Armstrong · Military psychology : the official journal of the Division of Military Psychology, American Psychological Association 2024 · prospective uncontrolled cohort study · n=45

Prospective associations of psychedelic treatment for co-occurring alcohol misuse and posttraumatic stress symptoms among United States Special Operations Forces Veterans.

Level 4 - case-series / case-control

Uncontrolled prospective observational cohort study

PubMed 38377244 · doi:10.1080/08995605.2022.2156200 · record verified 2026-08-26

What was done

Prospective observational study evaluating outcomes among 45 United States Special Operations Forces Veterans with baseline risky alcohol use (mean age 44 years, 100% male, 91% White; subgroup from 86 total program completers) who underwent clinical treatment with sequential ibogaine and 5-MeO-DMT at a clinic in Mexico. Assessments were completed at pre-treatment, 1 month, 3 months, and 6 months post-treatment.

What was found

Alcohol use scores significantly decreased from pre-treatment (mean = 7.2, SD = 2.3) to 1 month (mean = 3.6, SD = 3.5) and remained reduced at 6 months (mean = 4.0, SD = 2.9; p < .001, partial eta squared = .617). At 1 month, 24% were abstinent, 33% reported non-risky drinking, and 42% reported risky drinking. At 6 months, 16% were abstinent, 31% reported non-risky drinking, and 53% reported risky drinking. Responders (abstinent/non-risky drinkers) showed significantly greater improvements than non-responders in PTSD symptoms (p < .01, d = -3.26) and cognitive functioning (p < .01, d = -0.99).

Why it matters

Provides preliminary naturalistic evidence that combined ibogaine and 5-MeO-DMT protocols may reduce heavy drinking while concurrently improving comorbid trauma symptoms in combat veterans.

Limits

Uncontrolled open-label design with no comparator group, precluding attribution to the drugs versus expectancy, placebo, or setting effects. Small sample size (n = 45) restricted entirely to male military veterans, limiting generalizability. Alcohol consumption and clinical symptoms were self-reported without biological verification, and the dual-intervention protocol prevents isolating the effects of ibogaine from 5-MeO-DMT.

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