Psilocybin-facilitated psychotherapy may be effective across many mental health conditions, but vulnerable populations, who carry a disproportionate mental health burden, have been largely excluded from clinical research. This report highlights the need to include these groups in studies, considering their problematic historical context and differential experiences with psychedelics. It offers actionable recommendations for future research, such as improved recruitment strategies, careful communication of subjective effects, building therapeutic alliance, multicultural competence, and flexible study designs. The authors call for expanded and improved research in this rapidly advancing field.
A single 25 mg dose of psilocybin, combined with psychotherapy, led to a higher percentage of cocaine-abstinent days, a greater likelihood of complete abstinence, and a longer time before the first cocaine lapse over 180 days compared with an active placebo (100 mg diphenhydramine) in a randomized, quadruple-blind trial. Among 40 participants with cocaine use disorder, 33 were men, 33 were Black, and most had low income. Psilocybin appeared safe, with no serious adverse events, and may offer a treatment for cocaine use disorder in underrepresented populations.