Recovery

Where the evidence stands

The strongest signal is for alcohol. A 2022 randomised trial at NYU found that two psilocybin sessions with therapy roughly halved heavy-drinking days over eight months compared with an active placebo. Ketamine has trials in alcohol and cocaine use with encouraging but smaller results. For opioids, there is very little controlled evidence for any psychedelic. None of this is an approved treatment anywhere in Canada or the US.

What that means in practice

Oregon and Colorado allow adults to attend a licensed psilocybin service for any reason, including substance use, but those programs are not addiction treatment: there is no medical detox, no withdrawal management, and facilitators are not clinicians unless the listing says so. Ketamine clinics will sometimes treat substance use alongside depression, but few advertise it, and most require that you already be in treatment or stable.

If you are physically dependent on alcohol, benzodiazepines or opioids, withdrawal can be dangerous and a supervised program comes first. The providers below are places to bring up as an adjunct, with your treatment team, not a substitute for one.

Questions to ask any provider on this page

• Do you require that I be in, or have completed, a treatment program?
• Who screens for withdrawal risk and interactions with medications like naltrexone or buprenorphine?
• What happens if I relapse after a session?