cocaineFull doseFullStrong evidence

Psilocybin reduced cocaine use in its first controlled trial

Eighty-two percent Black participants, in a field that has been overwhelmingly white.

2026Published
Randomised placebo-controlled trialStudy type
40 peopleSample
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What they did

Forty people with cocaine use disorder were randomly assigned to a single dose of psilocybin or an active placebo, each with weekly psychotherapy for a month before and after dosing, then followed for 180 days. The sample was 82.5 percent Black and 65 percent had annual incomes at or below $20,000.

What they found

The psilocybin group had substantially more cocaine-free days and lower relapse risk than the placebo group through the six month follow-up.

82.5%Black participants
180 daysof follow-up
40randomised

Worth knowing

Forty people, with 36 completing. The representation here matters because almost every other trial on this page recruited overwhelmingly white, higher-income participants, which limits how far any of their findings generalise.

Hendricks et al. Psilocybin in the Treatment of Cocaine Use Disorder, A Randomized Clinical Trial. JAMA Network Open, 2026.

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