The Dark Side of the Mushroom: Understanding the Rise in Psilocybin Exposures

As psychedelics gain mainstream attention for their potential therapeutic benefits, there's another side to the story that deserves equal consideration. Recent data from poison centers across the United States reveals a concerning trend: calls related to psilocybin exposure have skyrocketed by over 317% in the past five years. This dramatic increase comes at a time when several states, including Colorado, are implementing regulated access programs for psychedelic substances. While these programs aim to provide safe, controlled environments for psychedelic therapy, the vast majority of psilocybin use continues to occur outside these regulated settings—often with troubling consequences.

Tracking the Trend: New Data Collection Programs

To better understand the real-world impacts of increasing psychedelic use, Rocky Mountain Poison and Drug Safety (RMPDS) has developed two innovative data collection programs: the Sentinel Poison Center Program and the National Survey Investigating Hallucinogenic Trends (NSIHT)."These innovative Rocky Mountain Poison Center programs leverage the training of our toxicology experts and epidemiologists to collect data to differentiate risks of safe use from cases of misuse or unmonitored use," explains Dr. Andrew Monte, Chief Scientific Officer for RMPDS. The Sentinel Poison Center Program captures detailed information about psychedelic exposures reported to poison centers, including contextual factors that typical poison center data might miss. This includes the nature of the exposure, the source of the drug, dosage, reason for use, setting, and who else was present during the experience. Meanwhile, NSIHT represents the largest ongoing U.S.-based survey developed to understand behaviors associated with psychedelic use, tracking patterns across 16 different psychedelic substances.

The Numbers Tell a Story

The data collected through these programs paints a nuanced picture of psilocybin use and its risks:

Poison Center Calls

• Psilocybin calls to U.S. poison centers have increased by over 317% in the past five years
• The Colorado Poison Center alone received 133 calls for psychedelic exposures between March and December 2024
• Psilocybin was by far the most common psychedelic involved in these calls, followed by MDMA (ecstasy), LSD, and ketamine
• The age range for these calls was startlingly broad—from 10-month-old infants to 90-year-old seniors

Usage Patterns

• Nationwide, about 4.8% of adults (approximately 12.5 million people) used some form of psychedelic drug within the past year
• Psilocybin is the most frequently reported psychedelic, with 1.8% of U.S. adults (about 4.9 million people) using it in the past year
• Colorado shows an even higher rate of psilocybin use, with 3.1% of adults (approximately 140,000 Coloradans) reporting use

Reasons for Use

• The main reason adults gave for using psychedelics was "celebratory purposes" (to have fun)
• For psilocybin specifically, the reasons were mixed: 58% recreational, 43% spiritual, and 40% medical
• Half of those who used psilocybin agreed with the statement that it improved their mental health
• Only two cases in the Colorado data involved psilocybin use for medical treatment in a regulated setting

Understanding the Risks

The sharp increase in poison center calls suggests that as psilocybin use becomes more common, so do adverse experiences. But what exactly are people calling about? While the RMPDS data doesn't detail specific symptoms, psilocybin exposures can lead to a range of concerning effects:

Psychological Distress

• Overwhelming anxiety and panic
• Frightening hallucinations
• Paranoia and suspicion
• Confusion and disorientation
• Temporary psychosis-like symptoms

Physical Symptoms

• Nausea and vomiting
• Increased heart rate and blood pressure
• Muscle weakness or coordination problems
• Dilated pupils and visual disturbances
• In rare cases, seizures

Behavioral Risks

• Impaired judgment leading to accidents
• Self-harm or suicidal thoughts during difficult experiences
• Risky behaviors while under the influence

For most healthy adults, psilocybin's physical toxicity is relatively low compared to many other substances. However, the psychological risks can be significant, especially for those with underlying mental health conditions or those using in unsafe environments.

The Vulnerability of Children and Pets

Particularly concerning in the poison center data is the wide age range of exposures, including very young children. Accidental ingestion by children represents a serious risk as psychedelic mushrooms become more common in homes. "Mushrooms can look like ordinary food to a child," notes one poison center specialist. "Parents who have psilocybin in their homes need to treat it like any other potentially harmful substance—stored securely and completely out of reach of children. "The same applies to pets, who may accidentally consume mushrooms left accessible in the home. Animals can experience severe distress from psychedelic effects they cannot understand or process.

Regulated vs. Unregulated Use

One of the most telling findings from the RMPDS data is that only two cases involved psilocybin use in regulated medical settings. This suggests what many experts have long argued: the context of use matters enormously for safety. Colorado's Natural Medicine regulated access program, which began accepting applications for psychedelic healing centers on December 31, 2024, aims to provide structured, supervised environments for psychedelic experiences. These centers will include screening for contraindications, preparation sessions, supervised administration, and integration support afterward. "This suggests that use within the Natural Medicine Healing Centers in the Colorado State Psychedelic program may be safer than unmonitored use," the RMPDS report notes. However, the vast majority of psilocybin use occurs outside these regulated contexts—often in recreational settings without proper screening, supervision, or support.

Risk Factors and Vulnerable Populations

Not everyone faces the same level of risk when using psilocybin. Several factors can significantly increase the likelihood of adverse reactions:

Pre-existing Mental Health Conditions

People with certain psychiatric conditions—particularly psychotic disorders like schizophrenia or bipolar disorder with psychotic features—face heightened risks from psilocybin use. Family history of these conditions can also be a risk factor.

Medication Interactions

Psilocybin can interact dangerously with certain medications, including some antidepressants, particularly MAOIs (monoamine oxidase inhibitors).

Setting and Support

Using psilocybin in chaotic, unfamiliar, or threatening environments dramatically increases the risk of difficult experiences. Similarly, using without trusted support people present can leave someone vulnerable if challenging psychological material emerges.

Dosage Uncertainty

Unlike regulated medicines, psilocybin mushrooms vary widely in potency. Someone may inadvertently consume a much higher dose than intended, increasing the risk of overwhelming effects.

Harm Reduction Approaches

While abstinence is the only way to completely avoid risks, harm reduction approaches can help minimize negative outcomes for those who choose to use psilocybin:

Education

Understanding psilocybin's effects, risks, and contraindications before use can help people make informed decisions and recognize warning signs of problems.

Setting and Support

Choosing calm, familiar environments and having trusted, sober support people present can significantly reduce risks.

Start Low, Go Slow

Beginning with very low doses can help minimize the risk of overwhelming experiences, especially for those new to psychedelics.

Emergency Planning

Knowing when and how to seek help, including having emergency contacts readily available, can be crucial if difficulties arise.

Secure Storage

Keeping psilocybin products securely stored away from children, pets, and visitors who might accidentally consume them is essential.

The Path Forward: Balancing Access and Safety

The dramatic rise in psilocybin exposures highlights the need for thoughtful approaches to psychedelic policy and education. As states like Colorado implement regulated access programs, monitoring their safety outcomes compared to unregulated use will provide valuable insights. "This helps us provide real data on the safety of Colorado's Natural Medicine regulated access program & legalization for personal use," Dr. Monte explains. The RMPDS data collection efforts represent an important step toward evidence-based approaches to psychedelic use. By capturing detailed information about both beneficial outcomes and adverse events, these programs can help guide policy, healthcare responses, and public education efforts. For individuals considering psilocybin use—whether for therapeutic, spiritual, or recreational purposes—this data underscores the importance of careful preparation, appropriate screening, and safe contexts. While psilocybin may indeed offer benefits for some, the rising poison center calls serve as a reminder that these powerful substances deserve respect and caution. As one addiction specialist puts it: "The same properties that make psychedelics potentially healing—their ability to profoundly alter consciousness and perception—also create risks. Acknowledging both sides of this reality is essential for truly informed approaches to these substances."*This article is based on data from Rocky Mountain Poison and Drug Safety (RMPDS) regarding rising cases of psilocybin exposure. 

Source: Denver Health 

Disclaimer: Psychedelic Assisted Psychotherapy has not been approved by any regulatory agencies in the United States, and the safety and efficacy are still not formally established at the time of this writing.