Psilocybin Boosts Cocaine Abstinence in Clinical Trial
SkimNews Take
Psilocybin's potential to treat addiction by disrupting established neural pathways offers a novel approach, contrasting with typical treatments that focus on managing cravings or withdrawal.
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- Psilocybin led to higher cocaine abstinence rates in a JAMA Network Open study, with 19 participants receiving the psychedelic and showing better outcomes than 17 on diphenhydramine placebo
- Dr Peter Hendricks led the trial at the University of Alabama at Birmingham, emphasizing the urgent need for treatments given no FDA-approved medications exist for cocaine or methamphetamine addiction
- Cocaine overdoses are rising globally, according to the UN, as production hits record highs, increasing the public health urgency around effective treatments
- Robin Carhart-Harris suggests psilocybin’s effect on neuroplasticity and psychological flexibility may disrupt rigid addictive behaviors, a mechanism also relevant to depression and anxiety
- Gabrielle Agin-Liebes highlights that psilocybin differs from traditional addiction medications by acting as a catalyst in therapy rather than targeting the same neurochemical pathways as the abused substance
- The trial included a majority of Black participants, a notable shift from typical US psychedelic studies that disproportionately enroll white, higher-SES individuals, due to recruitment focused on cocaine cessation rather than psychedelic interest
- The study design minimized expectation bias by not advertising psychedelics, instead recruiting people seeking help quitting cocaine, making the sample more representative of affected populations in Birmingham
Why it matters: People with cocaine use disorder, especially in marginalized communities, may gain access to a rare effective treatment where none currently exist; the trial’s real-world recruitment and focus on a neglected population increase its clinical relevance and challenge the norm in psychedelic research, which often excludes those most affected by addiction.
