Status:

RECRUITING

Outpatient Buprenorphine Induction With Psilocybin for Opioid Use Disorder

Lead Sponsor:

Johns Hopkins University

Conditions:

Opioid Use Disorder

Eligibility:

All Genders

21-70 years

Phase:

PHASE2

Brief Summary

This study will examine the effect of a single high dose of psilocybin therapy (30 mg) versus a very low dose (1 mg) as an adjunctive therapy to individuals undergoing standard-of-care outpatient bupr...

Detailed Description

The proposed study is a double-blind, controlled investigation of the effect of 1 high-dose psilocybin (30 mg) session compared to a very low dose session (1 mg) in the period immediately following st...

Eligibility Criteria

Inclusion

  • Age 21-70 years
  • Have given written informed consent
  • Meet Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for OUD
  • No antidepressant medications for approximately 5 half-lives prior to enrollment
  • Willing to undergo buprenorphine induction or has undergone buprenorphine induction in the past 3 weeks
  • Reports previous buprenorphine maintenance
  • Urine toxicology positive for an opioid
  • Has access to stable housing
  • Can read, write, and speak English fluently
  • Be judged by study team clinicians to be at low risk for suicidality
  • Have limited recent use of classic psychedelics (no use in the past year).
  • Expresses a desire for sustained recovery from disordered opioid use.

Exclusion

  • General medical exclusion criteria:
  • Women who are pregnant, nursing, or not practicing an effective means of birth control
  • Cardiovascular conditions: hypertension with resting blood pressure systolic \>139 or diastolic \>89, angina, heart rate \> 99, a clinically significant ECG abnormality (e.g., atrial fibrillation, QTc \> 450), transient ischemic attack (TIA) in the last 6 months, stroke, peripheral or pulmonary vascular disease, cardiac valvulopathy
  • Epilepsy
  • Insulin-dependent diabetes; if taking oral hypoglycemic agent, then no history of hypoglycemia
  • Currently taking on a daily basis any medications (including herbal substances and supplements) with a central nervous system effect on serotonin, including serotonin-reuptake inhibitors and monoamine oxidase (MAO) inhibitors.
  • For individuals who have intermittent or as needed (PRN) use of such medications, psilocybin sessions will not be conducted until at least 5 half-lives of the agent have elapsed after the last dose.
  • Currently taking efavirenz, Acetaldehyde dehydrogenase inhibitors such as disulfiram (Antabuse), Alcohol dehydrogenase inhibitors, or UDP-glucuronosyltransferase (UGT)1A9 inhibitors or UGT1A10 inhibitors such as phenytoin, regorafenib, eltrombopag.
  • Currently taking methadone or naltrexone.
  • Currently on longstanding buprenorphine maintenance (3+ weeks post-induction)
  • Naïve to buprenorphine
  • Reports of significant adverse events (severe withdrawal, medical complications, hospitalization) during previous buprenorphine induction(s).
  • Unable or unwilling to discontinue acid-reducing agents or major metabolizing enzyme inhibitors for 5-half lives prior to the experimental dosing session.
  • Have a seizure disorder, multiple sclerosis, history of significant head trauma, central nervous system (CNS) tumor, movement disorders or any neurodegenerative condition.
  • Morbidly obese (\>100 lbs above ideal body weight, or Body Mass Index (BMI) \>=40, or BMI \>=35 with high blood pressure or diabetes)
  • Body weight \< 45 kg
  • Be judged by a study team clinician to be at risk for moderate or severe alcohol or benzodiazepine withdrawal.
  • Allergic to buprenorphine
  • For blood samples, the following lab values will be exclusionary: transaminases greater than x2 the upper limit of normal lab reference range, hemoglobin less than 11 g/d, and creatinine clearance \< 40 ml/min using the Cockraft and Gault equation.
  • Psychiatric

Key Trial Info

Start Date :

February 8 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

May 1 2029

Estimated Enrollment :

90 Patients enrolled

Trial Details

Trial ID

NCT06067737

Start Date

February 8 2024

End Date

May 1 2029

Last Update

July 28 2025

Active Locations (1)

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Johns Hopkins Center for Psychedelic and Consciousness Research

Baltimore, Maryland, United States, 21224