Psilocybin demonstrates therapeutic potential in cocaine use disorder

In the treatment of individuals with cocaine use disorder, the use of psilocybin may help improve abstinence rates and reduce the risk of cocaine lapse over time, as shown in a study.

Forty participants (median age 50 years, 82.5 percent male, 82.5 percent Black, 65 percent had lower socioeconomic status) with cocaine use disorder who were motivated to quit and without significant comorbidities participated in the study.

The participants were randomly assigned to receive a single oral dose of psilocybin (25 mg per 70 kg of body weight) or active placebo (100-mg diphenhydramine). Manualized psychotherapy incorporating cognitive-behavioural treatment was also administered approximately 1 month before and 1 month after an all-day investigational drug treatment session.

Outcomes of interest included percentage of cocaine abstinent days, rates of complete cocaine abstinence, and time to first cocaine lapse through 180 days after end of treatment. Assessments were by timeline followback interview and confirmed with urinalysis. Hypotheses were formulated before data collection, and analyses followed intention-to-treat principles.

Of the participants, 36 completed assessments through 180 days after end of treatment. Compared with active placebo recipients, psilocybin recipients had a significantly higher percentage of cocaine abstinent days (p<0.001), greater likelihood of complete cocaine abstinence (odds ratio, 18.37; p=0.007), and a reduced risk of cocaine lapse over time (hazard ratio, 0.28; p=0.001).

None of the participants experienced serious adverse events.

The findings show that psilocybin may be a novel treatment for cocaine use disorder.