Highlights
• Successful pilot randomised controlled trial of novel psychotherapy for cocaine use disorder conducted at community NHS addictions clinic.
• Adaptation of imaginal and in vivo exposure to help patients helped to elicit and reconsolidate cocaine-related memories for craving control.
• Protocol found to be acceptable to patients, safe (no induced drug use), and with low attrition after enrolment and through follow-up.
• Preliminary evidence that Memory-Focused Cognitive Therapy (MFCT) for cocaine-use disorder can help patients reduce craving and cocaine use.

Cocaine use disorder is prevalent in many countries, associated with substantial global burden of disease and hard to treat. Patients urgently need more effective therapies. This study lends support for a continued science-driven development pathway for MFCT. A superiority randomised controlled trial of MFCT will determine the effectiveness of MFCT for people attending public treatment services with cocaine use disorder.