Could “magic mushrooms” help tobacco smokers quit for good? A randomized clinical trial from Johns Hopkins suggests psilocybin, given alongside cognitive behavioral therapy (CBT), may be substantially more effective than standard nicotine replacement therapy.
The study enrolled 82 adult daily smokers ages 21 to 80 who had tried and failed to quit previously but wanted to stop. Participants were about 59.8% male and 89% white, smoked roughly a pack per day, and had attempted quitting about six times on average. Both groups received 13 weeks of CBT to identify triggers, manage cravings, and build quitting strategies.
One group received a single supervised dose of psilocybin (30 mg per 70 kg body weight). The comparison group followed a standard 8- to 10-week regimen of FDA‑approved nicotine patches. Researchers followed participants for six months, using self-reports and biological tests to verify abstinence.
Key findings:
– Prolonged abstinence at six months (stopped smoking and remained smoke-free after a brief grace period): 40% (17 participants) in the psilocybin group versus 10% (4 participants) in the nicotine patch group — translating to about six times greater odds of quitting with psilocybin.
– Seven-day point-prevalence abstinence at the six-month visit (no smoking in the previous week): 52% (22 participants) in the psilocybin group versus 25% (10 participants) in the patch group — roughly three times higher odds of short-term abstinence.
Lead author Matthew Johnson, PhD, said the psilocybin group “did much better,” and that the odds of prolonged abstinence were markedly higher with psilocybin plus CBT. Independent experts described the results as exciting and a useful expansion of treatment options for a major preventable cause of illness and death.
The study has limitations. Most participants (64.6%) had prior exposure to classic psychedelics, which may limit generalizability. The sample size was modest, and follow-up was limited to six months; longer-term outcomes remain unknown.
Context and caveats:
– Smoking still causes widespread harm; fewer than 10% of adults who smoke successfully quit each year.
– Existing aids include nicotine replacement therapy, bupropion (Zyban), and varenicline (Chantix), which are often most effective when combined with counseling.
– Researchers do not expect psilocybin to replace established therapies but to add another tool for those seeking to quit.
– These trials occur under controlled conditions with specific dosages and professional support. Psilocybin carries risks (including legal risks), and experts caution against attempting self-treatment outside therapeutic settings.
The findings add to growing evidence that psilocybin-assisted therapy may help treat addiction, but further, larger and longer trials are needed to confirm effectiveness and safety.
