A single dose of magic mushrooms could assist cocaine addicts in breaking the cycle of addiction, according to recent research. Global cocaine consumption reached unprecedented levels in 2023, with more individuals turning to the illicit substance during the pandemic than ever before. In the United Kingdom, cocaine ranks as one of the most prevalent illegal drugs, second only to cannabis.
Currently, there are no approved medications for cocaine addiction or other stimulant use disorders. The sole resource available to users is cognitive behavioural therapy, a form of psychotherapy. Hallucinogens like psilocybin, the active compound in magic mushrooms, have demonstrated potential in treating various mental health conditions, including alcohol use disorder and smoking cessation. Now, this substance offers hope to those dependent on cocaine.
Study Details and Findings
The new study, published in JAMA Network Open, followed 40 cocaine users in the United States for approximately six months. Participants were randomly assigned either a single dose of psilocybin or a placebo antihistamine, with both groups supported by a licensed therapist. Results indicated that those who received psilocybin were more likely to abstain from cocaine than those given the placebo.
To be included, participants had to be over 25 years old, have used cocaine on at least four days in the past month, and express a desire to quit. Individuals with other mood disorders treated with antidepressants, high blood pressure, or a history of bipolar disorder were excluded. After initial prescreening, participants completed up to five psychotherapy sessions and seven days of cocaine abstinence before the study period began. Following the all-day drug session, where capsules containing either psilocybin or antihistamine were administered, participants underwent five additional therapy sessions. Follow-up assessments were conducted 90 and 180 days after the final therapy session.
Key Results
The findings showed that those treated with psilocybin alongside psychotherapy were significantly less likely to relapse and experienced a higher percentage of cocaine-free days. Study lead author Dr. Peter Hendricks from the University of Alabama noted that these results are particularly relevant given the rising number of Americans dying from stimulant overdoses. Cocaine-related deaths are increasing globally, as addicts struggle to challenge impulsive behaviours.
Unlike cocaine, which works on specific receptors, psilocybin alters a user's state of consciousness, typically in a single therapy session. This altered state is believed to facilitate shifts in perspective, helping users change their behaviour. Dr. Hendricks stated, "These findings are a potentially important advancement in the treatment of cocaine use disorder, a condition for which there are no approved pharmacotherapies and limited psychosocial interventions."
Population Representation and Expert Opinions
The representation of vulnerable populations in previous trials has been a concern, as data suggest that cocaine use is the strongest predictor of criminal conviction and re-offending rates. This is particularly true for low-income black men, who made up the majority of the current study, while white individuals are more likely to report lifetime addiction. Experts commented that the results are "a long time coming, arriving at a critical juncture of the overdose epidemic's fourth wave and a national mental health crisis."
However, Professor Erin Bonar, a licensed clinical psychologist, cautioned that emerging treatments must be effective for both substance use disorder and depression, a common symptom of cocaine withdrawal, which the current study could not prove. She added that a "careful balance" is required when considering psilocybin as a potential treatment to avoid a rise in psychedelic use and associated adverse events among vulnerable populations seeking relief.
Cocaine remains one of the most widely used illegal drugs in the UK, second only to cannabis. Despite its reputation as a "middle class" party drug, it is used across all demographics, income levels, and social groups. It is also a leading cause of sudden cardiac death, and combining it with alcohol increases the risk by up to 25 times.
