Research

Study: Psilocybin Shows Potential Promise in Treating Cocaine Addiction

Is psilocybin a breakthrough for cocaine addiction or another psychedelic overhyped before the science is ready?

Published MAY 19

Study: Psilocybin Shows Potential Promise in Treating Cocaine Addiction

Story

Above: Psilocybin mushrooms grow in a humidified monotub in Fairfield County, Conn., on Dec. 24, 2023. Image credit: John Moore/Getty Images

The Facts

A randomized clinical trial published in JAMA Network Open found that a single dose of psilocybin combined with psychotherapy led to more cocaine-abstinent days, a greater likelihood of complete abstinence and a longer time to first lapse compared with an active placebo over 180 days.
ReachMD
JAMA Network
The trial, conducted at the University of Alabama at Birmingham and published May 7, enrolled 40 adults with cocaine use disorder between May 2015 and August 2023. Of those, 33 were men, 33 were Black and 26 had an annual income of $20,000 or less.
Science
UAB
Participants received either a single oral dose of psilocybin at 25 mg per 70 kg of body weight or 100 mg of diphenhydramine as an active placebo, alongside manualized cognitive-behavioral psychotherapy sessions held before and after an all-day drug session.
guardian
JAMA Network
At the 180-day follow-up, six of 20 psilocybin recipients had achieved complete cocaine abstinence confirmed by urinalysis, compared with none of the 20 placebo recipients. On average, the psilocybin group reported using cocaine 1.5 times a month versus 12 times a month in the placebo group.
Science
ReachMD
No serious adverse events were recorded during the trial. The most common adverse effect among psilocybin recipients was transient hypertension, occurring in six of 20 participants, which resolved without intervention.
Psychology Today
UAB
Researchers and outside experts noted the trial's small sample size, wide confidence intervals and blinding challenges as limitations, and called for larger, multisite trials to replicate the findings. Currently, no FDA-approved medications exist for cocaine use disorder.
Psychology Today
guardian

Sources Split

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The Spin

Narrative A

Psilocybin just cracked open a door that's been locked for 40 years — no drug has ever worked for cocaine use disorder until now. A UAB clinical trial published in JAMA Network Open showed psilocybin recipients had 29% more cocaine-abstinent days, with 30% achieving complete abstinence compared to zero in the placebo group. This is a durable, confirmed result across a deliberately diverse, low-income population that's been ignored by research for too long.

Psychology Today

UAB

Narrative B

Psychedelic research has a serious credibility problem that can't be papered over with promising headlines. The FDA already rejected MDMA-assisted therapy, and a systematic review found high bias risk across nearly all psychedelic addiction and mental health trials. Rushing psilocybin toward approval before fixing these foundational research flaws risks repeating the same mistakes and harming the very vulnerable people these treatments claim to help.