Early Research on LSD for Alcohol Problems
Early Research on LSD for Alcohol Problems: A Look at State Mental Hospitals and Elsewhere
By Kenneth Anderson, MA
In the 1950s, researchers such as Humphry Osmond and Abram Hoffer in Saskatchewan, Canada developed a unique therapy for alcoholism which entailed using a psychedelic experience to alter the beliefs and values of the alcoholic patients. Set and setting were essential variables in successfully inducing a psychedelic experience. The term “set” refers to the internal mindset of the person about to undergo the psychedelic experience. Patients were given weeks of psychological preparation by the researchers before they were given LSD, in order to ensure that they had the proper mindset for a positive and life-altering psychedelic experience. The term “setting” referred to the external surroundings of the person undergoing the psychedelic experience. An appropriate setting for a positive psychedelic experience included music, flowers, pictures, eyeshades, and most essentially, a trip guide to guide the subject through the psychedelic experience. Although the LSD research studies conducted in Saskatchewan had no control groups, the researchers claimed high success rates with alcoholics who had a poor prognosis, and who had not benefitted from other types of treatment. (Note that I will be using the historically correct terminology “alcoholic” and “alcoholism” throughout this post as these constructs are fundamentally conceptually different than the contemporary construct “alcohol use disorder”–these are not merely different words for the same entity–they are entirely different entities.)
Later LSD researchers in Toronto and the United States frequently ignored the set and setting variables in their research and failed to produce and appropriate psychedelic experience in their alcoholic subjects, and hence, failed to produce behavioral change. In fact, the Toronto researchers declared set and setting to be extraneous variables which had to be eliminated in order to evaluate the efficacy of LSD in inducing behavioral change, i.e., abstinence from alcohol. To this end, the Toronto researchers blindfolded their subjects and strapped them to their beds, almost guaranteeing a bad trip. It is no wonder that the Toronto researchers found LSD no more effective than a placebo.
Twentieth century research conducted on LSD treatment of alcoholism in the United States can be divided into two distinct eras: that conducted prior to the passage of the Drug Efficacy Amendment (Pub. L. 87-781) on October 10, 1962, and that conducted after the passage of the amendment. The intent of the Drug Efficacy Amendment, among other things, was to prevent the distribution of untested and dangerous drugs such as thalidomide, which had resulted in large numbers of horrific birth defects. However, the amendment also had the effect of greatly restricting LSD research. Prior to 1962, any MD could easily and legally acquire LSD for research or treatment purposes, and much LSD research was of poor quality and little of it was documented. After 1962, LSD research in the United States was strictly limited to facilities approved by the FDA and the manufacturer, and only high-quality research studies were approved. Post-1962 research on LSD treatment for alcoholism in the US was conducted at five VA hospitals, three state mental hospitals, and UCLA. A few other facilities were approved to conduct LSD research for other indications such as neuroses, anxiety, depression, and pain associated with terminal cancer; however, these investigations are beyond the scope of this blog post, as is the clandestine LSD research conducted by the CIA with the MKUltra project. All LSD research in the US ceased in 1976 and was not resumed until the 21st century.
I would like to acknowledge that a primary source of information for this blog post is Matthew Oram’s 2018 book The Trials of Psychedelic Therapy.
Studies of LSD for Alcoholism in the US Before 1962
Much use of LSD for the treatment of alcoholism in the US prior to the 1962 Drug Efficacy Amendment was undocumented, what follows is an exhaustive as possible account of all pre-1962 US studies of the use of LSD to treat alcoholism or drug addiction published in scholarly journals.
International Foundation for Advanced Study – Menlo Park CA
The International Foundation for Advanced Study was incorporated as a nonprofit in Menlo Park, California on August 30, 1956 by electrical engineer Myron Joe Stolaroff (Aug 20, 1920 – Jan 6, 2013). Stolaroff had dropped acid for the first time in April of 1956, while visiting Canadian LSD researcher Alfred Matthew Hubbard (Jul 24, 1901 – Aug 31, 1982) in Vancouver, British Columbia. Hubbard was known as the “Johnny Appleseed” of LSD; in the 1930s he had gone to prison for a million-dollar liquor smuggling operation. Stolaroff became a fervent convert to LSD after his first trip and spent the rest of his life promoting it. The International Foundation for Advanced Study was loosely affiliated with a new age religious group known as the Sequoia Seminar.
The researchers at the International Foundation for Advanced Study included Hubbard, Charles Wilfred Savage, MD (Sep 25, 1918 – Dec 25, 2007), Stanford University professor of engineering Willis Harman, Stanford graduate student in psychology James Fadiman, and San Francisco State College associate professor of psychology Robert Mogar. A 1962 paper published by the International Foundation for Advanced Study reported that three of 15 people treated at the foundation were alcoholics and all three showed great improvement.
However, the focus of the International Foundation for Advanced Study was on using LSD to help normal people achieve mystical experiences rather than on treating substance or psychiatric problems. After the passage of the 1962 Drug Efficacy Amendment, the FDA denied the International Foundation for Advanced Study permission to study LSD. Stolaroff described his work with LSD in the 1994 book Thanatos to Eros: Thirty-Five Years of Psychedelic Exploration.
Lexington Narcotic Farm – Lexington KY
Psychiatrists Arnold Myron Ludwig, MD (Jul 28, 1933 – ????) and Jerome Levine, MD (Jul 10, 1934 – ????) developed a combination of LSD and hypnosis which they dubbed hypnodelic therapy which they used to treat narcotic addicts at the Lexington Narcotic Farm. Although Ludwig and Levine reported that hypnodelic therapy led to improved scores on a test for psychopathology, there was no followup after discharge from the Lexington Narcotic Farm, so it is unclear whether the treatment had any effects on abstinence rates. Ludwig and Levine worked at the Lexington Narcotic Farm from 1962 to 1964 as a condition of their draft deferment. In 1964, Levine was appointed to oversee psychedelic research for the National Institute of Mental Health (NIMH) at Bethesda, Maryland. Ludwig left Lexington to conduct LSD research at Mendota State Hospital in Madison, Wisconsin, as discussed below.
Mental Research Institute – Palo Alto CA
The Mental Research Institute is a non-profit corporation currently located in Menlo
Park, California which is regarded as a leader in the field of brief and family therapy. The institute was founded in 1959 in Palo Alto as a division of the Palo Alto Medical Research Foundation; it became an independent entity in 1963.
Most of the subjects of LSD studies at the Mental Research Institute were normals, although there was also a mix of subjects with alcoholism or neuroticism. Psychiatrist Charles Wilfred Savage, MD (Sep 25, 1918 – Dec 25, 2007) presented a paper titled “LSD, Alcoholism and Transcendence” at the January 16, 1960 symposium on LSD held at Napa State Hospital; this paper was later published in the book LSD: the Consciousness Expanding Drug. Savage’s paper discussed LSD research at the Mental Research Institute; however, it only gave a few anecdotes and one case study concerning the LSD treatment of alcoholism there. There is no other information published on this topic, although a number of papers were published about other uses of LSD at the Mental Research Institute.
Savage had been publishing research about LSD since 1952; more information about Savage can be found in the section below about Spring Grove State Hospital.
Napa State Hospital – Napa CA
Psychologist Ernest Belden, MA (Oct 16, 1919 – ????) and psychiatrist Richard Charles Horatio Hitchen, MD (Apr 16, 1919 – Jul 6, 2006) published a paper titled “The Identification and Treatment of an Early Deprivation Syndrome in Alcoholics by Means of LSD-25” in the April 1963 issue of the American Journal of Psychiatry. Belden and Hitchen reported positive outcomes from treating alcoholics with psychedelic therapy at Napa State Hospital in Napa, California. This was an uncontrolled study, and the number of subjects treated was not reported. There were no other publications about psychedelic therapy for alcoholism at Napa State Hospital.
South Oaks Hospital – Amityville NY
South Oaks Hospital is a private psychiatric hospital in Amityville, New York. Psychiatrist Andre Rolo, MD (May 21, 1910 – Feb 28, 1995) et al. published an article titled “LSD as an Adjunct to Psychotherapy with Alcoholics” in the July 1960 issue of The Journal of Psychology. Rolo was the physician in charge of South Oaks Hospital. The article reported that 12 alcoholics had been treated at South Oaks Hospital by giving them psychotherapy while under a low dose of LSD (100 mcg). It was reported that 10 out of the 12 subjects had successfully gained insight into their problem. Long-term follow-up of abstinence rates was not conducted.
Studies of LSD Treatment for Alcoholism in the US After 1962
After the 1962 Drug Efficacy Amendment was enacted, research using LSD was strictly regulated by the FDA and the manufacturer. Trials of LSD for the treatment of alcoholism were carried by UCLA, by three state mental hospitals (Mendocino, Mendota, and Spring Grove), and by five VA hospitals (Topeka, KS, Palo Alto, CA, Sheridan, WY, Lexington, KY, and Dallas, TX)–no other trials were allowed for this indication, although a few facilities were approved to study the use of LSD for other indications such as the treatment of neuroses. I have written about LSD studies at the five VA hospitals elsewhere, so here I will focus on UCLA and the three state mental hospitals.
UCLA
UCLA psychiatric researcher Keith Samuel Ditman, MD (Apr 18, 1921 – Jul 19, 2001) conducted a study of LSD treatment for alcoholism at Viejas Treatment Center in San Diego County from 1965 to 1967. Viejas Treatment Center was a carceral alcoholism treatment center for men who had been arrested and sentenced at least four times elsewhere for alcohol-related offenses. It was a part of the San Diego County Honor Camp system. Ditman’s fellow researchers on this project were Thelma Moss, Edward W. Forgy, Leonard M. Zunin, Robert D. Lynch, and Wayne A. Funk. The research was conducted in cooperation with San Diego’s Vista Hill Psychiatric Foundation. The researchers published their study in the January 1969 issue of Psychopharmacologia in an article titled “Dimensions of the LSD, Methylphenidate and Chlordiazepoxide Experiences.”
Subjects were 99 inmates who had volunteered for the study. Subjects were randomized into three groups: one group received LSD (200 mcg), one group received Ritalin, and one group received Librium. The researchers were also blinded as to which drug was administered. All subjects were told that they were receiving injections of LSD regardless of which drug they were actually given, and all were given an orientation lecture regarding what they could expect from the LSD session. No description of setting was given so presumably there was no special setting for the drug experience.
Reactions to the three drugs were measured by administering the DWM Card Sort to the subjects both before and after the drug experience. The DWM Card Sort is a 156-item test devised to measure aspects of the LSD experience. Interestingly, the DWM Card Sort test showed that subjects who had received Ritalin had the greatest therapeutic gains from the drug experience, followed by those who had received LSD, with those who had received Librium showing the lowest therapeutic gains. There was no follow-up study to determine if the drug experiences had any effects on rates of abstinence from alcohol.
Mendocino State Hospital – Talmage CA
State hospitals in California had been offering alcoholism treatment since the 19th century. The LSD alcoholism research project at Mendocino State Hospital in Talmage, Mendocino County, California was headed up by psychologist Wilson Miles Van Dusen, PhD (Sep 11, 1923 – Apr 25, 2005). Van Dusen was chief psychologist at Mendocino State Hospital; he had received his PhD from the University of Ottawa in 1952. Van Dusen was a Swedenborgian mystic; his doctoral dissertation had posited a seven-dimensional model of the mind, claiming that the four dimensions of physical space-time were inadequate to describe mind. Van Dusen was an experienced consumer of LSD; in 1961 he had published a paper titled “LSD and the Enlightenment of Zen” in Psychologia. Van Dusen later wrote several books on mysticism.
Other researchers on the Mendocino LSD alcoholism research project were Mendocino’s director of alcoholism services, Wayne Wilson, MSW; senior psychologist, William Miners, BA; and assistant superintendent, Harry Hook, MD. The researchers published their results in the June 1967 issue of the Quarterly Journal of Studies on Alcohol in a paper titled “Treatment of Alcoholism with Lysergide.”
The subjects were 71 women who were undergoing the standard inpatient treatment for alcoholism at Mendocino State Hospital. The control group consisted of 37 women who received the standard inpatient treatment for alcoholism at Mendocino State Hospital without the addition of LSD therapy. The women in the LSD group received a high dose of LSD (400 mcg) and tripped in a pleasant room with pictures, concert music, and a therapist available. There were no significant differences in the outcomes of the women who received the LSD therapy and the women in the control group in terms of abstinence from alcohol or any other outcome measures. It is unclear how much preparation the women were given for their trips.
Mendota State Hospital – Madison WI
Mendota State Hospital in Madison, Wisconsin had a long history of treating alcoholics although a separate alcoholic ward was not established until 1964. Nineteen sixty-four was also the year that psychiatrist Arnold M. Ludwig, MD left the Lexington Narcotic Farm and moved to Madison, Wisconsin to conduct LSD research at Mendota State Hospital, as mentioned above. Ludwig was working under the direction of his former research partner at Lexington, psychiatrist Jerome Levine, MD, who was now in charge of psychedelic research at the National Institute of Mental Health (NIMH) at Bethesda, Maryland. Ludwig and Levine decided that they would conduct randomized controlled trials of LSD therapy for alcoholism at Mendota State Hospital and once and for all answer the question of whether LSD therapy for alcoholism was effective or not.
The trial had four arms: one arm utilized the hypnodelic therapy which Ludwig and Levine had developed at Lexington, one arm gave subjects LSD with conventional psychotherapy, one arm simply gave subjects LSD with no accompanying therapy at all, and one arm gave subjects no LSD, but assigned them to meditate on their problems instead. A total of 176 male patients took part in the study. All subjects receiving LSD received a dose of 3 mcg per kilogram of body weight, e.g., 270 mcg for a 200-pound man. The trial was carried out over a period of three years.
Ludwig and Levine reported their results in a paper titled “A Clinical Study of LSD Treatment in Alcoholism” published in the July 1969 issue of the American Journal of Psychiatry and in a 1970 book titled LSD and Alcoholism: A Clinical Study of Treatment Efficacy.
Ludwig and Levine claimed that they had definitively proven that LSD was worthless in the treatment of alcoholism. This claim, together with claims by other researchers that LSD had proven useless for alcoholism treatment, sounded the death knell on research on LSD treatment for alcoholism for decades.
Yet, Ludwig and Levine’s claim was false, for they had failed to test the type of LSD therapy for alcoholism in Saskatchewan in the 1950s. The Saskatchewan treatment used LSD in conjunction with set and setting to produce a transcendental, life-changing experience. None of the treatment arms of the Ludwig and Levine study did this. This was not due to malice on Ludwig and Levine’s part, rather, in the 1960s, researchers did not yet grasp the essentials of carrying out a randomized controlled trial which involved more than a drug and a placebo.
Spring Grove State Hospital – Catonsville MD
State mental hospitals in Maryland admitted few alcoholics until the late 1950s; however, in August of 1959, Spring Grove State Hospital in Catonsville opened an alcoholic rehabilitation unit. After the alcoholic rehabilitation unit opened, a number of clinical trials and research studies on the treatment of alcoholism were conducted at Spring Grove State Hospital, such as a clinical trial of an antidepressant named nialamide and one of Librium.
The creative force behind the Spring Grove State Hospital research study on LSD treatment for alcoholism was Sanford Martin Unger, PhD (May 4, 1931 – ????). Unger received his PhD from Cornell University in 1960 and went to work for the National Institute of Mental Health (NIMH) in Bethesda, Maryland. While at NIMH, Unger took an interest in hallucinogens and was assigned to write a review of the literature on them. The result was an article titled “Mescaline, LSD, Psilocybin, and Personality Change” published in the May 1963 issue of Psychiatry. Unger also tried LSD himself and was profoundly impressed by the experience. When Unger expressed a desire to investigate LSD further and see if the reports of LSD curing alcoholism were true, his boss at NIMH put him in touch with psychiatrist Albert Alexander Kurland, MD (Jun 29, 1914 – Dec 8, 2008), who was both director of research at Spring Grove State Hospital and director of research for the Maryland State Department of Mental Hygiene. Unger and Kurland decided to initiate a trial of LSD treatment of alcoholism at Spring Grove State Hospital.
Research on LSD treatment of alcoholism at Spring Grove State Hospital began in late 1963. In September of 1964, psychiatrist Charles Wilfred Savage, MD (Sep 25, 1918 – Dec 12, 2007) was added to the team as director of research for Spring Grove State Hospital.
Savage was no stranger to either Spring Grove State Hospital or LSD research. Savage had begun conducting research on LSD in 1952 while he was still a research psychiatrist with the US Navy. After leaving the Navy in 1953, Savage began researching the effects of LSD on schizophrenics at Spring Grove State Hospital. Savage relocated to California in the late 1950s. While in California, Savage was involved in LSD studies at the Center for Advanced Studies in Behavioral Sciences at Stanford University, the Mental Research Institute in Palo Alto (see above), Napa State Hospital, the Palo Alto Veterans Administration Hospital, and the International Foundation for Advanced Study (see above); he was made medical director of the latter in November 1961. After LSD research opportunities in California dried up, Savage returned to Spring Grove State Hospital.
The Spring Grove study consisted of two phases: an uncontrolled pilot study to determine safety and treatment procedure, and a controlled trial. The Spring Grove researchers were meticulous in reproducing the psychedelic procedures which had been utilized by the Saskatchewan researchers to produce a positive psychedelic experience. On July 5, 1966, CBS News aired a documentary titled LSD: The Spring Grove Experiment, which is available on YouTube.
The Spring Grove researchers published outcomes of the pilot study in the April 1967 issue of the American Journal of Psychiatry in a paper titled “Psychedelic Therapy Utilizing LSD in the Treatment of the Alcoholic Patient: A Preliminary Report.” The subjects of the pilot study were 69 male alcoholic inpatients. The subjects showed significant improvements on MMPI scores after the LSD experience and 23 subjects (about one third) remained abstinent at six-month followup.
Stanislav Grof and Walter Pahnke joined the research team in 1967. In 1968, the Maryland Psychiatric Research Center was established on the grounds of Spring Grove State Hospital to take over the psychiatric research conducted at the hospital. Kurland was appointed superintendent of the Maryland Psychiatric Research Center, and Savage was associate director, and the rest of the LSD researchers were also given positions at the center.
Outcomes of the controlled trial of LSD treatment for alcoholism were reported in the March 1971 issue of Pharmacopsychiatry in an article titled “LSD in the Treatment of Alcoholics.” The subjects of this study were 135 alcoholics who had been admitted to Spring Grove for inpatient treatment: 90 were assigned to the treatment group and 45 were assigned to the control group. Patients in the treatment group were given a high dose of LSD (450 mcg) and those in the control group were given a low dose of LSD (50 mcg). Set and setting were identical for both groups, i.e., both groups were given several weeks of preparatory psychotherapy intended to produce a peak LSD experience. Researchers and therapists were blinded as to who was in which group in order to assure that all patients were treated equally. At six-month follow-up, the drinking behaviors of the high-dose group showed significant improvements compared to the low-dose group. However, these differences had disappeared at the 12- and 18-month follow-ups.
The Spring Grove researchers also conducted a trial of LSD treatment for narcotic addiction; the results were published in an article titled “Residential Psychedelic (LSD) Therapy for the Narcotic Addict: A Controlled Study” in the June 1973 issue of the Archives of General Psychiatry. Subjects were 74 male narcotics addicts released from prison on parole. The control group (37 addicts) was released directly into an outpatient program. The experimental group (37 addicts) was released into a halfway house where they received six weeks of psychedelic therapy, after which they were released into the same outpatient program as the control group. Subjects at the halfway house received five weeks of preparatory psychotherapy, a single session of high-dose LSD (300-450 mcg), then one week of integrative psychotherapy. At follow-up, abstinence rates for the LSD group were significantly higher than those for the control group.
Any treatment for alcohol problems that shows as much promise as LSD has is worth further investigation. Most successful treatments for addictive problems require some amount of ongoing care, and LSD may be no different. All US experimental studies of LSD for any indication ceased in 1976. They would not be resumed until the 21st century.
Liked this article on LSD for alcohol problems? You might also be interested in: Mushroom Therapy for Addiction Treatment.