‘Magic mushrooms’ safety in spotlight as Colorado prepares for increased use

The use of psilocybin, the psychoactive compound in “magic mushrooms,” is expected to rise significantly this year with the launch of Colorado’s Natural Medicine Program, which oversees its use in regulated environments.

Colorado voters in 2022 approved Proposition 122, making Colorado the second state, after Oregon, to decriminalize the use of psychedelic mushrooms for those 21 or older. Prop 122 provides for the use of psychedelic mushrooms under supervision by a licensed guide. While proponents highlight its therapeutic potential, experts at Denver Health’s Rocky Mountain Poison and Drug Safety (RMPDS) are sounding a note of caution about its use without the supervision of a guide.

Richard Dart, MD, director of RMPDS, said that many people assume that psychedelics are safe, which may be true in a controlled setting with proper supervision. But Dart said the poison center has had a concerning uptick in calls from people reporting negative experiences while using it recreationally.

“Our results conflict with common views about magic mushrooms,” Dart said. “Much more information is needed to assess the safety of these products and the other psychedelic drugs available.”

The effects, both beneficial and detrimental, need to be monitored to assess how to use psychedelics in an optimal manner.

Poison center calls related to psychedelics – particularly psilocybin – have spiked in recent years, with cases involving children as young as 18 months. Calls to poison centers in the U.S. have increased 317% over the past five years. The increase has been greater in Colorado and Oregon. Most incidents stem from recreational use, not supervised therapeutic settings.

“We’re also seeing cases where psychedelics were given to someone without their knowledge or where children accidentally ingested them,” Dart said.

Growing public health concern

RMPDS is monitoring the public health effects of psychedelics through three programs:

• National Survey Investigating Hallucinogenic Trends (NSIHT): This is the most thorough survey of the U.S. population measuring real-world use of psychedelic substances in and outside of licensed clinical settings. The NSIHT survey found that 2.1% of adults (roughly 5.4 million people) used psilocybin in the past year. The percentage is higher in Colorado.  In contrast to national news reports, we are finding that the primary reason for use is abuse and celebration rather than people trying to address issues like depression or PTSD. “These issues highlight the need for more robust safeguards and public education,” Dart said.

• Poison Center Psychedelic Case Monitoring: This program collects exposure data from patients and health care providers who call poison centers, which helps to understand patterns of psychedelic drug use, including accidental exposures in children. Nearly all callers to the centers report that they used it for celebration purposes or to harm themselves.

• Longitudinal Psychedelic Treatments Study: This program will track Colorado’s healing centers program, expected to launch in April, and measure the effect of therapies for people receiving psychedelic treatment. Measures include patient experience before and after treatment, overall well-being and adverse experiences. While Colorado’s forthcoming healing centers aim to provide a safer environment for psilocybin use, their effectiveness remains to be seen.

Lessons from the opioid crisis

Dart draws parallels between the current enthusiasm for psychedelics and the initial optimism surrounding prescription opioids.

“Many news reports focus on the therapeutic potential of opioids and ignore their broader misuse,” he said. “We’re seeing a similar dynamic with psychedelics.”

As Colorado ventures into this new frontier, Denver Health and RMPDS emphasize the importance of understanding the risks of psilocybin. Through continued research and public outreach, they aim to ensure that psychedelics are used safely and responsibly.