Even before the pandemic, heavy drinking among women had risen precipitously, growing an astounding 58% from 2002 to 2013. This is especially troubling, given that females experience alcohol-related problems sooner and at lower levels of drinking than males.
The statistics put a dark spin on all those cheeky “Mommy needs her wine” memes that have proliferated across pop culture and social media in recent years.
But COVID-19 led to an increase in problem drinking across the gender spectrum, with deaths caused by alcohol rising 25% in 2020 over 2019, as both men and women sought solace in a bottle.
It’s long past time to look deeper at how this country addresses alcohol use disorder, a problem that afflicts nearly 15 million Americans — especially now that a promising new treatment may be on the horizon.
For decades, the go-to answer for alcoholism has been the 12 Steps of Alcoholics Anonymous, a program that helps millions of problem drinkers, but not all. (More on that later.) In recent years, a number of medications have sought to treat alcohol use disorder — anti-craving drugs and the like — but the results have been mixed or mediocre at best.
Now, a small group of researchers believe they may have hit on an improbable tool in helping free folks from an addiction to alcohol, and it comes in the form of a magic little mushroom.
That’s right: Psilocybin.
Psilocybin is a psychedelic and non-addictive drug that is illegal but has been cleared to be used in a number of studies by scientists at prestigious universities. The mushroom joins a number of other mind-altering drugs — ketamine, LSD and MDMA, also known as Ecstasy — that researchers are hoping will open new avenues of relief for those suffering from mental health issues and addiction.
The most encouraging study to date regarding psilocybin and alcoholism was done at New York University. It found that just two doses of magic mushrooms led to an 83% decline in heavy drinking among participants, all of whom had alcohol use disorder.
By the end of the eight-month experiment, almost half of those who received psilocybin had completely stopped drinking, compared with about a quarter of those who were given a placebo.
We’re not talking about tripping out at a Grateful Dead concert: Participants received psychotherapy in addition to the drug, which was administered under carefully controlled settings and guided by a therapist.
Nobody had an adverse reaction. What participants did have, according to the study, were fantastical and dreamlike experiences. More importantly, many underwent deeply meaningful — even spiritual — journeys that somehow removed their desire to drink.
Other studies have found those treated with psilocybin were able to stop drinking for years.
Researchers aren’t sure how the drug does this. One theory is it “rewires” the brain and helps ameliorate the effects of early psychological trauma, which experts now believe underlies much of addiction.
On an episode of 60 Minutes devoted to psilocybin, those who took the drug talked about a “loss of ego” and a quieting of the negative chorus of voices in their heads.
Loss of ego. Spiritual experiences. Rewiring the brain.
Anyone who belongs to AA — as I have, very happily, for the past 12 years — will notice striking similarities in what psilocybin evidently does and what the program aims to do through its 12 Steps and supportive fellowship.
Founded in 1935, the main thrust of AA — a spiritual program that is not based on any specific religious sectarian creed or dogma — is to help alcoholics find a Higher Power that will enable them to overcome their addiction to alcohol and live lives that are “happy, joyous and free.”
Besides finding and turning their lives over to this Higher Power (be it God, Jesus, Buddha, Mother Nature, the fellowship of AA itself, whatever) members take deep dives into the troubling aspects of their personalities, examine past hurts, make amends and in general seek to lead lives that are purposeful and harmonious, surrounded by a fellowship of others trying to do the same.
The question has always been: How effective is AA?
The program is notoriously hard to study, given that its fellowship maintains strict anonymity. (I’m breaking my own here, no doubt to the consternation of more than one “old timer.”) But a recent review of 27 high-quality studies found that AA does better in helping participants both achieve and maintain abstinence from alcohol when compared to other, secularly-based treatments, such as cognitive behavioral therapy, which involves doctors or therapists and can be expensive.
The review — based on an analysis of studies involving more than 10,000 participants — notes that AA meetings are ubiquitous and free (although members typically toss a buck or two in the basket.)
“It’s the closest thing in public health we have to a free lunch,” said one of the lead researchers.
Still, the success rate isn’t exactly stunning: The review found somewhere between 22% and 37% of people who try AA are able to maintain long-term abstinence. One study showed that the more meetings a person attends, the greater his or her chances are of staying sober — lending credence to the old AA adage “meeting makers make it.”
The Big Book — the foundational text of AA — claims that those who can’t find sobriety through the program are “constitutionally incapable of being honest with themselves,” a concept that has always struck me as victim-blaming. After all, alcoholism is a disease, not a moral affliction, and one that can be hard to push into remission once it’s taken root.
The sentiment also doesn’t square with my experience of working as a sponsor to various women through the years, some of whom have struggled to achieve sustained sobriety. (Fortunately, there have been some success stories, too.) These struggling women desperately wanted to stop drinking, were scorchingly honest about their predicament and claimed to have a deep spirituality guiding them. Yet long-term abstinence eluded them.
Here’s why, I think: Addiction is a bitch. As the Big Book puts it, it’s “cunning, baffling and powerful.”
And that’s why we need Alcoholics Anonymous, as well as other forms of secular and/or medical treatment — including psilocybin, if it proves to be legitimate — to address alcoholism, a scourge that claims too many lives, damages too many children and truncates too many people’s futures in this country. We need the whole tool box to fight this monster.
Already, some researchers are exploring ways to combine psychedelic drugs and 12 Step programs, given their overlapping synergies.
Lately it’s been opioids, especially the drug fentanyl, that have grabbed the headlines, because the resulting deaths tend to be sudden, visible and dramatic, and involve many younger users. But in reality, the far more pedestrian (and socially acceptable) drug alcohol is the bigger killer, more than other illicit drugs, claiming more than 140,000 lives a year in the U.S.
Excessive drinking is responsible for $250 billion per year in lost productivity. Alcohol-related deaths in America more than doubled between 1999 and 2017.
Some in AA will argue that using psilocybin — which, of course, is a drug — even in a controlled setting, means breaking total abstinence, the widely stated goal of the program. Some may view it as an illegitimate short-cut to sobriety, a crutch used by those not willing to “do the work.”
Such arguments belie the personal history of AA’s co-founder, the late Bill Wilson, who until the end was a tireless advocate for finding medical treatments for alcoholism. Wilson himself underwent experimental trials with LSD in the ‘50s, in an effort to cure the depression that dogged him his whole life.
No doubt there will also be pushback from the alcohol and drug rehab industry, a $42 billion a year juggernaut that includes more than 15,000 treatment centers scattered across the land, including in the Texas Hill Country, where you can’t throw a rock without hitting one. The vast majority use programs based on the 12 Steps.
Christine Varela Mayer, chief executive officer at Blue Heron Recovery, an 18-acre outpatient recovery center and sober campus in San Antonio, advises caution.
“New and alternative (treatments) are always exciting, but before we grab hold of (psilocybin) and make it the next magic fairy pixie dust, we need a lot of evidence-based research, lots of empirical proof of how it really works,” she said. “People need to be able to make informed decisions on whether it or other (psychedelic) drugs are worth the possible risk of getting triggered” and relapsing.
Indeed, only time will tell if psilocybin represents a miracle cure for alcoholism, or if it will join all the other failed medical treatments that litter the historical hallways of science.
But if a simple mushroom could heal some of the pain that alcoholism causes — if it could save even a subset of human lives — who in their right minds would be against it?
