Can a single dose of psilocybin help people quit cocaine?

A randomized controlled trial tested psilocybin plus structured psychotherapy for a disorder with no approved medications.

Researchers ran a rigorous randomized controlled trial testing whether a single dose of psilocybin, combined with structured psychotherapy, could help people quit cocaine, a disorder with no currently approved medications. Forty adults with cocaine use disorder, most of them Black and lower-income, a population historically underrepresented in psychedelic research, were randomly assigned to receive either psilocybin or an active placebo, alongside the same therapy protocol either way. Neither participants, therapists, nor the people analyzing the data knew who got what. The results were striking: people who got psilocybin had far more cocaine-free days, were about 18 times more likely to achieve complete abstinence through 180 days, and had a much lower risk of relapsing compared to the placebo group. No serious side effects occurred, though the drug's effects made it hard to fully disguise who'd received it, a known challenge in psychedelic research. While the sample size is small and a few questions remain (like exactly how much unblinding affected the results), this is the first trial of its kind for cocaine use disorder and represents a genuinely promising signal for a notoriously hard-to-treat addiction.