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.”