First-Ever Clinical Trial Will Investigate Psilocybin Therapy as a Treatment for Gambling Addiction

The Centre for Psychedelic Research and Neuropsychopharmacology at Imperial College London has announced an upcoming study to determine the effectiveness of psilocybin-assisted therapy on individuals with gambling disorder. The government-funded study is the world’s first clinical trial of its kind and could yield groundbreaking results as a much-needed treatment for problem gamblers.

The growing need for gambling addiction treatment

Gambling disorder is a chronic mental health condition that causes individuals to engage in gambling despite its detrimental impact on their lives. The disorder can have significant consequences on an individual’s mental health, social life, and financial state. The risk and potential for a big win releases dopamine in the brain, which can lead to addictive behaviors, driving individuals to engage in more risky bets to gain the pleasurable feeling.

Global gambling statistics reveal that roughly 4.2 billion people gamble at least once a year, with approximately 26% of the worldwide population having gambled at least once in their lives. About 1-3% of adults struggle with problem gambling; however, there are limited treatment options and a high risk of relapsing even after treatment. These figures are projected to rise, primarily due to the COVID-19 pandemic, which has contributed to the rise in online gambling platforms. These online platforms have made various forms of gambling more easily accessible, exacerbating pre-existing gambling problems or creating new ones. Alarming trends in worldwide gambling behaviors have demonstrated the growing need for treatment for this disorder.

Untreated gambling problems can lead to severe mental health problems and even thoughts of suicide. The majority of individuals with a gambling disorder also have another underlying mental health disorder that intensifies their condition. Along with the shame and guilt that comes from heavy financial loss, individuals with gambling addiction are at an incredibly high risk for suicidal behavior. Out of all addictive disorders, gambling disorder has the highest suicide rate, with about 1 in 5 pathological gamblers succumbing to suicide.

Cognitive behavioral therapy (CBT) is the primary treatment approach for those with gambling addiction problems. By identifying and altering harmful thought patterns and behaviors related to gambling, patients can determine strategies to manage their triggers and urges without turning back to gambling. While CBT presents a promising treatment option, it requires active engagement and willing commitment from the patient over an extended period of time. Moreover, CBT’s efficacy varies, particularly for those with an underlying treatment-resistant mental illness. There are currently no licensed pharmacological interventions for the disorder. Research into psilocybin-assisted psychotherapy provides another treatment option for those with gambling disorder who have not had luck with traditional therapy and medication.

Details of the future trial

To date, no clinical trials have evaluated the potential of psilocybin, the psychedelic compound in magic mushrooms, for treating individuals with gambling disorder. The future study will receive funding from Imperial College London through U.K. government funding. The British government has also endorsed it.

The trial is currently in the process of recruiting individuals who meet specific criteria. This criteria includes being a male between the ages of 20 and 65 who can provide written consent to undergo the study. The five chosen participants will have a health screening and a baseline Electroencephalogram (EEG) test to determine what changes occur in their minds before treatment. Then, the participants will receive a combination of psilocybin and talk therapy. They will then be tasked with engaging in gambling-related activities or observing gambling-related clips. Through the use of functional magnetic resonance imaging (fMRI) and EEG, the researchers will look for any changes in their brain’s reward system. The data will allow the researchers to determine whether these changes occur in response to gambling stimuli following treatment.

 The researchers of the study hope that the results will provide insights into alternative approaches for addressing addiction disorders. Furthermore, they anticipate that the results will contribute to the advancement of more developed brain imaging methods in the future, enabling them to measure brain activity and the brain’s messenger molecules at the same time. Should the study yield successful treatment outcomes, it will be made available through England’s publically funded healthcare system, the NHS.

Treating addiction beyond drugs and alcohol

Several recent studies have uncovered the potential of psychedelic therapy in treating several forms of addiction disorders, primarily substance use disorders like alcohol use disorder and opioid use.

For instance, a double-blind randomized critical trial conducted last year found that psilocybin-assisted treatment significantly helped improve drinking outcomes in patients with alcohol use disorder compared to the placebo by 83% (1).

Another study published last year examined data from 214,505 American adults in the National Survey on Drug Use and Health (NSDUH). The researchers found that individuals with past psilocybin use significantly correlated with a lowered probability of opioid use disorder. Although the study could not provide definitive proof that psilocybin use reduced the risk of an opioid use disorder, the correlation adds to the mounting evidence of psilocybin’s potential for treating substance use disorders (2).

The researchers of the upcoming study are hopeful that psilocybin’s therapeutic use goes beyond substance addictions and provides similar results for people with gambling addictions. Pathological gambling has a similar impact on the brain as other addiction disorders, suggesting that the participants of the study might experience symptom relief similar to the positive results observed in the previous studies.

“Given the similarities in clinical and brain characteristics between substance use addictions and behavioral addictions, we believe psychedelics may be able to target the same psychological and physiological mechanisms underlying this condition,” said Dr. Rayyan Zafar, one of the study’s lead researchers.

The promising possibilities that lie ahead in psychedelic therapies can unlock life-changing new options for treating addiction disorders. The study is scheduled to take place in October this year.

References

1. Bogenschutz, Michael P., Stephen Ross, Snehal Bhatt, Tara Baron, Alyssa A. Forcehimes, Eugene Laska, Sarah E. Mennenga, et al. 2022. “Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients with Alcohol Use Disorder.” JAMA Psychiatry 79 (10). https://doi.org/10.1001/jamapsychiatry.2022.2096.
2. Jones, Grant, Jocelyn A. Ricard, Joshua Lipson, and Matthew K. Nock. 2022. “Associations between Classic Psychedelics and Opioid Use Disorder in a Nationally-Representative U.S. Adult Sample.” Scientific Reports 12 (1). https://doi.org/10.1038/s41598-022-08085-4.