I Went to Rehab for Alcoholism 18 Times. Only Psychedelics Helped

A version of this article originally appeared on VICE Germany.

I met Amanda at a pain therapy clinic in Zurich last December. She was sitting on a chair, hands folded neatly in her lap – she’d come here with her husband Tim for one of her regular visits to neurologist Livia Granata, one of the few specialists in Switzerland offering psychedelic therapy. 

British-born Amanda is 50 years old and has been an alcoholic for two decades. She also struggles with severe depression and anxiety stemming from childhood trauma. It took a lot for her to share her story, so she asked to be referred to on a first-name basis to protect her and her husband’s privacy. 

For the past seven years, Amanda hasn’t lived in her flat with her partner and their children, but outside on the balcony. She stays in an improvised shelter her husband made for her, only going in to use the toilet – and the pandemic only further tightened the grip her anxiety disorders have on her life.

A year ago, Amanda probably wouldn’t have shown up for this appointment at all, either cancelling at the last minute or simply letting it pass. Over the years, she’s been through too many treatments – experimental therapies that brought little to no relief. But in April 2022, she found her way to the clinic – and to the first treatment she felt ever truly worked.

About 30 percent of depression patients experience treatment-resistant depression, meaning an illness that doesn’t improve with traditional psychiatric therapy. In 2022, a study of 79 patients with treatment-resistant depression found that a single dose of psilocybin (the psychedelic compound in magic mushrooms), accompanied by immediate therapy, improved a third of the participants' mood. These promising results contribute to a growing body of evidence that psychedelics might present an important tool for treating mental disorders.

The first studies looking at psychedelic therapy date back to the 50s and 60s, but research projects were shut down in the two decades that followed as psychedelics became increasingly criminalised. One of the countries that contributed most to this research is Switzerland, where psychedelic therapy was briefly legalised between 1988 and 1993 and used to treat almost 200 private patients. 

Research began again in the early 2010s and, since 2014, doctors can apply for an exemption with the Swiss government to administer otherwise illegal substances like magic mushrooms, LSD and MDMA to patients. Dr. Granata has been granted a licence to do this for a year and has treated 20 people with psilocybin over this period.

Most of her patients come to her practice for chronic pain: migraines, cluster headaches, phantom pains. Our scientific understanding of why exactly psychedelics work is still unclear, but studies have shown that they probably help with brain plasticity, meaning they can stimulate neurons into forming new connections which in turn reorganises thought patterns.

Psychedelic therapy was Amanda’s last resort. After growing up in a traumatic environment, she initially managed to get her life on track as a young adult. She went to uni, where she met Tim in 1988; she travelled, she partied. In 2003, the two moved to Zurich and started a family. But then, something unknown precipitated a state of emotional turmoil which she attempted to lessen by drinking.

“I was a functional alcoholic,” said Amanda, recalling the first years of her addiction. “I only drank in the evenings, but I drank way too much and it was starting to affect my family life.” In the beginning, alcohol helped her escape unwanted thoughts, but that soon stopped being effective. She kept drinking anyway.

In 2007, Amanda realised she had a problem and decided to seek help. But her children were little at the time and she couldn’t bear the thought to leave them for long stretches of time. Over the intervening years, she’s visited rehab centres and psychiatric clinics over and over again – 18 times in total, some for a few weeks, others for months. She was often institutionalised with people with severe and diverse mental health conditions, and that made her feel unsafe. Sooner or later, she’d relapse. “Even though I was there voluntarily and I could ask to go out, it was just the feeling of being locked in [that scared me],” she remembers.

She even tried to quit at home a few times, using anti-withdrawal drugs like benzodiazepine. “It took quite a lot of willpower… but once I put my mind to it, I could get off it at home for a while,” she says. “Then pressures would build up, build up until it just got to this point when I was totally paralysed in my mind and relapsed again.”

As time went on, Amanda became suicidal because she “couldn't beat this thing”, as she puts it. Her attempts at suicide – 12 in total – caused her to be forcibly committed, fuelling the cycle of failed therapies and making her sicker and sicker.

Her last hospital stay in the summer of 2021 made it clear to her she never wanted to go back to a psychiatric ward again. “I'd lost a lot of weight, it went down to 50kg,” she says. “I’d just had enough.” Then, she came across a documentary about a study in Switzerland where alcoholics are treated with psychedelics. She signed up to participate and was referred to Livia Granata.

Initially, the two tried a course of therapy involving ketamine IVs. Ketamine is an anaesthetic used in emergency care and as a recreational drug, but has psychedelic effects. It’s also been shown to be an effective antidepressant and anti-suicidal drug, and particularly good with cases of treatment-resistant depression.

Amanda received infusions on four consecutive days. She lost consciousness, had wild hallucinations and called out for her husband in fear. Still, after the sessions, there was hardly any change in her mental state. 

Then Granata decided to try administering her psilocybin – 20 milligrams per session at first, then 30 because she “tolerated it extremely well”, Granata says. They did six sessions of about eight hours, or until the psychedelic high was over. Granata and her team are not therapists – they simply supervise Amanda while she listens to music, lies down on the couch or the carpet, puts a mask over her eyes and just gives in to the feeling.

Many patients cry during treatment, says Aisha Savdi, a medical assistant in the team. Some want to be held, others want to be left alone. The sessions often bring up past memories and emotions that have been repressed. Many report that they look at their lives like an outsider. Things become clearer; perspectives change.

For Amanda, the hallucinogenic effect was weaker than with ketamine. The lights were slightly blurred, but above all, she felt good: relaxed, anxiety gone. “Tim had trouble getting me back to the car, because I was looking at all the bright colours like a kid,” she says. “It certainly changed my attitude a bit, I feel the weight lifted.” 

Since then, she and the people in her life have observed a huge improvement in her severe depression and anxiety. Although she still can’t bear to move out of the balcony, she’s been able to leave her house, visit the hairdresser, go on a walk or to see a friend. She can watch some videos explaining childhood trauma without shutting down. “My mind seemed more open so I could really take it in,” she explains. 

Last September, Tim and her were even able to go on holiday for the first time in years, “to Greece, to our favourite spot that we used to go to every year,” Tim recalls. “Yeah, that was a pretty big thing.” 

And something else is different, too – her urge to drink is gone. She has been abstinent since April 2022 – her longest time without alcohol in 20 years. Granata has prescribed a ketamine nose spray to help with the cravings, which sometimes still happen, especially when something changes in her life. The holiday was challenging, for instance – but so far, she’s been able to swerve drinking.

“I haven't gone back to that place [of addiction and depression]. Well, briefly, but not a really bad place,” Amanda said. Four months after the initial treatment, her mood dipped again, so Dr Granata decided to give her a booster, starting a new course of therapy in September 2022. Amanda has also been on the hunt for a trauma-informed therapist to explore talk therapy while high.

Granata is very impressed with her progress, especially given her history of psychiatric interventions and drug courses. “Using this substance four to six times has managed to achieve [for Amanda] what the other therapies didn’t do in years,” she says. “That’s what’s special about these drugs – how quickly they work and how long-lasting their effect is.”

Although things are still difficult, her partner Tim has seen a marked improvement in Amanda’s mood, in her ability to go do things, get to appointments and be present for her family. No matter the final outcome of the treatment, he believes this type of therapy is much better than the traditional methods that Amanda has used. He remains hopeful for her and their lives together; as he puts it: “I'm a born optimist.”