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Child Psychiatrist /Adult Psychiatrist

Poison Center Calls for Adolescents Exposed to Psilocybin Have Tripled Since 2018

Keypoint: Psilocybin poisoning exposures started to significantly increase starting in 2019 for adolescents and in 2020 for adults.


From 2018 to 2022, psilocybin poisoning calls have tripled for adolescents and doubled for young adults, as reported in the Journal of Adolescent Health.

The psychoactive agent in hallucinogenic mushrooms, psilocybin, can cause intense psychedelic hallucinations, euphoria, and altered perception of space and time. Although psilocybin is designated as a Schedule I substance in the US, multiple cities and states have taken steps to decriminalize psilocybin.

To evaluate trends in adolescent and young adult exposures to psilocybin in the US, investigators from the University of Virginia School of Medicine sourced data for this study from the National Poison Data System (NPDS). The investigators identified cases between 2013 and 2022 in which individuals (N=4055) aged 13 to 25 years were exposed to psilocybin. The investigators also collected the available demographic data, level of healthcare received, reason for exposure, and medical outcome.

Among reported psilocybin exposures, 2372 cases involved adolescents and 1683 involved young adults. Most psilocybin poisoning calls involved boys or men (74.8% to 75.1%), most events involved intentional abuse (78.3% to 81.1%), and 65.8% were single-substance exposure events.

The number of psilocybin-related cases was relatively stable between 2013 and 2018. However, the number of cases started to significantly increase starting in 2019 for adolescents and in 2020 for adults (both P <.001). By 2022, cases had more than tripled among adolescents (P <.0001) and more than doubled among young adults (P <.0001) compared with 2018. From 2013 to 2022, the number of cases more than doubled among men and boys (246 to 545; P <.0001) and almost tripled among women and girls (73 to 213; P <.0001).

In single substance cases, 72.3% of adolescents and 72.1% of adults received medical attention and the event resulted in a moderate effect on 47.1% of adolescents and 45.3% of adults. The most common effects included hallucinations or delusions (36.6%), agitation (27.6%), tachycardia (20.2%), and confusion (16.0%). In addition, seizures were reported in 1.8% of cases.

In multiple exposure cases, the most common co-occurring substances were marijuana among adolescents and alcohol among adults. Two deaths occurred in cases that involved fentanyl and hallucinogenic amphetamine, in which psilocybin was determined to be the secondary cause of death in both cases.

These findings indicate that psilocybin poisoning exposures have significantly increased in recent years among adolescents and young adults in the US. Study authors concluded, “As psilocybin might become more available, continued surveillance is critical to inform lawmakers and guide public policy.”

The primary limitation of this study is that reporting to poison control is voluntary and only includes cases that rise to the level requiring medical attention, so rates of psilocybin use in this study are likely an under-representation of real-world use.

Note: This article originally appeared on Psychiatry Advisor

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