New Research on Psilocybin for Cocaine Use Disorder

For years, researchers have explored whether psychedelic-assisted therapy could help treat some of the most challenging mental health and substance use conditions. While much of the attention has focused on depression, PTSD, and alcohol use disorder, another important area is beginning to emerge: cocaine use disorder (CUD).

A recently published randomized clinical trial marks an exciting step forward as one of the first controlled studies to evaluate psilocybin-assisted psychotherapy for cocaine use disorder. The results offer encouraging evidence that psilocybin may become a valuable new tool in helping people achieve lasting recovery.

The Need for New Cocaine Addiction Treatments

Cocaine use disorder remains a significant public health challenge, and unlike some other substance use disorders, there are currently no FDA-approved medications specifically for treating it. Treatment typically relies on behavioral therapies, which can be effective but often have limited long-term success.

That makes the search for new treatment approaches especially important.

This clinical trial investigated whether adding a single therapeutic dose of psilocybin to a structured psychotherapy program could improve outcomes compared with psychotherapy alone.

How Psilocybin-Assisted Therapy Was Studied for Cocaine Addiction

Researchers conducted a randomized, quadruple-blind, placebo-controlled study involving adults seeking treatment for cocaine use disorder.

All participants received the same structured psychotherapy throughout the study. They were then randomly assigned to receive either a single therapeutic dose of psilocybin or an active placebo (diphenhydramine). This design allowed researchers to determine whether psilocybin provided benefits beyond psychotherapy alone.

Participants were followed for six months after treatment, enabling investigators to evaluate both short-term outcomes and the durability of treatment effects over time.

Study Results: Psilocybin and Cocaine Use Disorder

The findings were remarkably positive.

Compared with the placebo group, participants who received psilocybin-assisted therapy experienced:

• More cocaine-free days throughout the six-month follow-up period.
• A significantly greater likelihood of remaining completely abstinent from cocaine.
• A substantially longer time before experiencing a relapse.

Perhaps most encouraging, these improvements were observed after just one psilocybin dosing session integrated into a structured psychotherapy program. The study also reported no serious adverse events, adding to the growing body of evidence that psilocybin can be administered safely in carefully supervised clinical settings.

How This Study Could Shape Future Addiction Treatment

This study represents an important step forward in the exploration of psychedelic-assisted therapy for cocaine use disorder, an area where effective treatment options remain limited. While larger studies are still needed to confirm these findings, the results suggest that psilocybin-assisted psychotherapy may offer a promising new approach by helping individuals address the underlying psychological factors that contribute to addiction, alongside supporting sustained recovery. As research in psychedelic medicine continues to advance, studies like this are helping shape a better understanding of how these therapies may one day become valuable additions to evidence-based addiction treatment.

Source: Hendricks PS, Lappan SN, Shelton RC, Lahti AC, Cropsey KL, Johnson MW, Bradley M, Simonsson O, Davis LL, Grossman DH, Ortiz CE. Psilocybin in the Treatment of Cocaine Use Disorder: A Randomized Clinical Trial. JAMA Netw Open. 2026 May 1;9(5):e2611029. doi: 10.1001/jamanetworkopen.2026.11029. PMID: 42096204; PMCID: PMC13153991.