Magic mushrooms show promise as cocaine addiction treatment, study finds

A new randomised clinical trial reported by The Guardian suggests that psilocybin, the psychoactive compound found in so-called magic mushrooms, may be an effective treatment for cocaine addiction. The trial results were published in The Lancet Psychiatry.

The study enrolled 144 adults aged 30 to 65 with a cocaine-use disorder. All participants had used cocaine regularly for at least two years and had not achieved sustained abstinence with previous treatments.

Participants were randomised into two arms. The active group received two high doses of psilocybin, three weeks apart, alongside psychological support. The control group received placebo (niacin) with the same psychological support. All participants were placed under long-term follow-up.

At six months, 42 per cent of the psilocybin group had abstained from cocaine, compared with 11 per cent in the placebo arm. Improvement was also seen in secondary outcomes such as a reduction in weekly use among those who did not fully abstain.

Lead author Dr Felipe Albuquerque, of Imperial College London's Psychedelic Research Centre, said in a press briefing: "These results are striking, but the first requirement is a larger, multi-centre confirmatory trial. Psilocybin therapy is not yet at the stage where it can enter clinical guidelines."

Reported side effects included transient anxiety, nausea and headache. No participants withdrew because of serious adverse events. Brain imaging data showed lasting changes in default-mode-network connectivity patterns in the psilocybin group.

Cocaine-use disorder affects around 22 million people worldwide and currently has no approved pharmacological treatment. Cognitive behavioural therapy and peer-support programmes are the conventional recommendations, but sustained remission rates fall below 20 per cent.

Dr Sara Mendola, professor of addiction medicine at the University of London, told The Guardian: "The effect size is genuinely interesting, but to translate this into clinical practice we need to assess durability and cost-effectiveness."

Under current legal frameworks, psilocybin is classed as a controlled substance in most countries. Clinical research use is permitted in the United Kingdom and Australia, but therapeutic use remains illegal in many jurisdictions, including Turkey.

The research team has announced plans for a 600-patient multi-centre Phase III trial as the next step. The study is expected to begin in 2027 with a budget of around 28 million US dollars, funded by the Wellcome Trust and a private Dutch foundation.