Psilocybin use is on the rise as public perception changes, report shows

S E E D E D   C O N T E N T

By Kaitlin Sullivan

More Americans are using psilocybin, the hallucinogenic compound found in psychedelic mushrooms.

A report published Monday in the journal Annals of Internal Medicine found psilocybin use has been rising since 2019, after remaining relatively stable for years.

"That tells us something is changing," said Kari Rockhill, an epidemiologist and assistant statistical scientist at Rocky Mountain Poison & Drug Safety in Denver, who worked on the report.

In adults, a changing public perception of psychedelics is likely at the forefront of this shift — combined with decriminalization of psilocybin across several U.S. jurisdictions.

"We saw a similar phenomenon with cannabis when it started to be legalized across the country. There is probably a stigma around this that is going down," Rockhill said.

In 2019, the city of Denver voted to decriminalize the Schedule I drug, allowing people to grow and gift, but not sell, psychedelic mushrooms that contain psilocybin. Oregon followed suit in 2020, and decriminalization expanded to the entire state of Colorado in 2022. Books like Michael Pollan's "How to Change Your Mind" have also helped change public perception of psychedelics, said Dr. Todd Korthuis, an internist and addiction medicine specialist at Oregon Health and Science University.

"This is not surprising at all given the developments over the last 10 years," said Korthuis, who is also co-director of the Open Psychedelic Evaluation Nexus, which conducts research on psychedelics.

Andrew Yockey, an assistant professor of public health at the University of Mississippi, added that an unregulated online market, mounting research that suggests psilocybin could be used as a treatment for mental health conditions, and a rise in microdosing also likely contributed to the increase in use. Indeed, the researchers found that psilocybin use was highest among adults with mental health or chronic pain conditions.

Rockhill and her team analyzed five national databases that included self-reported data on psilocybin use, calls made to 55 poison control centers, and medical records to get a picture of how many people used psilocybin across the nation from 2014 through 2023.

Overall, use of the drug remains relatively low: In 2023 — the most recent year for which data was available — just about 2% of adults in the U.S. said they had taken psilocybin in the past year. Twelve percent reported ever taking the drug, up from 10% in 2019, when rates began to increase.

Among adults ages 18 to 29, past-year psilocybin use rose by 44%, to 2.1% in 2023; for adults ages 30 and up, use nearly tripled, to 1.8% in 2023. About 2.5% of 12th graders reported using psilocybin in the last year in 2023, a 53% increase from 2019.

"It is interesting to see the rise in adolescents," Yockey said. "I want to see where they are getting it from, why they are taking it."

The study also found that calls to poison control centers for psilocybin rose sharply over the study period, particularly among children ages 11 and under. In 2023, calls for this age group rose 723% from 2019, though the rates were still low, at less than one child per 100,000 people. For children 12 to 18, calls increased 317%, to just over two people per 100,000. Adults saw a 200% increase in calls, rising to a rate of less than half a person per 100,000.

In addition, 1,550 people, including 1,192 adults, sought medical care because of psilocybin in 2023. From 2015 to 2021, there were just three cases involving medical care.

The calls to poison control for the children under 11 in the report were almost certainly due to kids getting into psilocybin edibles that were not meant for them, Korthuis said.

Although psilocybin alone has a relatively safe toxicology profile, meaning it's highly unlikely to cause life-threatening physical health problems, an unregulated market of edibles can lead to people ingesting things other than psilocybin, even if the packaging does not list them, Yockey said.

"If someone comes to the ER saying I have psilocybin exposure, one of the first things a doctor should do is test for it," he added.