The findings highlight the value of qualitative research in the psychopharmacological investigation of psychedelics. They describe perceived connections between drug- and non-drug factors, and provide suggestions for future research trial design and clinical applications.

Participants reported gaining vivid insights into self-identity and reasons for smoking from their psilocybin sessions. Experiences of interconnectedness, awe, and curiosity persisted beyond the duration of acute drug effects. Participants emphasised that the content of psilocybin experiences overshadowed any short-term withdrawal symptoms. Preparatory counselling, strong rapport with the study team, and a sense of momentum once engaged in the study treatment were perceived as vital additional factors in achieving abstinence. In addition, participants reported a range of persisting positive changes beyond smoking cessation, including increased aesthetic appreciation, altruism, and pro-social behaviour.

Participants were invited to a retrospective follow-up interview an average of 30 months after initial psilocybin sessions. Semi-structured interviews were conducted with 12 of the 15 participants. Data were analysed using thematic analysis.

The aims of this study were as follows: (1) to identify perceived mechanisms of change leading to smoking cessation in the pilot study; (2) to identify key themes in participant experiences and long-term outcomes to better understand the therapeutic process.

Recent pilot trials suggest feasibility and potential efficacy of psychedelic-facilitated addiction treatment interventions. Fifteen participants completed a psilocybin-facilitated smoking cessation pilot study between 2009 and 2015.

References

Belser, AB, Agin-Liebes, G, Swift, TC. ( 2017 ) Patient experiences of psilocybin-assisted psychotherapy: An interpretative phenomenological analysis . J Humanist Psychol 57: 354 – 388 .

Google Scholar SAGE Journals | ISI

Bogenschutz, MP, Johnson, MW ( 2016 ) Classic hallucinogens in the treatment of addictions . Prog Neuropsychopharmacol Biol Psychiatry 64: 250 – 258 .

Google Scholar Medline | ISI

Bogenschutz, MP, Forcehimes, AA, Pommy, JA. ( 2015 ) Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study . J Psychopharmacol 29: 289 – 299 .

Google Scholar SAGE Journals | ISI

Bogenschutz, MP, Pommy, JM ( 2012 ) Therapeutic mechanisms of classic hallucinogens in the treatment of addictions: From indirect evidence to testable hypotheses . Drug Test Anal 4: 543 – 555 .

Google Scholar Medline | ISI

Cahill, K, Stevens, S, Lancaster, T ( 2014 ) Pharmacological treatments for smoking cessation . JAMA 311: 193 – 194 .

Google Scholar Medline | ISI

Campbell, J, Cousineau, P, Brown, SL ( 1990 ) The Hero’s Journey: Joseph Campbell on His Life and Work. Vol. 7. Novato, CA : New World Library .

Google Scholar

Carbonaro, TM, Bradstreet, MP, Barrett, FS. ( 2016 ) Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences . J Psychopharmacol 30: 1268 – 1278 .

Google Scholar SAGE Journals | ISI

Cicchetti, DV ( 1994 ) Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology . Psychol Assess 6: 284 – 290 .

Google Scholar

Cohen, J ( 1960 ) Kappa: Coefficient of concordance . Educ Psychol Meas 20: 37 – 46 .

Google Scholar SAGE Journals | ISI

Dedoose ( 2016 ) Version 7.0.23, Web Application for Managing,Analyzing, and Presenting Qualitative and Mixed Method Research Data. LosAngeles : Socio Cultural Research Consultants . Available at: www.dedoose.com.

Google Scholar

De Vries, H, Elliott, MN, Kanouse, DE. ( 2008 ) Using pooled kappa to summarize interrater agreement across many items . Field Methods 20: 272 – 282 .

Google Scholar SAGE Journals | ISI

Doblin, R ( 1991 ) Pahnke’s Good Friday experiment: A long-term followup and methodological critique . J Trans Psychol 23: 1 – 28 .

Google Scholar

Doering-Silveira, E, Grob, CS, De Rios, MD. ( 2005 ) Report on psychoactive drug use among adolescents using Ayahuasca within a religious context . J Psychoactive Drugs 37: 141 – 144 .

Google Scholar Medline | ISI

Fabregas, JM, Gonzalez, D, Fondevila, S. ( 2010 ) Assessment of addiction severity among ritual users of Ayahuasca . Drug Alcohol Depend 111: 257 – 261 .

Google Scholar Medline | ISI

Fagerström, K ( 2012 ) Determinants of tobacco use and renaming the FTND to the Fagerström Test for Cigarette Dependence . Nicotine Tob Res 14: 75 – 78 .

Google Scholar Medline | ISI

Fantegrossi, WE, Woods, JH, Winger, G ( 2004 ) Transient reinforcing effects of phenylisopropylamine and indolealkylamine hallucinogens in rhesus monkeys . Behav Pharmacol 15: 149 – 157 .

Google Scholar Medline | ISI

Fleiss, JL ( 1971 ) Measuring nominal scale agreement among many raters . Psychol Bull 76: 378 – 382 .

Google Scholar

Garcia-Romeu, A, Griffiths, RR, Johnson, MW ( 2014 ) Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction . Curr Drug Abuse Rev 7: 157 – 164 .

Google Scholar Medline

Garcia-Romeu, A, Kersgaard, B, Addy, PH ( 2016 ) Clinical applications of hallucinogens: A review . Exp Clin Psychopharmacol 24: 229 – 268 .

Google Scholar Medline | ISI

Gasser, P, Holstein, D, Michel, Y. ( 2014 ) Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-Threatening Diseases . J Nerv Ment Dis 202: 513 – 520 .

Google Scholar Medline | ISI

Griffiths, RR, Johnson, MW, Carducci, MA. ( 2016 ) Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial . J Psychopharmacol 30: 1181 – 1197 .

Google Scholar SAGE Journals | ISI

Griffiths, RR, Johnson, MW, Richards, WA. ( 2011 ) Psilocybin occasioned mystical-type experiences: Immediate and persisting dose-related effects . Psychopharmacology (Berl) 218: 649 – 665 .

Google Scholar Medline | ISI

Griffiths, RR, Richards, WA, Johnson, MW. ( 2008 ) Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later . J Psychopharmacol 22: 621 – 632 .

Google Scholar SAGE Journals | ISI

Griffiths, RR, Richards, WA, McCann, U. ( 2006 ) Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance . Psychopharmacology (Berl) 2006 ; 187(3): 268 – 283 .

Google Scholar Medline | ISI

Halpern, JH ( 1996 ) The use of hallucinogens in the treatment of addiction . Addict Res 4: 177 – 189 .

Google Scholar ISI

Halpern, JH, Sherwood, AR, Passie, T. ( 2008 ) Evidence of health and safety in American members of a religion who use a hallucinogenic sacrament . Med Sci Monit 14: SR15– SR22 .

Google Scholar

Hari, J ( 2015 ) Chasing the Scream: The Opposite of Addiction is Connection. New York : Bloomsbury .

Google Scholar

Hays, JT, Ebbert, JO, Sood, A ( 2008 ) Efficacy and safety of varenicline for smoking cessation . Am J Med 121: S32 – S42 .

Google Scholar Medline | ISI

Heatherton, TF, Kozlowski, LT, Frecker, RC. ( 1991 ) The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire . Br J Addict 86: 1119 – 1127 .

Google Scholar Medline

Hendricks, PS, Clark, CB, Johnson, MW. ( 2014 ) Hallucinogen use predicts reduced recidivism among substance-involved offenders under community corrections supervision . J Psychopharmacol 28: 62 – 66 .

Google Scholar SAGE Journals | ISI

Hendricks, PS, Thorne, CB, Clark, CB. ( 2015 ) Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population . J Psychopharmacol 29: 280 – 288 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Richards, WA, Griffiths, RR ( 2008 ) Human hallucinogen research: Guidelines for Safety . J Psychopharmacol 22: 603 – 620 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Garcia-Romeu, A, Cosimano, MP. ( 2014 ) Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction . J Psychopharmacol 28: 983 – 992 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Garcia-Romeu, A, Griffiths, RR ( 2016 ) Long-term follow-up of psilocybin-facilitated smoking cessation . Am J Drug Alcohol Abuse 43: 55 – 60 .

Google Scholar Medline | ISI

Johnson, MW, Garcia-Romeu, A, Johnson, PS. ( 2017 ) An online survey of tobacco smoking cessation associated with naturalistic psychedelic use . J Psychopharmacol 31: 841 – 850 .

Google Scholar SAGE Journals | ISI

Kabat-Zinn, J ( 1990 ) Full Catastrophe Living: Using the Wisdom of your Body and Mind to Face Stress, Pain, and Illness. New York : Delacorte .

Google Scholar

Krebs, TS, Johansen, PØ ( 2012 ) Lysergic acid diethylamide (LSD) for alcoholism: Meta-analysis of randomized controlled trials . J Psychopharmacol 26: 994 – 1002 .

Google Scholar SAGE Journals | ISI

Krupitsky, EM, Burakov, AM, Dunaevsky, IV. ( 2007 ) Single versus repeated sessions of ketamine-assisted psychotherapy for people with heroin dependence . J Psychoactive Drugs 39: 13 – 19 .

Google Scholar Medline | ISI

MacLean, KA, Johnson, MW, Griffiths, RR ( 2011 ) Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness . J Psychopharmacol 25: 1453 – 1461 .

Google Scholar SAGE Journals | ISI

Marks, DF, Sykes, CM ( 2002 ) Randomised controlled trial of cognitive behavioural therapy for smokers living in a deprived area of London: Outcome at one-year follow-up . Psychol Health Med 7: 17 – 24 .

Google Scholar

McCrae, RR, Costa, PT ( 1985 ) Openness to experience . In: Hogan, R, Jones, WH (eds) Perspectives in Personality. Greenwich, Connecticut : JAI Press , pp. 145 – 172 .

Google Scholar

Mottillo, S, Filion, KB, Bélisle, P. ( 2009 ) Behavioural interventions for smoking cessation: A meta-analysis of randomised controlled trials . Eur Heart J 30: 718 – 730 .

Google Scholar Medline | ISI

O’Brien, CP ( 2006 ) Drug addiction and drug abuse . In: Brunton, LL, Lazo, JS, Parker, KL (eds) Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 11th ed. New York : McGraw-Hill , pp. 607 – 627 .

Google Scholar

Osmond, H ( 1957 ) A review of the clinical effects of psychotomimetic agents . Ann N Y Acad Sci 66: 418 – 434 .

Google Scholar Medline | ISI

Pahnke, WN ( 1969 ) Psychedelic drugs and mystical experience . Int Psychiatry Clin 5: 149 – 162 .

Google Scholar Medline

Pahnke, WN, Richards, WA ( 1996 ) Implications of LSD and experimental mysticism . J Relig Health 5: 175 – 208 .

Google Scholar

Ross, S ( 2012 ) Serotonergic hallucinogens and emerging targets for addiction pharmacotherapies . Psychiatr Clin North Am 35: 357 – 374 .

Google Scholar Medline | ISI

Ross, S, Bossis, A, Guss, J. ( 2016 ) Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial . J Psychopharmacol 30: 1165 – 1180 .

Google Scholar SAGE Journals | ISI

Savage, C, McCabe, OL ( 1973 ) Residential psychedelic (LSD) therapy for the narcotic addict: A controlled study . Arch Gen Psychiatry 1973 ; 28: 808 – 814 .

Google Scholar Medline

Stace, WT ( 1960 ) Mysticism and Philosophy. Philadelphia, PA : Lippincott .

Google Scholar

Sedgwick, E ( 2003 ) Touching Feeling: Affect, Pedagogy, Performativity. Berkeley, CA : Duke University Press .

Google Scholar Crossref

Sessa, B, Johnson, MW ( 2015 ) Can psychedelic compounds play a part in drug dependence therapy? Br J Psychiatry 206: 1 – 3 .

Google Scholar Medline | ISI

Swift, TC, Belser, AB, Agin-Liebes, G. ( 2017 ) Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress . J Humanist Psychol 57: 488 – 519 .

Google Scholar SAGE Journals | ISI

Sykes, CM, Marks, DF ( 2001 ) Effectiveness of a cognitive behaviour therapy self-help programme for smokers in London, UK . Health Promot Int 16: 255 – 260 .

Google Scholar Medline | ISI

Tønnesen, P, Tonstad, S, Hjalmarson, A. ( 2003 ) A multicentre, randomized, double-blind, placebo-controlled, 1-year study of bupropion SR for smoking cessation . J Intern Med 254: 184 – 192 .

Google Scholar Medline | ISI