Peter Hendricks

Dr. Hendricks is a clinical psychologist, University Professor, and Heersink Endowed Chair of Psychiatry in the Department of Psychiatry and Behavioral Neurobiology at UAB. His research centers on the development of novel and potentially more effective treatments for substance use disorders and comorbid conditions, with specific areas of focus on vulnerable populations, including individuals in the criminal justice system. He completed the first ever study of psilocybin in the treatment of cocaine use disorder, and is currently Principal Investigator of pilot trials of psilocybin-facilitated psychotherapy in the treatment of fibromyalgia, and low doses or “microdoses” of psilocybin in the treatment of demoralization. Dr. Hendricks is site PI of a NIDA-funded study of psilocybin for smoking cessation and co-editor-in-chief of Psychedelic Medicine.

Psilocybin for cocaine use disorder and Swedish epidemiological data

Annual cocaine-related deaths are estimated at 28,000 in the US, an almost 75% increase since 2019. Most interventions for cocaine use disorder (CUD) result in modest success rates, and there are no approved pharmacotherapies for CUD. Prior research suggests that psilocybin may have broad anti-addictive properties, with recent clinical trials suggesting safety and efficacy of psilocybin in the treatment of alcohol use disorder and tobacco user disorder. Methods: This clinical trial randomized 40 individuals with CUD to receive either 25 mg/70 kg psilocybin (n = 20) or 100 mg diphenhydramine (n = 20). Both groups received an 8-session manualized cognitive behavioral therapy (CBT) intervention for CUD. Drug administration sessions occurred after the 4th CBT session. Biochemically verified percentage of abstinent days and complete abstinence rates through 180 days after end-of-treatment were compared between groups using intention-to-treat analysis. Results: No unexpected or serious adverse events were attributed to psilocybin or diphenhydramine. Percentage of abstinent days and complete abstinence rates were significantly higher among those randomized to psilocybin, with large effect sizes. Conclusions: One psilocybin session, compared to diphenhydramine, with manualized CBT, significantly and substantially increased long-term cocaine abstinence. These results indicate the promise of psilocybin in the treatment of CUD.

Clinical trials have increasingly highlighted the potential therapeutic benefits of psychedelics for psychiatric disorders, such as depression and bipolar disorder, when administered in controlled settings. However, epidemiological research on naturalistic psychedelic use reveals a distinct profile of risks. Observational studies with large US cohorts (N=21,990) demonstrate that naturalistic psychedelic use, particularly in high-risk contexts (e.g., without psychological support or with negative mindset), is associated with modest increases in depressive, psychotic, and manic symptoms. These adverse outcomes are moderated by factors such as frequency of use, intensity of challenging psychedelic experiences, and personal psychiatric history, including schizophrenia or bipolar I disorder. Notably, psychedelic use in risk contexts correlates with more challenging experiences, which may exacerbate depressive symptoms, while manic symptom increases appear linked to subjective insights and psychiatric predispositions. These findings underscore the need for careful monitoring of naturalistic psychedelic use to identify circumstances that heighten harm. Future epidemiological research should prioritize elucidating the contextual and individual factors driving these adverse mental health outcomes to inform harm reduction strategies and public health policies as psychedelic accessibility grows.