One Dose, Many Shifts: What a Psychedelic Trial Reveals About Recovering From Alcohol Use Disorder
A new study in Addiction asks people in a 5-MeO-DMT trial what actually changed inside them.
Originally published on Substack.
Anyone who has struggled with alcohol, or loved someone who has, knows the cruel loop. You can see clearly that you drink too much and still not be able to stop.
Treatments exist, but relapse is common and the most-studied therapy, CBT, tends to help only modestly. That gap is why researchers are testing psychedelics alongside therapy. A trial in London paired a single dose of a fast-acting psychedelic called 5-MeO-DMT with structured talk therapy. A new qualitative paper from that trial skips the numbers and asks a more human question: what did it feel like to change?
The study
Mathieu Seynaeve and colleagues interviewed people from a phase 2a trial run at King's College Hospital in London. Each participant received one intranasal dose of 5-MeO-DMT, in a synthetic formulation called BPL-003, plus psychological support and a manualised CBT programme focused on relapse prevention.
Who: 10 adults (8 men, 2 women) with moderate to severe alcohol use disorder, plus 6 of the trial's therapists.
When: participants were interviewed remotely the day after dosing and again at the end of the study, on day 84. Therapists were interviewed once.
What they discussed: drinking history and motivation, expectations and preparation, the dosing day itself, changes they noticed afterwards, and how the therapy fit in.
5-MeO-DMT is unusually short-acting. Its effects come on within minutes and fade over about half an hour, which makes it practical to give in a clinic.
What participants described
In the hours after dosing, many reached for the same kinds of images: a reset, a cleanse, a rebirth. These descriptions often came with an emotional release and a sudden shift in how people saw themselves.
Over the following weeks, participants reported four broad changes:
Clarity about alcohol. They saw their relationship with drinking more plainly.
Emotional openness. Feelings that had been numbed or avoided became easier to sit with.
Self-compassion. They were gentler with themselves, rather than stuck in shame.
Connection. Relationships with other people felt closer.
What the therapists saw
The therapists' accounts lined up closely with what participants said. They noticed greater psychological flexibility: clients could step back from a craving or a harsh thought instead of being swept along by it. They also saw more emotional openness in sessions and healthier ways of responding to old triggers.
That matters because the psychedelic was never meant to work alone. The CBT sessions gave people a place to turn a powerful experience into new habits and coping skills.
The numbers behind the stories
The interviews sit inside a larger trial of 12 patients, whose results were published earlier. After 12 weeks, half stayed fully abstinent, a quarter cut down meaningfully, and a quarter changed little or not at all.
Alcohol units per day (average): 9.3 before treatment, 2.2 at week 12
Heavy drinking days: 56% before, 13% at week 12
Alcohol-free days: 33% before, 81% at week 12
The dose was well tolerated. Side effects were mild or moderate, with no serious adverse events reported.
Read this with caution
These are promising early signals, not proof. A few reasons to stay grounded:
Tiny sample. Ten people were interviewed, from a trial of twelve.
No comparison group. Everyone knew they were getting the drug, and there was no placebo arm.
Self-reports. Interviews capture how change felt, not whether the drug caused it. People who volunteer for psychedelic trials may also arrive hopeful and motivated.
Not a shortcut. The trial team's own public guidance stresses that psychedelic therapy is not a brain reset or a quick fix. And 5-MeO-DMT outside a medical setting is a different, riskier thing entirely.
The next step is larger, controlled trials that can test whether these shifts hold up and who benefits most.
The takeaway
What stands out in this study is not the drug alone. It is the pairing: a brief, intense experience that seems to loosen old patterns, followed by steady therapy that helps new ones take root. Whether that combination holds up in bigger trials is the question to watch.
If you or someone you know is struggling with alcohol, talk to a doctor or a local addiction service. Psychedelic treatments for AUD are still experimental and only available in clinical trials.
Sources
Seynaeve M, et al. Psychological change processes in alcohol use disorder: A qualitative study of 5-MeO-DMT with cognitive behavioural therapy. Addiction, 2026.
Marsden J, et al. 5-MeO-DMT for alcohol use disorder: An open-label, phase 2, proof-of-concept clinical trial. Addiction.
Trial overview, King's College London.