Psilocybin-Assisted Therapy May Enhance Conservation Values in Patients with Alcohol Use Disorder

Psilocybin can produce long-term changes in personality, personal values, and behavior. Although psilocybin-assisted therapy (PAT) is being actively studied for various psychiatric conditions, its effects on personal values in patients with alcohol use disorder (AUD) remain unexplored. This study examined the effects of PAT on personal values in patients with AUD and assessed relationships between value changes, acute psilocybin experiences, and drinking outcomes.

In a phase II clinical trial (NCT02061293), 93 participants with AUD received 12 weeks of treatment, including manualized psychotherapy and two 8-h drug administration sessions with either psilocybin (n = 48) or active placebo (n = 45). Personal values were assessed before and after treatment using the Schwartz Value Survey (SVS), which includes 4 domain scores (Openness to Change, Self-Enhancement, Conservation, Self-Transcendence) and 10 subscales. The acute psychedelic experience was measured using the 30-item Mystical Experience Questionnaire (MEQ) and the 5-Dimensional Altered States of Consciousness Scale (5D-ASC). Treatment effects were assessed using univariate ANCOVAs, with baseline SVS values as covariates. Time effects within each group were evaluated using paired t-tests. Pearson correlations examined the relationship between value changes and acute effects, and also value changes and drinking outcomes.

Significant treatment effects were detected for the Conservation domain and its subscales "security" and "tradition." No other domains or subscales showed significant treatment effects. Within the psilocybin group, time effects were significant only for conservation, and its subscales "tradition," and "security". No significant time effects were detected in the placebo group. In the psilocybin group, the MEQ subscale Ineffability was significantly associated with increases in Conservation, "security," and "tradition" (r = 0.31-0.34). 5D-ASC subscale Vigilance Reduction was associated with Conservation (r = 0.31), but not its subscales. 5D-ASC subscale Dread of Ego Dissolution during the psilocybin sessions correlated with increases in "tradition" (r = 0.31). None of the value changes were significantly associated with drinking outcomes.

PAT may alter value structure in patients with AUD patients by increasing Conservation. Although some associations were found between acute psychedelic effects and changes in Conservation, these value changes were not related to drinking outcomes.