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Since 2019, the number of people in the United States using psilocybin has gone up sharply, which lines up with when some states began to decriminalize the hallucinogenic chemical found in “magic mushrooms.”

Psilocybin use increased across all age groups, with the largest uptick seen in young adults and older adults. With increased use of the hallucinogen came a parallel increase in psilocybin exposure–related calls to poison-control centers. 

“Public views on psilocybin are shifting. However, that means we also need to make sure people understand the risks, know how to use it safely if they choose to, and that healthcare systems are prepared,” Joshua Black, PhD, co–lead author and senior scientist at Rocky Mountain Poison and Drug Safety, Denver, said in a statement. 

The study was published online on April 22 in Annals of Internal Medicine. 

Psilocybin is being studied as a potential treatment for posttraumatic stress disorder, depression, substance use disorders, and other psychiatric conditions. 

As the first hallucinogenic substance to be decriminalized in some states, patterns of use have likely changed, the study team said.

They quantified changes in prevalence of psilocybin use and healthcare utilization by psilocybin users from 2014 to 2023 using five nationally representative datasets — the National Survey on Drug Use and Health, the Survey of Nonmedical Use of Prescription Drugs, Monitoring the Future, the National Poison Data System, and the National Hospital Ambulatory Medical Care Survey.

The key findings include:

• Psilocybin use across datasets was relatively stable before 2019, the first year psilocybin was decriminalized anywhere in the United States
• Lifetime psilocybin use among adults aged 18 years or older rose from 10% in 2019 (about 25 million people) to 12.1% in 2023 (over 31 million people)
• From 2019, past-year use increased 44% among young adults aged 18-29 years and 188% among adults aged 30 years or older. Psilocybin use in the past year among high school seniors increased 53% from 2019
• In 2023, more adults used psilocybin than drugs like cocaine, lysergic acid diethylamide, methamphetamine, or illegal opioids
• People with mental health conditions or chronic pain were more likely to report using psilocybin than individuals without these conditions 

“What really surprised us was how quickly these numbers changed and how many people using psilocybin had conditions like depression, anxiety, or chronic pain,” co–lead author Karilynn Rockhill, PhD, with Colorado School of Public Health, Aurora, Colorado, said in the statement. 

“New laws or growing interest in its potential mental health benefits may be prompting people to seek psilocybin as a form of self-treatment,” Rockhill added. 

The data also show that between 2019 and 2023, the rate of psilocybin-related calls to poison centers rose 201% in adults, 317% in adolescents aged 12-17 years, and 723% in children aged 11 years or younger. However, few cases were recorded in emergency departments of outpatient facilities.

Investigators called for education and enforcement of dose limits in states that have legalized psilocybin use and in those contemplating similar legislation. Passive and active surveillance that better describe who is using the substance and for what reason and clinical outcomes are needed, they added.

“If hospitals and public health systems aren’t seeing the full picture, they can’t respond appropriately. Improved tracking tools and education are critical as more states consider regulating or legalizing psilocybin,” Black said.

The study received no commercial funding. Disclosures for study authors are available with the original article.