By Sandee LaMotte, CNN
(CNN) — Unsupervised use of psilocybin, or “magic mushrooms,” has accelerated among all age groups in the United States, but especially among adolescents and people 30 and older, a new study found.
“The prevalence of psilocybin use in 2023 rose dramatically over the prior five years since states began liberalizing policy in 2019,” said study coauthor Dr. Andrew Monte, a professor of emergency medicine at the University of Colorado Anschutz Medical Campus in Aurora.
Use of psilocybin increased by 2.4% among 12th graders in 2023, an increase of 53% over five years, according to the study published Monday in the Annals of Internal Medicine. While the study only had official data through 2023, additional data being collected for 2024 is showing a continued rise, Monte said.
Psilocybin use in 2023 among adults was higher than estimates for cocaine, illicit opioid use, methamphetamine or LSD (lysergic acid diethylamide), the study found. Since 2019, these higher levels of psilocybin use reflected an increase of 188% among adults 30 and older and 44% among 18- to 29-year-olds.
Adults with mental health or chronic pain conditions were more likely to use psilocybin, the study found. The trend is especially worrisome due to the corresponding rise of calls to poison control centers, especially among US adults 30 and older, according to the research.
“As these drugs are used more in the community, you will see more adverse events, because people are not using psilocybin in a controlled setting such as a clinical trial, which is the only scenario in which we have study data on benefits,” said Monte, who is also the chief scientific officer and medical director at the Rocky Mountain Poison & Drug Safety in Denver.
A few clinical trials have found psychedelics show promise in treating depression, anxiety, substance use, and post-traumatic stress disorder, or PTSD, said Dr. Petros Petridis, a clinical assistant professor of psychiatry at NYU Grossman School of Medicine in New York City. He was not involved in the study.
“These are powerful agents that can profoundly alter consciousness,” Petridis said via email. “In clinical trials, their use is tightly regulated, with careful psychological screening, preparation, and integration afterward to ensure safety and adequate emotional processing. Outside of those guardrails, the risk for adverse psychological reactions, especially in younger users without adequate support, increases substantially.”
Because psilocybin leads to hallucinations, people may become agitated and hurt themselves or others and end up in a hospital emergency department, Monte said.
“Psilocybin can cause your heart to race, so people with cardiovascular disease may be at increased risk of adverse cardiac events,” he said. “These drugs also interact with medications such as antidepressants, so it’s really important to talk to your doctor about potential dangers before you consider using psilocybin.”
“My major take-home messages is that people need to plan before they trip,” Monte said. “You need a safe place and have somebody with you in case you have a bad reaction, which absolutely happens.”
The downside of psychedelics
The dangers of unsupervised use of psychedelics such as psilocybin should not be taken lightly, experts say. A study published in March found a link between bad psychedelic trips and a more than twofold increased risk of death within five years. The study found suicide to be the most common reason for an early death, along with unintentional drug poisoning, respiratory disease and cancer.
About 1 in 20 people report ongoing difficulties after their psychedelic experience, Dr. Charles Raison, a professor of psychiatry and human ecology at the University of Wisconsin School of Medicine and Public Health in Madison, told CNN in a prior interview. He was not involved in the new research.
“A year later, they say, ‘I had an experience that was so distressing to me that it messed up my ability to function, or alienated me from my family, or gave me post-traumatic stress disorder,’” Raison said.
However, no study can definitively establish that increased mortality is due to a bad experience with a psychedelic, he said: “It could well be that the things that drove the person to have a bad psychedelic experience are the things that then also make them more likely to die.”
A significant jump in use
The new study analyzed data from five national drug surveys: the National Survey on Drug Use and Health, the Survey of Non-Medical Use of Prescription Drugs, Monitoring the Future, the National Poison Data System and the National Hospital Ambulatory Medical Care Survey.
Psilocybin use was relatively stable before the drug was first decriminalized in Denver in May 2019, according to the study.
However, lifetime use of psilocybin increased from 10% to 12.1% of the US population between 2019 and 2023, moving from 25 million people to 31.3 million people as state and local governments have removed restrictions, according to the study.
“Oregon and Colorado have legalized psilocybin, some jurisdictions have decriminalized possession, and other states have or are looking at approving medical use of psilocybin,” Monte said.
While the current study did not look at rationales for psilocybin use, a national survey done by Rocky Mountain Poison & Drug Safety does provides insights, he said.
“We know a majority of use is still for recreational purposes, not medical purposes, even when people do have mental health conditions,” Monte said. “That’s worrisome due to the potential negative reactions when not used as directed by a doctor.”
Much more study needs to be done before the full impact of recreational psilocybin use will be known, Raison said.
“We don’t know what percentage of people would report benefit and what percentage would report harm and how severe that harm will be,” he said. “My guess, based on data to date, is that the increased use reflected in the study will produce both benefit and harm. I also suspect the harms would be reduced if psilocybin were administered in a safe setting, with appropriate supervision.”
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