Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction

Abstract

Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment.

Figure 1. Relationships between psilocybin session experiences and changes in smoking-related measures

Change in Questionnaire on Smoking Urges (QSU) smoking craving from study intake to 6-month follow-up as a function of mean States of Consciousness Questionnaire (SOCQ) mystical experience score (A). Change in Smoking Abstinence Self-Efficacy (SASE) Confidence to abstain (B), and SASE Temptation to smoke (C) from study intake to 6-month follow-up as a function of mean rating of how personally meaningful psilocybin session experiences were. Data points show data from each of the 15 individual participants with best-fit linear regression.