Psilocybin combined with psychotherapy reduces cocaine use, while animal findings highlight the need for relapse-prevention support

A randomized clinical trial involving 40 adults with cocaine use disorder found that one dose of psilocybin combined with structured psychotherapy led to substantially more cocaine-free days than an active placebo over 180 days. During the final three months, the psilocybin group had about 28 additional abstinent days per 100 days, and 30% maintained complete abstinence compared with none in the placebo group. A complementary study in male rats found that psilocybin and ibogaine accelerated extinction of cocaine-seeking behavior, but neither prevented relapse when cocaine-associated cues were reintroduced. Together, the findings suggest that psilocybin may help treat cocaine addiction when paired with psychological and environmental support, while the human evidence remains limited by the small sample, difficulty masking psychedelic effects, and potential expectancy effects. Future studies should test larger, more diverse populations and clarify how treatment settings affect relapse prevention.