Source: Marsden et al., Addiction 2025 (doi:10.1111/add.70260)

Alcohol use disorder is one of the world's biggest health burdens. Existing treatments help only some people: more than half resume drinking within two weeks of stopping, and around two-thirds relapse within six months. Psilocybin, LSD and ayahuasca have shown promise, but their effects last 4-12 hours, which makes them hard to fit into ordinary care. This was the first clinical trial of 5-MeO-DMT for alcohol use disorder. It was run by researchers at King's College London and sponsored by Beckley Psytech.

The study

Design: Phase 2a, open-label, single-dose proof-of-concept trial (NCT05674929), with 12 weeks of follow-up. It ran from March 2023 to July 2024.
Where: two clinics in England, an NHS addictions service in South London (with dosing at King's College Hospital) and Clerkenwell Health, a psychedelic research clinic in Central London. Dosing took place in a quiet private room with low lighting, relaxing music, and plants or nature artwork.
Participants: 13 adults were enrolled and 12 completed the study. All met criteria for severe alcohol use disorder, drinking an average of about 54 units a week, with a longest alcohol-free stretch of only about six days in the three months before. Most were men (10 of 13) and White (12 of 13), with an average age of 49.
Screening: a medical history, physical exam, ECG, blood tests and psychiatric assessment. People were excluded for conditions made risky by temporary rises in blood pressure or heart rate, regular use of other drugs, any psychedelic use in the past 6 months, or current suicidal intent.
Dose: a single 10 mg intranasal dose of BPL-003, a benzoate salt form of 5-MeO-DMT, delivered as a dry powder nasal spray.

The support around the dose

The structure of this trial is unusually close to ceremonial practice.

Preparation: three 90-minute sessions over about two weeks with two licensed therapists, one experienced in psychedelic therapy and one in alcohol treatment. Sessions covered what to expect, breathing and visualization practices, and each person's wishes about therapeutic touch.
Dosing day: both therapists stayed in the room, offering non-directive support only if wanted. Reassurance came through voice, breathing together, or a hand on the forearm, placed with the participant's hand on top so they could remove it at any time.
Integration: three 60-minute sessions in the two weeks after dosing.
Ongoing therapy: ten weekly sessions of relapse-prevention cognitive behavioural therapy (CBT), building on insights from the dosing session.

What it found

Abstinent days: rose from 33% of days before treatment to 90% two weeks after dosing, and 81% at 12 weeks.
Heavy drinking days: fell from 56% of days to 13% at 12 weeks.
Amount: average weekly drinking fell from about 65 units to 15, and daily drinking from about 9.3 units to 2.2.
Three distinct groups: 6 of 12 participants stayed completely abstinent for all 12 weeks. 3 cut their drinking meaningfully, and 3 had little or no change.
Biomarkers: blood and urine tests for alcohol matched what participants reported, suggesting the self-reports were accurate.
Other measures: craving and alcohol-related problems both decreased, and every participant rated themselves at least somewhat improved. By week 12, a third rated themselves "very much improved."
The experience: a third of participants had a complete mystical experience. Notably, some people without one still cut their drinking, which suggests change can happen through other routes too.

Safety

Overall: 41 side effects were reported by 11 of 13 participants. All were mild or moderate. There were no serious events, and no one withdrew because of side effects.
Most common: nasal pain (4 people, lasting about 40 minutes to 3 hours) and a temporary rise in blood pressure (4 people). Blood pressure peaked around 10 minutes after dosing and returned to normal within 2 hours. Two people had nightmares and two vomited. Single reports included anxiety, fear, a panic reaction and dissociation.
Reactivations: two people briefly re-experienced elements of the state after it had worn off. One saw lights and felt fleeting, non-distressing body sensations on waking during two nights that first week. The other, 22 days later, briefly felt they could see inside their own body while in the bath. Both lasted moments, resolved fully, and both people stayed aware of their surroundings throughout.
Recovery: people were ready to leave about 2 hours after dosing (median 2.1 hours), and went home with a responsible adult.

Limitations

Only 12 participants completed the study
No placebo and no CBT-only comparison group, so the medicine's effect can't be separated from the therapy's
Not blinded, and participants started with positive expectations of treatment
Mostly White men, so results may not reflect everyone with alcohol use disorder
A single dose with only 12 weeks of follow-up, and some participants' drinking crept back up toward the end
Funded by Beckley Psytech, which was involved in the study design and the decision to publish. Several authors are company employees or advisors.

What this means, and doesn't

These are encouraging early results, and the authors are clear that larger, randomized, controlled trials are needed before drawing firm conclusions. Without a comparison group, it's impossible to know how much of the change came from the medicine, how much from the CBT, and how much from the care and attention of being in a trial. The gradual drift back toward drinking in some participants is also a reminder that a single experience is rarely the whole story.

What stands out is the shape of the care. The medicine sat inside weeks of preparation, integration and ongoing therapy, with consent around touch agreed in advance and a calm, natural setting. That mirrors what careful ceremonial practice aims for: the experience is one important moment inside a larger process.

The trial also documented reactivations openly, and noted research suggesting they are often experienced as neutral or positive. That's useful for anyone preparing for 5-MeO-DMT to know about in advance. Ceremonial work isn't addiction treatment, though. Anyone struggling with alcohol should speak with their doctor or an addiction specialist.

Research summaries are for education, not medical advice. Considering 5-MeO-DMT yourself?
Start with Safety & Screening.