To Beat Alcoholism, Take a Trip

Although largely overlooked, the hallucinogen LSD is highly effective at preventing relapse by alcoholics, according to new study.

Lysergic acid diethylamide, the powerful hallucinogen known as LSD, was once seen as a promising treatment for conditions including alcoholism and pain. Over the past few decades, the drug has been largely stigmatized and included very rarely in clinical trials. Results of a new meta-analysis of randomized, controlled trials published between 1966 and 1971, however, suggest that LSD is highly effective at preventing relapse by alcoholics.

The meta-analysis, conducted by Teri Krebs and Pål-Ørjan Johansen, PhD candidates in the neuroscience department at the Norwegian University of Science and Technology, was published online March 8 in the Journal of Psychopharmacology. It examined 6 trials including 536 participants, all of whom had been admitted to alcoholism treatment programs before being recruited into the trials. All of the participants were male inpatients, except for 2 women and a small number of outpatients in 1 of the trials. Of the participants, 321 (61%) received full doses of LSD (median dose 500 mcg) and 211 (39%) received control treatment, which included low-dose LSD (25 mcg or 50 mcg), stimulants, or non-drug control conditions.

The researchers found that the pooled odds ratio of reduced alcohol abuse between patients who received LSD and those in the control groups was 1.96 at the first follow-up, which ranged from 1 to 12 months after treatment. They also found that the beneficial effect of LSD in reducing alcohol abuse was statistically significant in the short term (2-3 months after treatment) and medium term (6 months after treatment), but not in the long term (12 months after treatment). In addition, among the trials that reported on complete abstinence from alcohol use, LSD had a statistically significant benefit in the short term, but not the medium term.

There were 8 acute adverse reactions to LSD reported in 5 of the trials, but no lasting harmful effects. Adverse effects included bizarre behavior, agitation, and a grand mal seizure, although in this case the participant had a history of alcohol withdrawal seizures. Interestingly, 2 of the 3 studies that reported data on employment found statistically significant improvement in employment for those who received LSD.

To help explain how LSD may have helped the trial participants grapple with their alcoholism, investigators in 1 of the trials wrote, “It was rather common for [LSD] patients to claim significant insights into their problems, to feel that they had been given a new lease on life, and to make a strong resolution to discontinue their drinking.” In another trial, researchers wrote, “It was not unusual for patients following their LSD experience to become much more self-accepting, to show greater openness and accessibility, and to adopt a more positive, optimistic view of their capacities to face future problems.”

The researchers note that, based on their findings, LSD compares favorably with meta-analyses of daily naxeltrone, acamprosare, or disulfiram for reducing alcohol abuse. They also note that their findings generally accord with reports of clinical experience and a broad range of non-randomized controlled and open-label studies of LSD for alcoholism. “Given the evidence for a beneficial effect of LSD on alcoholism, it is puzzling why this treatment approach has been largely overlooked,” they write.

In order to further investigate the potential of LSD to treat alcoholism, the researchers suggest that trials should be conducted to determine whether repeated doses could achieve more sustained effects, whether particular groups are more likely to benefit from LSD or to experience adverse effects, whether varying doses of LSD produce different results, and whether LSD can be beneficially combined with other alcoholism treatments.