How does LSD work? But the study didn’t delve into how psychedelics make alcoholics abstain — especially after a single dose — remains unclear.
What is known, though, is that LSD and its chemical cousins share structural similarities with the neurotransmitter serotonin — the neurotransmitter in the brain that’s vital for memory, feeling pleasure, mood, sleep and appetite. These psychedelics mimic serotonin in that they also bind to the same receptor sites in the brain. But that’s where the similarity ends. Studies show that hallucinogens trigger chemical cascades that differ from those triggered by serotonin. At the same time, LSD also acts on other receptors in the brain.
Some researchers speculate that LSD works because it changes perception — patients in the clinical trials said they felt they were given a new lease on life. Subsequently, they made strong resolutions to stop drinking.
This explanation is backed up by Dr. Roland Griffiths, a behavioral biologist at the Johns Hopkins University School of Medicine in Baltimore, Maryland who is investigating the influence of psilocybin on smoking cessation. Sometime, he explains, psychedelics trigger unique, insightful experiences that can help bring about enduring positive changes in mood, attitude, and then behavior.
Indeed, how LSD works to treat addiction must be understood on both biological and psychological levels by studying both human behavioral responses as well as brain chemistry.
“Psychedelics probably work in addiction by making the brain function more chaotically for a period — a bit like shaking up a snow globe — weakening reinforced brain connections and dynamics,” surmises Dr. Robin Carhart-Harris, a psychopharmacologist at Imperial College London who has researched how psilocybin could treat depression.
Commenting on the retroactive meta-analysis, Dr. Matthew Johnson says, “This is impressive and important work.” A psychiatrist at the Johns Hopkins University, Dr. Johnson is now running a small trial looking at the effectiveness of psilocybin to treat nicotine addiction.
“Although this meta-analysis doesn’t 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,” he ends.
Context also matters, TIME writer Szalavitz points out. “Studies show that the psychedelic experience is very sensitive to context, which is why the CIA used the drug as an interrogation aid while hippies viewed it as vehicle for bring about worldwide peace and love,” she writes.
In some of the trials reviewed by Dr. Krebs and Dr. Johansen, Szalavitz explains, LSD didn’t work because it was used to “break down” alcoholics’ egos in an attempt to create a spiritual awakening. In one such unsuccessful trial, patients were actually strapped to their beds and were confronted and humiliated extensively with the goal of revising their personalities.
This turned out to be counterproductive, she reports, because new research now shows that trying to annihilate people emotionally is dangerous and can lead to long-term damage — even when it’s done without a powerful hallucinogen.
What’s more, “in addiction research, however, it’s important to temper enthusiasm and keep from overselling psychedelic ‘cures’,” notes Szalavitz.
She recounts how a heroin addict, Howard Lotsof discovered in 1962 that an African drug, ibogaine, could produce an intense and often emotionally exhausting trip, even as it reduced or even got rid of withdrawal symptoms from heroin.
Finding that he was able to remain heroin-free, Lotsof went on to patent the use of ibogaine to treat multiple addictions and spent the rest of his life advocating for more research on the drug.
He also shared his experience with his fellow addicts. But while they reported the same lack of withdrawal symptoms and no longer felt a physical need for heroin, they still didn’t quit. This suggests that addiction goes beyond physical dependence, craving and withdrawal.
“Psychedelic experience — like all other intense life events –may offer the potential for growth and change,” she points out. “How people respond, however, depends on far more than a drug,” she concludes.
Dr. Ken Checinski, a consultant addiction psychiatrist and independent researcher based in London agrees.
While the results of the new meta-analysis are exciting, he says no pharmacological treatment should be seen as a magic bullet.
He also points out that modern therapeutic techniques have improved and can be just as effective. “The included LSD trials pre-date the use of psychological techniques such as motivational interviewing and cognitive behavior therapy,” he says.
In cognitive therapy, therapists help people who struggle with addictions to identify the negative views they have of themselves, how they interpret their experiences negatively and how they feel hopeless about their future. Then, they are taught how to combat these negative thinking patterns, and replace these with ways of thinking that are more positive. This helps them rely less on drugs to cope with life’s struggles, helping break their vicious cycles of addiction.
LSD Treatment for Alcohol Abuse: Krebs-Johansen Study. Posted 17 March 2012.