celia Morgan, says world’s first controlled trial to investigate efficacy of ketamine-assisted therapy for treatment of Alcohol Use Disorder "paves the way for a paradigm shift."​

Ketamine-assisted therapy may soon offer new hope for the hundreds of millions across the globe affected by alcohol addiction.

Awakn Life Sciences has announced very promising results from the world’s first controlled trial to investigate the efficacy of ketamine-assisted therapy for the treatment of Alcohol Use Disorder (AUD).

Published in the American Journal of Psychiatry, the double-blind, placebo-controlled Phase II trial demonstrated that AUD patients receiving low doses of ketamine combined with proprietary, manualized therapy (KARE) were considerably more likely than control groups to achieve alcohol abstinence and far less likely to relapse by the six month mark. Perhaps more importantly, those receiving the ketamine-assisted therapy were also 90 percent less likely to die in the following year.

The biotechnology company also reported no serious adverse effects.

The trial consisted of 96 patients with severe AUD who were randomly split into four groups. The first received three ketamine infusions (0.8 mg/kg IV over 40 minutes) and KARE therapy. The second a received the placebo—three saline infusions—and KARE therapy. The third received ketamine infusions and alcohol education. The fourth received the placebo along with alcohol education.

The first group reportedly achieved total abstinence in 162 of 180 days in the six-month period following the treatment—an improvement from 2 percent to 86 percent. Additionally, the risk of relapse at six months for the ketamine plus KARE group was 2.7 times less than it was for the group receiving the placebo with alcohol education.

Both groups receiving KARE therapy experienced significant decreases in the risk of mortality. According to the findings, 1 in 8 patients would have died within 12 months without the psychedelic treatment while the number decreased to 1 in 80 for those receiving it.

The study also produced multiple encouraging secondary outcomes, ranging from improved liver function in patients and a statistically significant decrease in depression to an increase in the ability to experience pleasure.

Conducted by England’s University of Exeter and led by psychopharmacology professor (and Awakn’s Head of Ketamine-Assisted Therapy for Addiction) Celia Morgan, the positive Phase II trial paves the way for a Phase III trial in service of eventually securing regulatory approval for ketamine-assisted therapy to treat AUD via the United Kingdom’s National Health Service.

“Alcohol Use Disorder is a pervasive and persistent public health issue, affecting at least 390 million people globally. Treatment rates are low and relapse rates post treatment tend to be high. We urgently need new and more effective treatments,” Professor Morgan said in a statement. “We found that controlled, low doses of ketamine combined with manualized psychological therapy can significantly increase post-treatment abstinence rates. This is extremely encouraging, as we normally see three out of four people returning to heavy drinking within 12 months of treatment. The data we’ve collected from this study paves the way for a paradigm shift in how AUD is treated.”

Awakn’s Chief Executive Anthony Tennyson added, “We will continue to support this research and future clinical trials as we push to bring a radical shift in the alcohol addiction treatment industry.”

While Awakn’s clinical trial is the first to link psychedelic therapy to improved AUD outcomes, it’s hardly the first credible study to extol the healing properties of ketamine-assisted therapy. In 2021, ketamine treatments were hailed as an effective antidepressant during the COVID-19 pandemic while investigations were launched into whether the dissociative medicine can help treat neurological conditions ranging from ALS to Parkinson’s Disease. Just last month, a comprehensive review of 83 published research papers found ketamine therapy rapidly reduced depression for up to two weeks and moderately reduced suicidal ideations as quickly as four hours after treatment.

*From the article here :

 
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Ketamine + Therapy help severe alcoholics abstain for longer

University of Exeter | Neuroscience | 11 Jan 2022

Combining psychological therapy with ketamine treatments resulted in longer periods of abstinence for those with severe alcohol use disorder, a new study reports.

People with severe alcohol disorder were able to stay off alcohol for longer when they were treated with low doses of ketamine combined with psychological therapy in a clinical trial.

The Ketamine for reduction of Alcohol Relapse (KARE) trial was led by the University of Exeter and funded by the Medical Research Council.

The phase II trial is the first of its kind to examine whether a low dose of ketamine could help prevent people from quickly returning to heavy drinking after stopping, when combined with therapy.

A biotech company AWAKN Life Sciences has licensed the therapy from University of Exeter to use in their clinics and partnerships. University of Exeter and Awakn have also signed an agreement with Devon Partnership NHS Trust to explore NHS readiness for ketamine-assisted psychotherapy.

The trial followed preliminary evidence that controlled ketamine therapy can reduce the numbers of alcoholics who relapse. Currently, few effective treatments exist for severe alcoholism, which has a devastating impact on lives. The KARE trial was the first trial to compare ketamine with and without therapy in any mental health context.

Published in The American Journal of Psychiatry, the study included 96 people with alcohol problems who were abstinent at the time of the trial. The team found that people who had ketamine combined with therapy stayed completely sober for 162 of 180 days in the six month follow-up period, representing 87 percent abstinence. This was significantly higher than any of the other groups, indicating that the therapy may also have promise for preventing relapse. This group was more than 2.5 times more likely to stay completely abstinent at the end of the trial than those on placebo.

The team also found some evidence that ketamine and therapy may prevent any drinking over six months, though the results were more mixed. Patients having ketamine also had lower depression after three months, and better liver function than those on placebo, regardless of whether it was combined with therapy or not.

Lead author Professor Celia Morgan, of the University of Exeter, said: “Alcoholism can destroy lives, and we urgently need new ways to help people cut down. We found that controlled, low doses of ketamine combined with psychological therapy can help people stay off alcohol for longer than placebo. This is extremely encouraging, as we normally see three out of every four people returning to heavy drinking within six months of quitting alcohol, so this result represents a great improvement.”

Before the trial, participants were drinking every day, consuming the equivalent of 50 pints of strong beer on average per week (125 units). Participants given ketamine and therapy drank over the recommended guidelines on just five days in total over the six month trial period on average. This represents cutting the risk of death from alcohol-related problems from one in eight, to one in 80.

Professor Morgan said: “The number of alcohol-related deaths has doubled since the pandemic begun, meaning new treatments are needed more urgently than ever. Previously, there were some concerns about using ketamine in alcoholics due to liver problems, but this study has shown that ketamine is safe and well-tolerated in clinical conditions. In fact, we found liver function improved in the ketamine group due to them drinking much less alcohol."

“This was a phase II clinical trial, meaning it’s conducted in people primarily to test how the safety and feasibility of the treatment. We now have an early signal this treatment is effective. We now need a bigger trial to see if we can confirm these effects.

“We’re certainly not advocating taking ketamine outside of a clinical context. Street drugs come with obvious risks, and it’s the combination of a low dose of ketamine and the right psychological therapy that is key, as is the expertise and support of clinical staff. This combination showed benefits still seen six months later, in a group of people for whom many existing treatments just don’t work.”

Professor Anne Lingford-Hughes, of Imperial College London, is a co-author on the study. She said: “The KARE trial is a significant step towards investigating a new approach to meet the immense unmet treatment need associated with alcoholism. The trial shows that ketamine therapy may be one way we’re able to reverse alcohol-related harms experienced by so many.”

Research on the experiences of 12 KARE trial participants were previously published in a separate paper, published in Frontiers in Psychiatry, in which researchers conducted detailed interviews.

Lead author Merve Mollaahmetoglu, of the University of Exeter, said: “The experiences people describe after taking ketamine infusions suggest the drug gives a new perspective that may be helpful in psychological therapy. Ketamine induces a sense of being outside of your body that some say can stimulate an ‘observer state’ similar to that described in mindfulness, which may help patients take a step back, and consider thoughts and emotions. Participants told us this experience helped change their relationship with alcohol.”

For one of the participants in the trial interviewed, thinking less about their own problems and feeling more connected with the world around seemed to affect their relationship with alcohol:

“The sense of oneness that I felt and the sense of moving away from focusing on the worries and the small stuff is helpful in terms of improving my relationship with alcohol. Because I think I used alcohol as a self-medication and as a blocking and avoiding mechanism. And I think feeling that those issues are less prevalent or at least less important means I feel less motivated to drink.”

Many of the participants saw the combination of ketamine and therapy as a beneficial combination.

One interviewee said: “Not only did I get a life changing and mind-altering experience, but then the therapist did plug some new thoughts to me that made me think differently. I feel that it is really important that when you are split open, you know, in such an intense and life changing way that you are given new thoughts and you know that someone gives you something to refill that, so you do change stuff.”

Anthony Tennyson is Chief Executive of AWAKN, a biotechnology company developing and delivering psychedelic therapeutics (medicines and therapies) to treat addiction, which has acquired the rights to the research.

He said “We are so pleased to see such encouraging results in an area of treatment that has been stagnant for so long, leaving so many people with little or sub-par options available to them. With Ketamine being a licensed medicine, it means we can deliver this treatment now in our clinics and through partnerships, which is a radical shift in the alcohol addiction treatment industry.”

Patrick Chinnery as MRC Clinical Director said: “Additional research is still needed, but it is promising that MRC funding for this study has facilitated these early results, which could lead to new ways to treat addiction. Funding this type of clinical neuroscience research, in humans, is important as it will help us improve our understanding of addiction and find more effective therapies that could prevent relapse.”

The study was led by the University of Exeter in collaboration with Imperial College London and University College London.

*From the article here :
 
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Can Psychedelics treat Alcohol Use Disorder?*

by Sophie Saint Thomas & Medical Editor: Dr. Benjamin Malcolm, PharmD, MPH, BCPP | Psychable

It may sound counterintuitive to treat alcoholism or alcohol use disorders with other substances. However, as our understanding of addiction, alcoholism, and psychedelics evolve, many medical professionals and persons affected by addiction are realizing that psychedelics have serious therapeutic potential in treating addictive disorders. According to the book Distilled Spirits by Don Latti, even Bill Wilson, the founder of Alcoholics Anonymous, reportedly used LSD to maintain his sobriety from alcohol. Some psychedelics, such as LSD and psilocybin, may be able to reduce the desire to drink after a single dose, although modern research has focused on giving 2-3 doses within a greater addiction psychotherapy and recovery program. Here’s what you need to know about overcoming alcohol addiction with psychedelics.

What are psychedelics and psychedelic-assisted psychotherapy?

Psychedelics are psychoactive substances that alter perception and induce non-ordinary states of consciousness. When used responsibly and under the direction of a therapist, risks of use are reduced and can result in positive life-changing events. Evidence suggests that unlike alcohol, psychedelics like psilocybin and LSD do not lead to dependence. In fact, they may help people recover from alcohol addiction.

Psychedelic-assisted psychotherapy is the embedding of supervised psychedelic sessions within larger psychotherapy interventions. While psychotherapy on its own can be helpful for some, it works modestly over time for most. Adding a psychedelic experience can expedite healing and is likely most helpful when used within a greater intervention promoting therapy and addiction recovery. In other words, psychedelics can assist in recovering from addiction, however are not ‘magic bullets’.

Do psychedelic drugs work for alcohol addiction?

Research conducted between the 1950s and 1970s on over 40,000 people suggests that psychedelics, in particular, LSD, can help alcoholics stop drinking. In six clinical trials between 1966 and 1970 doctors gave patients LSD once as a part of therapeutic treatment for alcohol abuse. The results found that 81 to 100 percent of the patients abstained from alcohol at the first follow-up. Six months later, participants were 15% more likely to remain abstinent from alcohol than those who did not take the psychedelic. A recent survey in which 343 people with alcohol use disorder took either LSD or psilocybin outside a clinical setting found that 83 percent no longer met clinical criteria for alcohol use disorder within three months of their psychedelic experience.

More recent pilot studies in clinical settings have found significant reductions in problematic alcohol use among trial participants. In these studies, a number of doses of psilocybin or MDMA have been used in conjunction with psychotherapy aimed at addiction recovery. These studies highlight that persons may have improved outcomes when they undergo a number of psychedelic sessions and couple their experiences with traditional therapy approaches for addiction recovery. One 2019 study suggests MDMA is well-tolerated for treating alcohol abuse disorder and plans to expand research. At the moment the science is somewhat limited, although these preliminary studies along with older clinical trials and survey reports of benefit strongly suggest significant therapeutic potential.

Another promising psychedelic in addiction research is ibogaine. Many report independently that after taking ibogaine just once, their alcohol cravings stopped. A 2016 study using rodents found that ibogaine reduced the self-administration of cocaine, opioids, and alcohol. However, unlike other psychedelics, ibogaine can have serious side effects such as cardiac toxicity or fatal arrhythmias.

How do psychedelics interact with traditional addiction recovery models?

Psychedelics don’t just treat addiction, but they treat addiction differently than traditional 12-step models. While historically, the 12-step model discourages substance use of any kind, many recovery groups are changing with the culture and laws. For instance, many AA groups agree that if a drug is prescribed by a doctor, then it’s okay. While this came as welcome news to medical marijuana patients, it still presents challenges for those seeking psychedelic therapy for addiction. That doesn’t mean that the two can’t co-exist. The 1st step in AA asks you to give yourself up to a higher power, which is compatible with the mystical experiences people report in studies of psilocybin-assisted therapy. Often, a cohesive approach with both medicine and a recovery program or therapy proves most useful.

Do psychedelics help manage alcohol withdrawal?

Psychedelic-assisted psychotherapies may be helpful in understanding the motivations, desires, and traumas that cause a person to drink alcohol. They may also have effects that are able to modulate brain function in a way that diminishes the craving to drink alcohol. However, psychedelics are not effective for the management of acute alcohol withdrawal, which can be characterized by seizures or delirium tremens in severe cases. Therefore, persons seeking treatment for alcohol use disorder with psychedelic therapies should not expect the therapy to provide management of acute withdrawal and manage detoxification separately.

*From the article here :
 
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Ibogaine shown to reverse Alcohol Addiction*

UCSF | Science Daily

Researchers using rodent models have found the controversial drug ibogaine reverses alcohol addiction by increasing the level of the protein GDNF (glial cell line-derived neurotrophic factor) in the ventral tegmental area of the brain.

Ibogaine, which is extracted from a West African shrub, has been shown to reverse addiction to alcohol and some drugs, but potentially serious side effects have prevented its widespread acceptance.

In a paper published in The Journal of Neuroscience, investigators at UCSF showed that ibogaine acted specifically on the ventral tegmental area of the brain. After injecting the drug into the brains of rats, the investigators found that loss of craving for alcohol was accompanied by an increase in the level of GDNF expressed by cells in the ventral tegmental area. Treating the animals with specific antibodies to prevent GDNF expression reversed the anti-addictive action of ibogaine, and direct injection of GDNF prevented addiction in the same manner as injection of ibogaine.

"By identifying the brain protein that ibogaine regulates to reduce alcohol consumption in rats, we have established a link between GDNF and reversal of addiction--knowledge of a molecular mechanism that should allow development of a new class of drugs to treat addiction without ibogaine's side effects," said senior author Dr. Dorit Ron, associate professor of neurology at the University of San Francisco. "If we can alter the GDNF pathway, we may well have a new treatment against alcohol and drug addiction, without the unwanted side effects of ibogaine."

*From the article here :
 
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Ketamine could treat Alcohol Use Disorder, study*

by Lauren Wilson | LUCID | 28 Feb 2022

The psychedelic renaissance has ushered in new hope for the treatment of a variety of substance use disorders. A recent phase two clinical trial conducted by researchers at University of Exeter examined ketamine coupled with psychotherapy as a treatment option for alcohol use disorder (AUD), finding further evidence to support the efficacy of psychedelics for treating substance abuse.

Ketamine has several possible mechanisms of action that may work well within the context of substance use treatments, including the enhancement of neurogenesis and synaptogenesis, the disruption of functional neural networks, blocking the reconsolidation of substance-related memories, and provoking mystical experiences.

Dr. Lawn and researchers at University of Exeter set out to further investigate the use of ketamine plus psychotherapy as a relapse prevention treatment for alcohol use disorder. Dubbed the “K.A.R.E. trial” (ketamine for reduction of alcoholic relapse), the team carried out a double-blind placebo controlled phase two clinical trial across two locations in Exeter and London.

According to Dr. Lawn, the significant burden of disease both in the U.K. and globally was a driving rationale for the trial. Globally, the World Health Organization (WHO) estimates that AUD impacts 8.6% of men and 1.7% of women, accounting for about 5% of the burden of disease and injury worldwide.

Alcohol use disorder impacted 14.5 million people in the United States in 2019 and, according to epidemiological surveys, as many as 30% of Americans will qualify for the general DSM-5 definition of AUD at some point in their lives. In the United Kingdom, there were 8,974 deaths related to alcohol-specific causes in 2020, more alcohol-related deaths than in any of the previous 20 years.

The first weeks following detoxification are particularly high-risk for relapse, and so another rationale for the trial was to investigate the effectiveness of psychotherapy in conjunction with ketamine—an area with relatively little empirical data as yet.

“If you’re dependent on a substance and you’re stuck in a rut, then having the flexibility to move yourself out of that rut may well be a helpful effect of ketamine,” Lawn told Lucid News.

The trial, which was funded by the Medical Research Council, included 96 participants (61 men and 35 women), all of whom had achieved abstinence before the trial began. Its design, which utilized input from Dr. Krupitsky, included four arms: ketamine infusions plus psychotherapy, ketamine infusions plus alcohol education (as placebo for the psychotherapy), saline infusions (as placebo for ketamine) plus psychotherapy, and saline infusions plus alcohol education.

Participants were invited to attend 10 study visits, including three intravenous ketamine infusion sessions administered one to three weeks apart. Each ketamine session was immediately preceded by one and a half hours of therapy or education, and followed by another session 24 hours later. The therapy included a combination of modalities, including cognitive behavioral therapy (CBT) approaches coupled with mindfulness-based relapse prevention (MBRP).

Published online in the American Journal of Psychiatry in January 2022, results from the study were in line with what the team hypothesized. There was a significantly greater percentage of days abstinent at the 6-month follow up in the ketamine groups as compared with the saline placebo groups.

The group who received ketamine plus psychotherapy had an average of 86% days abstinent at the six month follow-up, while the ketamine plus education group had an average of 83% days abstinent. In comparison, the saline plus therapy group had an average of 76% days abstinent while the saline plus education had an average of 69%.

While the difference between the ketamine plus therapy and placebo plus education groups was not large, according to Lawn they are “statistically significantly different and that, therefore, merits attention and more research. We need to unpack this further.”

Though more recent studies have shown that the active placebo midazolam does not have unintended therapeutic consequences, this study elected to use an inactive saline infusion as placebo and recognizes it as a limitation of the trial. Blinding psychedelics in clinical trials is an ongoing challenge.

Psychedelic medicines offer novel and paradigm shifting treatment options in AUD and across many other conditions, but a lot of the heavy lifting is left to the individual’s personal work. This is where integration and supportive care comes into the picture, suggested Lawn. “Ketamine is not a silver bullet and it never will be. I would like to see a study powered to really detect the interaction between ketamine and therapy.”

According to Lawn, Dr. Celia Morgan, who heads up the K.A.R.E. center at Exeter and was not available for comment, is already planning for an expanded phase three trial to replicate these findings.

After the phase two K.A.R.E. trial was completed, Dr. Morgan and the University of Exeter agreed to license the trial’s treatment model to Awakn Life Sciences, Inc., a private clinical-biotech company. Awakn opened the U.K.’s first ketamine-assisted clinic in Bristol last year, where it charges £6,000 for a course of treatment. Awakn will also, pending regulatory approval, help fund the phase three K.A.R.E. trial.

And while ketamine therapy is only available privately at present, Dr. Morgan and her team are working with the National Health Service in an attempt to make it more available through public health services.

“What’s really exciting about ketamine, and obviously you’re seeing this in the United States, is that it’s already a legal medicine that is commonly used in human anesthetics,” said Lawn. “Anesthesiologists are very comfortable administering it.”

This means, especially when compared to emerging psychedelic therapies like MDMA and psilocybin, that ketamine is already feasible and scalable. “It is deliverable, feasible and scalable—and that’s exciting.”

 
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Is microdosing psychedelics the secret to sobriety?

by Iana Lecklitner | MEL Magazine

Maybe, but the friends you make along the way are the real motivation for change

Addiction treatments have come a hell of a long way. In the 1850s, there were “inebriate asylums,” comparable to jails and modeled after dilapidated, state-operated insane asylums. In the 1880s, a presumably neurotic Sigmund Freud recommended cocaine to treat alcohol and morphine addictions, which obviously didn’t go well. In the 1910s, appallingly, people with substance use disorders were nonconsensually sterilized “predicated on the protection of public health.”

Nowadays, we have somewhat more sophisticated avenues for anybody hoping to kick an addiction: Support groups like Alcoholics Anonymous, rehab and drugs like buprenorphine, which reduce the need to use heroin and other opioids. Still, more than 70,000 Americans died from drug-involved overdoses in 2019, and an estimated 95,000 people die from alcohol-related causes annually, in part because conventional addiction treatments simply don’t work for everyone.

On the frontier of nonconventional therapeutics is microdosing psilocybin mushrooms and other psychedelic substances — i.e., taking very low, sub-hallucinogenic doses — an approach backed by a burgeoning number of small, grassroots recovery groups. “Anecdotal reports from online forums suggest some people find microdosing to help with anxiety, depression and mood, which are closely linked to addiction,” says neuropharmacologist Allison Feduccia, cofounder of Psychedelic.Support and Project New Day, an organization concentrated on conquering addictions through the responsible and legal use of psychedelics. “Psychedelics have less potential for misuse compared to most other substances, including nicotine and alcohol.”

It may sound absurd — taking drugs to quit drugs — but studies demonstrate that large doses of psilocybin with clinical support can help people relinquish alcohol, tobacco and cocaine. To explain this, Feduccia says, “The neuroplasticity-promoting effects shown in non-human experiments point to a mechanism of how psychedelics could make behavioral changes easier.”

While encouraging, the science of microdosing in particular and psilocybin use outside of clinical situations — where participants follow a rigorous psilocybin-assisted psychotherapy protocol — is still coming up short. “The best I can say is that we have very limited data on microdosing,” says Peter Hendricks, who’s researching the effects of psilocybin on people with cocaine-related substance use disorder. “I can think of only one placebo-controlled study at the moment, which failed to show any subjective effects.”

But though more research is certainly needed — and even if established science never comes to fully support microdosing — Hendricks says it may still be a valid addiction treatment for some people, because anecdotal evidence is indeed evidence: “Ultimately, one’s personal experience carries the day, whether the experience is with an empirically-supported medication or an alternative approach lacking empirical support.”

In a similar vein, Charles Nichols, president of the International Society for Research on Psychedelics, suggests that the success of microdosing psychedelics may be reliant on at least some expectational bias, which doesn’t necessarily matter if it still helps someone. “If someone thinks microdosing will help before they do, and they think it does during and after — mind over matter — then in some form or another, the concept of microdosing is helping,” he explains.

Hard science aside, San Francisco Psychedelic Society member Adam Bramlage, CEO of Flow State Micro, says, “Healing is unique to the individual,” and microdosing psychedelics can simply kickstart your mind into more of a recovery mode. “It’s a leverage point,” adds fellow San Francisco Psychedelic Society member Seth Warner.
“This isn’t a solution. This is a step that can magnify your intentions to take every other step to getting your life back on track.”

“It’s not a magic substance,”
Bramlage reiterates. “It’s the combination of the therapist, the community of support, the coach and the substance.”

That said, psychedelics aren’t completely harmless. “There’s a concern that repeated usage of psychedelics, even at low doses, may produce heart valve problems over time,” Nichols warns. Feduccia adds, “Psychological dependence or habitual use could potentially develop with microdosing, and users should approach with caution and intention, especially individuals who have a history of substance misuse.”

For anyone in recovery, and for long-standing 12-step groups, like AA and Narcotics Anonymous, all of this gray area around microdosing has created a complex conundrum. Despite AA cofounder Bill Wilson believing that LSD could help alcoholics stop drinking, many members maintain complete sobriety and remain strongly opposed to federally illegal mind-altering substances — even though Kevin Franciotti, psychedelic researcher and substance use recovery advocate, says, “AA and 12-step organizations totally recognize the utility of psychiatric medications, like medicine that’s prescribed by a doctor.”

For sobriety seekers who find solace in psychedelics, this resistance to them can be massively isolating, which is one reason why Franciotti says psychedelic-friendly sobriety support groups are so important. “Helping to develop a community of support for people who are doing this kind of thing is bringing people out in droves,” he says. “People are coming together who’ve either long been doing this or are curious about doing this in traditional recovery communities, but felt ostracized or stigmatized into not saying anything about it.”

While these grassroots groups serve a purpose — people are going to use psychedelics, sometimes for recovery, and they need guidance as well as somewhere to go — we still need to be careful about the overall "Goop-ification" of microdosing before science and regulations catch up. Remember, there are many accepted and approved psychiatric treatments for substance use disorders, and Franciotti warns against gambling on psychedelics simply because you don’t trust conventional medicine. “One of the big areas of concern for recovery communities is, these medicines are really not available from legal avenues,” he says. “You’re basically limiting people to having to participate in the underground market, and obviously, how did they get the drugs of abuse?”

When it comes to psilocybin in particular, you could grow your own, but in most states, possession of shrooms is still illegal. Nonetheless, Warner says, “Mushroom cultivation is easier now than it’s ever been. Access to the medicine is so democratic,” which can’t be said for more conventional pharmaceuticals that are subject to price gouging and often limited to those with insurance.

None of this necessarily means you should wait if you’re struggling with addiction and nothing else is helping — for many people, Franciotti says it will be too late by the time government approval and medical regulations for psychedelics come around, if they ever do. “Future clinical trials will examine microdosing for addiction disorders, and if results are significant compared to placebos, then it could become an approved treatment,” Feduccia says. “More research is needed.”

In the meantime, know that psychedelic-friendly sobriety support groups and coaches like Bramlage are there to help you on your journey. “The peer-to-peer model, when it comes to addiction recovery, wouldn’t have been so successful had it not been for the shortcomings of the professional and medical models,” Franciotti says. “For people in recovery, community and connection is vital. Recovering people aren’t like mushrooms: You don’t feed them shit, stuff them in the dark and have them grow and flourish.”

 
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Psychedelic treatment for alcohol misuse in Special Ops vets, study*

Pratheek Mangini, Lynnette A. Averill, and Alan K. Davis

Special Operations Forces (SOF) constitute the most elite members of the United States military, selected for their superior physical and psychological resilience, and trained to endure the many challenges related to combat. The group cohesion experienced among SOF personnel has been identified as a protective factor against mental health problems..However, despite their resilience and specialized training, they are often exposed to a greater number of deployments and intense combat episodes, correlating with increased prevalence of mental health problems. Compounding this issue, SOF Veterans (SOFV) are reluctant to seek mental health treatment, and there is growing concern of a rise in mental health problems and an alarming increase in the incidence of suicides in this population, highlighting the limited effective treatment methods.

One primary concern is that alcohol misuse is pervasive among US Veterans, with 32% of Veterans meeting criteria for a diagnosis of alcohol use disorder (AUD). Heavy episodic drinking is similarly widespread and one of the most prevalent types of substance misuse among Veterans. Young male Veterans (18–25 years of age) are the most susceptible to alcohol misuse with 1 in 4 meeting criteria for AUD and 56% reporting heavy drinking. Furthermore, Veterans suffer significant deleterious effects from alcohol misuse that spans physical, cognitive, and social domains. For example, Veterans with AUD are at an increased risk for all-cause mortality, including suicidality, while heavy drinking is associated with work performance problems, alcohol-impaired driving, and criminal justice problems.

The high rates of alcohol misuse among Veterans can be attributed to the direct impact of traumatic experiences, such as combat exposure and military sexual assault, as well as secondary to mental health illness. The relationship between alcohol misuse and trauma is complex, but the prevailing self-medication hypothesis proposes that alcohol use is an attempt to regulate difficult emotions and suppress post-traumatic psychiatric symptoms. Studies among Veterans demonstrated a diagnosis of post-traumatic stress disorder (PTSD) doubled one’s risk of alcohol misuse compared to those without a diagnosis.

Beyond the harmful impacts on the individual, the Department of Defense reports alcohol misuse costs approximately 1.1 billion dollars per year, in part due to the limited efficacy of current treatments. The US Food and Drug Administration have approved three pharmacologic drugs for the treatment of AUD: disulfiram, naltrexone, and acamprosate. However, naltrexone is the only drug robustly studied in Veterans with AUD, demonstrating that compared to placebo, naltrexone did not show any benefit in reducing relapse, amount of alcohol consumed, or days spent drinking. Compounding the problems of limited effective treatments for AUD, a similar urgent need for effective treatments for PTSD exists.

Taken together, current pharmacologic treatments are lacking in efficacy, highlighting the importance of research exploring novel pharmacologic drugs for this vulnerable population. Therefore, the primary aim of this observational study was to assess whether psychedelic treatment with ibogaine and 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is associated with reductions in alcohol use and PTSD symptoms among SOFV engaged in high-risk drinking.

Discussion

The present findings demonstrated that psychedelic treatment with ibogaine and 5-MeO-DMT are associated with retrospective reports of rapid and significant decreases in alcohol use and PTSD symptoms among a clinical sample of SOFV. These findings are consistent with prior studies showing that MDMA, a serotonergic psychedelic, has been shown to produce significant PTSD symptom reduction. Additionally, animal studies have shown that ibogaine was effective in reducing alcohol consumption in alcohol-preferring rats, and a case report documented the reduction of alcohol use following ibogaine and 5-MeO-DMT treatment in Mexico. Moreover, a substantial amount of survey data has shown that psychedelics, in particular 5-MeO-DMT, has been associated with improvements in mental health, affect, cognition, and substance use in non-clinical samples. The current study extends this body of research by demonstrating the retrospectively reported utility of sequential administration of ibogaine and 5-MeO-DMT treatment in a clinical setting among an at-risk population of SOFV.

Findings from this study also showed that retrospectively reported decreases in alcohol use and PTSD symptoms were both correlated with increases in psychological flexibility attributed to the psychedelic treatment. Consistent with prior studies, psychological inflexibility has been implicated in a variety of pathologic mental states, in particular those suffering from PTSD and AUD, and therapies designed to enhance psychological flexibility (i.e., Acceptance and Commitment Therapy) have been shown to reduce symptom severity in patients with comorbid PTSD and AUD. However, the effect sizes found in this study are approximately 2–3 times greater than the effect sizes found in prior studies. Furthermore, prior studies implemented at least 10 therapy sessions to produce benefits. In contrast, ibogaine and 5-MeO-DMT treatment is associated with rapid (over the course of 3 days) improvement in symptoms. The rapid onset of symptom improvement highlights a potential breakthrough in therapeutics for this difficult to treat population that has high treatment dropout rates, but future controlled studies are needed to ascertain the clinical efficacy of this treatment.

Although the neurophysiologic effects of psychedelics are complex, there are proposed mechanisms that could explain the reductions in alcohol use and PTSD symptoms reported in this study. In animal models, ibogaine induced expression of glial-derived neurotrophic factor (GDNF) expression in the ventral tegmental area (VTA), a neurologic locus in the addiction pathway, and resulted in reductions in ethanol self-administration. Additionally, 5-MeO-DMT is an agonist at the 5-HT2A receptor, which reduces mesolimbic dopamine levels in the addiction pathway, potentially impairing the reward stimulus and the synaptic maintenance of this circuit in response to ethanol. It is possible that these two substances modulate synapse formation and dopaminergic transmission in this pathway, leading to their anti-addictive effects. With respect to PTSD, psychedelics are thought to mediate improvements in these symptoms through memory reconsolidation and fear extinction via inhibition of the amygdala and excitation of the hippocampus.

Although the results of this study are promising, there are limitations to consider. First, the sample was subject to selection bias, as respondents were those who personally sought treatment with ibogaine and 5-MeO-DMT for their symptoms. Similarly, it is possible that those who chose not to participate or were not able to respond to the survey recruitment may also have experienced neutral or negative outcomes associated with treatment. As this study used a cross-sectional retrospective report design, respondents may have also overestimated their improvement due to recall bias and future studies should incorporate a longitudinal design with clinician-rated measures. As such, these three factors may have resulted in anticipated and greater self-reported benefits. Further limits to generalizability were due to the demographic homogeneity of the largely Caucasian, middle-aged, male sample with prior military experience, representing a small percentage of the general population and may or may not be representative of the larger Veteran population that were not SOF. In addition, two different substances with varying doses were administered in succession, making it challenging to parse out differential benefits. Due to the classifications of ibogaine and 5-MeO-DMT as schedule I drugs, our study design was restricted, leading to a lack of randomization, blinding, and use of a control group ultimately preventing determinations of causality.

Future studies should work to elucidate whether there are heterogenous benefits provided by ibogaine or 5-MeO-DMT compared to placebo, utilizing clinician-rated outcomes measures as opposed to self-report to increase the validity of symptom improvement. Furthermore, although our study showed rapid benefits, we did not assess the extent these changes persisted in the long-term. Nevertheless, findings suggest that these psychedelic therapies offer potential alternative approaches to the debilitating mental health and substance misuse problems plaguing the Veteran communities. More research, with adequate control conditions and laboratory drug administration, is urgently needed to explore the clinical safety of this intervention and to determine whether this approach is sufficient to maintain the clinical benefits in the long-term.

*From the Study here :
 
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