Alcohol Use Disorder Research

Quick answer

Early trials suggest psilocybin and ketamine, each combined with psychological therapy, may reduce drinking in some adults with alcohol use disorder (AUD), but the studies are small, and results differ between outcomes. No psychedelic or ketamine product was found approved for AUD in the sources read. This page describes research, not treatment advice. If someone is in immediate danger, call 911 in the US. In the US, 988 offers crisis support.

Evidence labels: promising but limited (positive results from small or early trials), mixed (different outcomes disagree), insufficient evidence, approved medicine (none found here). Do not stop or change any treatment for alcohol use without talking to a clinician.

Psilocybin

Bogenschutz 2022 (JAMA Psychiatry). A double-blind randomized trial in 95 adults with alcohol dependence (93 analyzed) at two US academic centers. Everyone received 12 weeks of manualized psychotherapy (motivational enhancement and cognitive behavioral therapy) and two day-long medication sessions, psilocybin or the antihistamine diphenhydramine as an active placebo. Over 32 weeks, heavy drinking days averaged 9.7% with psilocybin and 23.6% with diphenhydramine (difference 13.9 percentage points; 95% CI 3.0 to 24.7). There were no serious adverse events among psilocybin recipients. Exclusions included major psychiatric and drug use disorders and current AUD treatment. [1]

Pooled review 2026. A systematic review and meta-analysis of six trials (202 people, only three randomized) found moderate short-term advantages over control for drinks per day, percent drinking days and percent heavy drinking days. At mid- to long-term follow-up only percent drinking days remained significantly better, and the odds of maintaining abstinence were higher with psilocybin. The authors described the evidence as mixed but suggestive of preliminary efficacy. [2]

Label: promising but limited. Only one large randomized trial was read, and people can often tell whether they received the active drug. [3]

Ketamine

Grabski 2022 (American Journal of Psychiatry). A double-blind phase 2 trial in 96 people with severe AUD. Participants were assigned to one of four conditions: three weekly ketamine infusions or saline infusions, each with either relapse-prevention psychological therapy or alcohol education. The ketamine group had more days abstinent at 6 months than the placebo group (difference 10.1%, 95% CI 1.1 to 19.0, a wide range), with the largest benefit in ketamine plus therapy. There was no significant difference in relapse rate. No serious adverse events were linked to the study drug. [4]

Ketamine itself is not FDA-approved for any mental health disorder, according to NIDA, and unsupervised use has serious health risks. [5] Label: promising but limited, early (phase 2). See the ketamine guide.

LSD

A 2012 meta-analysis of six randomized trials (536 participants) found a single dose of LSD, given within various alcoholism treatment programs, was associated with less alcohol misuse (odds ratio 1.96, 95% CI 1.36 to 2.84). [6] We read only the abstract, which gives no trial dates, doses or comparator details, so we cannot judge how the underlying trials were run or whether modern standards were met. Label: insufficient evidence for current practice questions, since the details needed to judge the trials were not available to us. See the LSD guide.

Risks and limits

• Mixing substances. Trials control the setting. NIDA reports that fatal overdoses involving these substances are typically associated with very high amounts or combinations of drugs. [7] See combining psychoactive substances, alcohol and other sedatives.
• Participants were selected. The psilocybin trial excluded people with major psychiatric or other drug use disorders. [1]
• Follow-up and size. Follow-up in the two main trials was about 6 to 7 months, and each enrolled fewer than 100 people.
• Therapy vs drug. The FDA states that the contribution of psychotherapy to the treatment effect is not established. [3]

Proper evidence not found for head-to-head trials of these approaches against standard AUD treatments in the sources we read. See how to read a psychedelic clinical trial.