Dr. Jeffrey Lieberman, MD Psychiatrist in Chief at Columbia University Medical CenterDr. Jeffrey Lieberman, MD Psychiatrist in Chief at Columbia University Medical Center
Keep Coming Back: Real Stories of Sobriety & Recovery
There's methods outside of a 12-step recovery room to get sober. For several decades, Dr. Lieberman has successfully treated patients with addiction with a combination of prescribed medicine and "faith-based healing." In today's interview we explore and debate the merits of both, and additionally discuss why he's an advocate for the use of psilocybin (lsd) in the treatment of alcoholism.
38:30•17 Aug 2021
Faith, Medicine and Psychedelics: Dr Jeffrey Lieberman on Addiction’s Point of No Return
Episode Overview
- Addiction can reach a psychological and then biological 'point of no return', meaning abstinence is possible but the brain is permanently changed.
- Genetic and biological factors influence who becomes dependent on substances, with only a portion of people exposed developing addiction.
- Opiates are among the most addictive substances because of their uniquely intense euphoric and pain-relieving effects.
- Dr Lieberman supports combining medication-assisted treatment with faith-based groups like AA, despite cultural friction between the two approaches.
- Psychedelics such as psilocybin may help some people with alcoholism by creating a powerful cognitive and emotional 'reset', though there are risks like bad trips and rare persistent psychosis.
“"At some point, psychologically, there's sort of a point of no return. And at a further point, there's a biologic point of no return. You will never be who you were."”
What drives someone to seek a life without alcohol and other drugs, especially when the brain itself has been rewired by addiction? This episode of **Keep Coming Back: Real Stories of Sobriety & Recovery** brings together host Mike S and psychiatrist-in-chief at Columbia University Medical Center, **Dr Jeffrey Lieberman**, for a candid, sometimes unsettling, yet very practical chat about what addiction actually does to the brain and what might help people get free.
The conversation starts with Mike sharing his own history: a teenage dental surgery, a first prescription for Percocet that felt "life-changing", and years of mixing opiates, stimulants, sedatives and alcohol like a daily science experiment. Dr Lieberman responds not with judgement, but with clinical clarity, explaining why opiates sit at the top of the addictive food chain and how repeated use can push someone past a "psychological" and then "biologic" point of no return.
You’ll hear Dr Lieberman draw a line between mental illnesses and addictive disorders, talk genetics and susceptibility, and explain why some people vomit on opiates while others feel "amazing". He also tackles the tension between **medication-assisted treatment** (like Vivitrol, Antabuse, Suboxone) and **faith-based groups** such as AA, arguing that for many people a mix of both is ideal, even if the cultures don’t always line up. The most striking section looks at **psychedelic-assisted treatment**.
Dr Lieberman, who has taken part in clinical trials, outlines why psilocybin and other psychedelics might help with alcoholism and depression by giving some people a powerful "reset" in how they see themselves and their lives, while also being honest about the small but real risks of bad trips and psychosis. If you’re curious about why you can’t "just stop", or you’re wondering what options exist beyond (or alongside) 12-step meetings, this conversation offers a grounded, science-based look at possibilities.
Where might your own recovery sit between faith, medicine and these emerging therapies?
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