Magic mushrooms (a.k.a. shrooms) are naturally occurring fungi whose primary compound, psilocybin, is converted into the mind-altering substance psilocin after ingestion.1 Psilocybin is a psychedelic drug that has long been known to induce perceptual alterations that can be mind-expanding but also disorienting. As such, psilocybin has recently received much attention for its potential medicinal and psychotherapeutic use.
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What Is Psilocybin?
Psilocybin (3-[2-(dimethylamino) ethyl]-1H-indol-4-yl dihydrogen phosphate) is a naturally occurring compound found in over 200 different species of mushrooms. Ingestion of this hallucinogen can affect one’s perception, cognition, and mood. It has been used recreationally and medicinally throughout history, with vacillating legal status to this day.
Psilocybin can be sourced naturally – often from the dung of animals like cattle, horses, and buffalo – however, it can also be synthesized chemically. Regarding natural varietals, some of the most common types used for recreational and medicinal purposes are the psilocybe semilanceata (Liberty Caps) or psilocybe cubensis (Golden Teacher, White Albino, and Penis Envy) strains.
The experience after ingesting psilocybin is quite variable between people. When harvested (as opposed to synthesized in a laboratory), the amount of psilocybin per gram of mushroom can also vary substantially between and within species but is generally more stable in dried form than fresh.2,3,4
Are Magic Mushrooms Legal?
Since 1970, psilocybin has been classified as a Schedule I drug with other drugs, like heroin, that are deemed to have no recognized medicinal uses and a high potential for abuse. Legally, however, things began to change in 2018 when the FDA granted breakthrough therapy status to psilocybin for treatment-resistant depression.
Then, in 2020, the Entheogenic Plant and Fungus Policy Act was passed, which eased the enforcement laws for psychedelic drugs, including psilocybin, lowering its priority for law enforcement attention and prosecution.5 In addition, since 2020, several states have decriminalized psilocybin, including Oregon, Washington, California, Colorado, Michigan and Massachusetts.
Most recently, on June 23, 2023, the FDA issued guidance for clinical research using psilocybin (and also LSD and MDMA), allowing for legal use of psilocybin nationally within healthcare treatment settings with observation by two trained monitors, where one must be licensed with graduate-level professional training and clinical experience in psychotherapy.6
What Are the Different Forms of Psilocybin?
Psilocybin is available in many forms. Dried shrooms can be steeped in boiling water to form a tea or coated in chocolate to mask the bitter flavor. Fresh mushrooms contain 80-90% water and a greater quantity is thus needed per gram of psilocybin (depending on the strain). Mushrooms can also be ground into powder and sold in capsules; however, this form is considered less safe than fresh or dry since it can more easily be tampered with or laced with other substances.
What Is the Dose of Psilocybin in a Mushroom?
Intra- and inter-species variability is considerable regarding the actual amount of psilocybin in each mushroom specimen.2,3 Accordingly, one gram of mushroom can contain between 0.5% and 2% psilocybin; thus, starting out with smaller doses is recommended.1
On average, one gram of a dried mushroom from the Psilocybe cubensis species contains approximately 1% psilocybin. Most clinical research studies employ a 25mg dose of psilocybin, which would require ingestion of 2.5 grams of dried mushroom. A high dose would be 35mg of psilocybin, and a supra-therapeutic dose is 50-60mg.1
How Does Psilocybin Work?
Primarily, psilocin acts on serotonin, particularly at 5HT-2A receptor sites. However, it also indirectly influences other neurotransmitters, like glutamate, NMDA, and AMPA in the prefrontal cortex and dopamine in the striatum. This domino effect is believed to be responsible for psilocybin’s efficacy in treating several mental health disorders (e.g., depression and addiction), stimulating the creation of new neural connections, and improving cognitive function.7
When ingested, psilocybin is converted to psilocin (4-hydroxy-N,N-dimethyltryptamine) in the digestive tract, where the acidic environment aids the conversion. Unlike psilocybin, which is water-soluble and can’t cross the blood-brain barrier, its metabolite, psilocin, is fat-soluble and can make its way into the brain to trigger its psychotropic effects in 20-40 minutes, with peak effects in 60-90 minutes.
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What Happens When You Take Magic Mushrooms?
As you interact with the world, your brain develops connections and pathways that strengthen the more they are used and reinforced. Psilocybin has been shown to be helpful in weakening dysfunctional connections that give rise to maladaptive thoughts and behavior – as with addiction, depression, and anxiety disorders (e.g., obsessive-compulsive disorder) – and encouraging new adaptive connections.9
Psilocybin affects the brain and body in the following ways:
- Serotonin: Psilocybin’s metabolite, psilocin, which closely resembles serotonin, activates serotonin pathways, particularly mediated through 5HT-2A receptors. This contributes to direct effects, like the generation of psychedelic effects and hallucinations, and is believed to underlie psilocybin’s role in treating depression and suicidality.10
- Glutamate: The flood of serotonin activity leads to a release of glutamate in the prefrontal cortex.10 Psilocin’s effect on prefrontal glutamate is believed to be central to its therapeutic role in treating addiction and improving cognition.7
- Dopamine: Psilocin also indirectly increases the release of dopamine in the striatum via the changes in serotonin levels. Changes to striatal dopamine are believed to underlie psilocybin’s therapeutic effect for patients who suffer from depression with suicidal ideation and addiction since it regulates dysfunction in the reward pathway.10
- Neural connectivity plasticity, neurogenesis: Psilocybin alters connections between neurons (plasticity) and stimulates new neuronal growth (neurogenesis) through activation of brain-derived neurotrophic factor (BDNF), which modulates N-methyl-D-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors in the prefrontal cortex. These changes can further affect gene expression and signal transduction.7
- Oscillatory brain activity: Brain oscillations are rhythmic patterns in brain activity that reflect the ongoing communication between brain areas as you move through your day or sleep at night. Psilocybin calms certain oscillations (e.g., resting-state and default-mode network) while leaving others intact (e.g., basic visual and motor). Essentially, it can be conceived as an orchestra conductor, helping brain areas synchronize to create a more balanced symphony.11
- Cerebral glucose metabolism: Cerebral glucose metabolism reflects how the brain uses energy and, essentially, how active it is. Psilocybin increases the regional cerebral glucose metabolism in the frontal cortex in a pattern similar to that observed during an acute psychotic episode.12
- Antioxidant activity: Psilocybin has been shown to reduce oxidative stress in the brain and has been theorized to reduce suicidal behavior.10,13,14
- Blood flow: Psilocybin decreases cerebral blood flow in key hub-like brain regions like the thalamus and cingulate.15 This is believed to play a role in the calming of existing neural connections, allowing alternative connections to form.16
- Cardiovascular changes: Magic mushrooms contain other compounds besides psilocybin: Phenylethylamine (PEA) is an amphetamine-like compound that can cause adverse side effects like tachycardia and high blood pressure as well as anxiety and nausea in some people. It is more variable between mushroom specimens than psilocybin and may be the reason why some people experience worse side effects than others.17
What Are the Main Effects of Magic Mushrooms?
Though people take magic mushrooms with different goals in mind, the main effect is a series of alterations in mood, sensory perception, and psychological perspective, along with a dissociative trance state leading to the separation of a person from their ego. Researchers believe that the therapeutic effects of psilocybin and other psychedelics are largely absent when this dissociative trance is not achieved.18
Magic mushrooms or ‘shrooms’ can cause the following effects:
- Feelings of euphoria
- Altered thoughts
- Seeing issues from a different perspective
- Synesthesia (blending of senses like tasting colors or seeing sounds)
- Improved cognition
- Reduced suicidality
- Reduced anxiety
- Spiritual connectedness
- Relief of existential distress
- Mystical feelings
- A cutting of the cord between one’s thoughts and emotions
- Feeling no separation between the self and the environment, which some people experience as beautiful and others experience as terrifying
- Altered perception of space and time
- Dissociation
- Dilated pupils
- Anti-inflammatory effects
Physical Side Effects
It’s not uncommon for people to experience negative physical side effects – particularly stomach-related – after ingesting psilocybin mushrooms. These gastro symptoms, including stomach pain, nausea, and occasional vomiting, often present for about 15-20 minutes before the onset of psilocybin’s psychedelic effects. It has been suggested that such side effects are not induced by the psilocybin itself but rather by other compounds in the fungus (e.g., phenylethylamine) and their interaction with stomach acids.4,17
Common physical side effects of psilocybin include:
- Nausea
- Transient hypertension
- Increased heart rate (tachycardia)
- Mild headache
- Muscle weakness
Less common physical side effects of psilocybin include:
- Physical discomfort
- Vomiting
- Fatigue
Negative Mental & Emotional Effects
Not every psilocybin trip will be experienced in a pleasurable or positive way. An estimated 9% of psychedelic users (slightly lower for psilocybin) will have a distressing experience leading to functional impairment lasting more than a day.19
Some negative mental effects can result from some powerful or unexpected sensations that result. Others may stem from feelings of dissociation or ego death that are too disorienting. And yet others may be the result of anxiety that manifests – either in direct or indirect response to the mental effects of the trip.
Common mental and emotional effects of psilocybin include:
- Perceptual distortions
- Nervousness
- Anxiety
- Confusion
Less common mental and emotional effects of psilocybin include:
- Hallucinations
- Paranoia
- Intense fear
- Mental discomfort
- Prolonged psychosis
Does Everyone Experience the Effects of Psilocybin Similarly?
The nature of each psilocybin experience can vary based on many factors, including one’s personality, biology, and mindset. While some biological factors like genetics, susceptibility to psychosis, and medical contraindications can skew the experience, psychological factors like mindset can play a role, too.
Factors that can influence your experience with mushrooms include:
- Set: Factors brought into the experience by the individual, like one’s drug sensitivity, previous experiences, expectations, and mental state
- Setting: Physical and social environment in which the drug is taken (e.g., serene retreat center or a loud dance club; music, religious or spiritual imagery; presence of support staff)
- Guide/Support: Having a trusted sober person (e.g., a therapist, guide, or friend) to stay with you and support you through the experience can reduce anxiety before and during.
- Stomach acidity: Greater stomach acidity can increase the metabolism of psilocybin to its active metabolite, psilocin.7 Some users have reported that mixing the shroom powder with lemon juice before ingesting it (called lemon tekking) can speed up the psychotropic effects, but this can also increase the side effects as well.
- Empty stomach: The amount of food one has in the stomach and the degree to which that food is fat-soluble can affect the metabolism of psilocybin. Research and clinical applications of psilocybin usually require fasting for 1-2 hours before ingestion.1
- Liver dysfunction: Since some conversion of psilocybin to psilocin occurs in the liver, dysfunction of this organ may change the experience.
- Prior psychedelic use: Recent use of psilocybin and other psychedelics (e.g., LSD) can raise one’s tolerance, resulting in reduced psychotropic effects.
- Purity and species/strain of the psilocybin: Synthetic psilocybin from a licensed laboratory has the highest purity. Naturally harvested fresh and dried mushrooms can vary substantially between and even within a given species and strain.
- Method of administration: Effects are first experienced around 40 minutes after oral ingestion of psilocybin and 4 minutes after intravenous administration. However, the effects last for 4-6 hours after oral administration and only 45-60 minutes after intravenous.10
- Age: While psilocybin has shown promise as a therapeutic for end-of-life anxiety and other conditions like dementia, most research studies have not included participants over the age of 60, so safety and efficacy for older adults is not well studied. Side effects like cardiovascular events are of particular concern.20
- Body weight and metabolism: While body weight does not seem to affect the subjective effects of a given psilocybin dosage, metabolism (how efficiently your body processes and breaks down the psilocybin) can.21,22
- Personality: Personality types that are most conducive to a positive experience are those that are not prone to anxiety. However, psilocybin can also alter certain facets of personality; for example, it was shown to reduce a person’s neuroticism and increase extraversion and conscientiousness at 3 months following treatment.23
- Contraindications: There are several conditions that increase the likelihood of a negative experience, including schizophrenia, psychosis, bipolar disorder, borderline personality disorder, and cardiovascular conditions.
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Potential Risks of Magic Mushrooms
Psilocybin is not recommended for individuals at risk for psychosis, schizophrenia, bipolar disorder, or borderline personality disorder, as it can increase the risk of psychological distress and psychotic symptoms. It is also not recommended for people who are pregnant or breastfeeding, as there is a lack of safety data.1
Physical risks include increases in blood pressure and heart rate and stress on liver function. Accordingly, psilocybin may be contraindicated for individuals with cardiac and liver conditions.
Some of the risks of taking magic mushrooms include:
Bad Trips
While many people have a positive experience when taking magic mushrooms, an estimated 30%-40% of individuals experience a “bad trip,” characterized by distressing feelings of fear, panic, and paranoia and somatic symptoms like heart palpitations and dizziness.24,25 A common theme of a bad trip involves “ego dissolution” (a.k.a., “ego death”) or a sense of one’s individuality vanishing, though some people experience this state as a spiritually blissful oneness with the universe.
Ironically, despite the distress caused by a “bad trip,” many of the individuals (80%) experiencing a bad trip also report improvement in well-being afterward and have found therapeutic benefits to the challenging experience.26
Several factors that can contribute to a bad trip include:
- Pre-existing mental health conditions (e.g., disorders involving psychosis)
- Dosage (higher doses are more likely to lead to negative experiences)
- Impurity of the substance being ingested
- Anxiety before the session starts
- Unfamiliar environment
- Threatening environment
- Unsupportive people around you
- Unresolved emotional conflict
Mushroom Poisoning/Overdose
According to research studies, 25mg is considered a standard dose, 35mg a high dose, and 50-60mg a supra-therapeutic dose. Overdosing on psilocybin is not likely as it has a favorable safety profile with an extremely high lethal dose. However, higher doses can increase the likelihood of side effects, especially in drug-naive individuals and those with cardiovascular contraindications.27,28
Given psilocybin’s relatively safe profile (especially compared with other psychedelics like MDMA and DMT), the larger concern is accidental poisoning from incorrectly identified mushroom species. Since psilocybin is currently not legal in many areas, individuals seeking to consume magic mushrooms for recreational or medicinal purposes may procure it from unreputable sources and risk accidentally ingesting a poisonous fungus species with a similar appearance.29
Drug Interactions
Research findings related to interactions between psilocybin and other psychoactive drugs are limited, and much of what is known is theoretical. Much of the existing research focuses on the 5HT2A receptor, which, when blocked by psychiatric medications like buspirone, risperidone, ketanserin, or chlorpromazine, seems to weaken psilocybin’s psychedelic effects. However, there doesn’t appear to be an observable interaction between psilocybin and serotonin agonists, like ergotamine, or dopamine antagonists, like haloperidol.30
Potential Benefits of Magic Mushrooms
There are few large studies examining the efficacy of magic mushrooms relative to traditional psychiatric medications. However, existing research does indicate some notable benefits for mushrooms over traditional treatments.
Psilocybin may offer benefits more medicinal in nature, including:
- Multiple mechanisms of action: Psilocybin mushrooms work on multiple neurotransmitters in the brain across multiple neural networks, which gives them the potential to treat multiple aspects of human functioning and, thus, multiple psychological conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD), to name a few.
- Low potential for abuse: There is little to no evidence of physical dependence or withdrawal from psilocybin.
- Few side effects: Psilocybin’s few adverse effects are mild in many (but not all) cases, like transient hypertension, tachycardia, and headaches; however, prolonged psychosis, though rare, is possible.31
- Works relatively quickly: Relative to many traditional psychiatric medications, and especially SSRIs, psilocybin works quickly, with peak effects occurring within 90 minutes of ingestion. Relative to other psychedelics, psilocybin shows faster elimination (its half-life is about three hours) but with longer therapeutic effects.32
- Few sessions are required: Since psilocybin builds up tolerance after just a few repeated uses, the number of sessions is necessarily limited and should be spaced out. Most therapeutic effects are observed after just a few sessions and sometimes even a single session (depending on the condition being treated).
- Medication compliance is not an issue: A common hurdle for psychiatric medications and weekly psychotherapy is patient compliance. Since psychedelic-assisted therapy does not require a structured regimen to stick to, it may be a low-maintenance therapeutic option for individuals who struggle to adhere to routine.
Medical Uses for Psilocybin
In most states, psilocybin’s current status as a Schedule I drug prohibits its medical use outside of clinical research studies. Given the significant interest in research into psilocybin’s therapeutic effects, extraction of psilocybin from natural or cultivated mushrooms is too limited and variable to meet current research needs. As such, efforts to improve the synthetic creation of psilocybin, which began in the 1950s, are underway to increase yields, purity, and financial efficiency.33
Disorders that can potentially be treated by magic mushrooms and other psychedelics include:
- Addiction: While studies have shown promising results for the treatment of nicotine and alcohol addiction, there are presently many ongoing studies examining efficacy and safety parameters for treating other substance and behavioral addictions that have not yet concluded.34
- Smoking cessation: Psilocybin-assisted treatment for tobacco addiction had success rates (80% abstinence at 6-month follow-up, 67% abstinence at 1-year follow-up) that exceeded those reported for other treatment methods like psychotherapy and medication (commonly less than 35%).35,36
- Alcohol use disorder (AUD): When combined with psychotherapy (motivational enhancement therapy or cognitive behavioral therapy), psilocybin can help with alcohol addictions. Research shows that two psilocybin treatment sessions resulted in reduced craving and alcohol consumption (27-41% fewer days) extending to at least 32 weeks.37,38 Although the results for AUD aren’t as robust as for smoking cessation, psilocybin may still be worthwhile as an add-on therapy for treatment-resistant individuals.
- Methamphetamine use disorder: Ongoing studies are investigating whether psychedelics can be useful in treating methamphetamine use disorder, but results are not yet available. Given notably high drop-out rates for methamphetamine treatment and the success rate of psychedelics with other substance use disorders, psilocybin provides a potential treatment alternative.39
- Other substance use disorders: There are currently no completed clinical trials on the efficacy of psilocybin-assisted therapy for many substances of misuse, including cocaine, hypnotics, and caffeine, to name a few.40 However, clinical trials should yield some results over the next couple of years. Given preliminary results with other addictive substances like nicotine, there is great interest in psilocybin’s potential for other types of substance misuse.
- Non-substance addictions: As with many substance addictions, there is reason to believe that psilocybin may show potential as a treatment for non-substance addictions like gambling addiction, food addiction, and sex addiction, since it does modulate areas of the brain involved in reward processing and specifically, craving.36,40 However, the resurgence of this line of research is young, and preliminary clinical trials are still ongoing.
- Eating disorders: Psilocybin-assisted psychotherapy improved shape concerns, weight concerns, and eating disorder scores for at least three months in 40% of the study participants, though the sample was small in this pilot study.41 Given relatively high comorbidity rates with other disorders that psychedelic treatment has shown efficacy for (e.g., depression, substance use disorder), this mode of treatment as an add-on therapy may be a feasible alternative treatment for eating disorders.
- Alzheimer’s disease: As with many diseases, clinical trials for psychedelic-assisted treatment for Alzheimer’s disease are still ongoing, and it is premature to determine its efficacy for this population.42 Nonetheless, several studies showing increased brain activation and generation of new neural connections certainly carry much interest for potential use in dementia and other cognitive disorders, particularly in early phases.43
- Treatment-resistant depression: A single dose of psilocybin-assisted therapy reduced symptom severity in a study of 52 participants with treatment-resistant depression.44 Even at a one-year follow-up, a similar study showed symptom improvement in 75% of participants and remission in 58%.45
- Obsessive compulsive disorder (OCD): Despite small samples for recent studies on psilocybin and OCD, one case study and another nine-person, the treatment-resistant sample showed marked symptom relief lasting 24 hours up to 6 months post-treatment.46 The case report of a patient described how he not only found remission of symptoms with a single dose of psilocybin, but years later, when symptoms returned, he was able to use insights obtained during the psilocybin treatment to improve his symptoms.47
- Headaches: Paradoxically, while transient headaches are an occasional side effect of psilocybin, it has also been shown to help treat migraines and cluster headaches, particularly regarding symptom frequency, intensity, impairment, and prevention.148,49,50,51 More research is needed to untangle this interesting paradox.
- Chronic pain: Case studies have described sustained relief of chronic neuropathic pain with psilocybin micro-dosing and without any psychedelic (mind-altering) experience.52 Pain relief in other conditions like phantom limb syndrome has also been augmented with psilocybin treatment, possibly due to neuroplasticity properties.53
- End-of-life distress: High-dose psilocybin appears to significantly reduce anxiety for individuals with life-threatening cancer and cancer-related depression and anxiety, with effects lasting at least six months after treatment and in one study, nearly five years after treatment.54
Psilocybin Therapy
Given the current legal hurdles to obtaining psilocybin therapy outside of a clinical research trial or a state where psilocybin use has been decriminalized, treatment is still impractical and often expensive. For those who can receive psilocybin treatment, numerous benefits await. The first is speed, as even a single session has shown significant efficacy for certain conditions.
Here are some questions to ask a therapist who specializes in psilocybin therapy:
- What type of therapeutic style do you use in conjunction with psilocybin?
- Will you have several sessions before incorporating psilocybin into treatment to build a trusting relationship?
- Are we going to prepare a plan in advance with topics to address?
- Do I have any medical conditions or risk factors that would be contraindicated for psilocybin use?
- What should I do in preparation?
Self-Medicating With Shrooms
Because of how expensive psilocybin therapy is, there has been an uptick in reports of self-medicating with shrooms.60 If you are planning to use shrooms therapeutically in an uncontrolled environment, there are several things you will want to consider to increase the likelihood of a successful outcome and reduce your risk of harm.
Here are some things to consider when exploring psilocybin in an uncontrolled environment:
- Do you have a support person or guide to ensure you stay safe while in an altered state? It is extremely important to ensure that you have someone who is sober and can help you or get help should you experience negative side effects that need medical attention.
- Where are the mushrooms sourced? Be sure it is from a reputable and trusted source, preferably a licensed medical provider (pending legality in some areas). If you don’t live in an area where psilocybin is approved for medical use, consider a retreat in a region where it can be sourced from a licensed and reputable establishment.
- Which strain and expected potency will you be ingesting? The wide variety of strains and potencies can offer very different types of experiences and come with varying risks of a bad trip.
- Will you have the right amount of time? Be sure you don’t have responsibilities (occupational, child care, etc.) that will need your attention for a couple of hours leading up to ingestion, as well as for the rest of the day after ingestion. Driving, operating machinery, and related activities can be highly dangerous while under the influence of psilocybin, and some effects can linger, especially if you are unaware of a contraindication (e.g., a family history of schizophrenia).
- Where will you be ingesting psilocybin? Be sure you are in a safe, relaxed, calm setting. The mood and ambiance can play a significant role in how pleasurable the treatment is.
- How are you preparing? Fasting is often recommended prior to optimal effects. There are also anti-nausea strategies that can help reduce side effects.
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What is Microdosing?
Psilocybin microdosing involves repeated self-administration of small doses that do not affect regular cognitive functioning or induce acute psychotropic symptoms. Sometimes using psilocybin for anxiety can help. Research studies show that the intake of psilocybin microdoses can improve mood, cognitive function, anxiety, depression, and experience of stress after one month.55
While dosing is variable as this is not a formal medical practice, a typical microdose is between 0.1g-0.3g of dried mushrooms which translates to 1mg-3mg of psilocybin.55 For perspective, a standard dose to induce mind-altering effects is 25mg. With incorporation as a medicinal therapeutic and unfolding legislative changes, psilocybin microdosing may be a viable treatment option in the future for mood and anxiety disorders.
Is Psilocybin Safe?
Despite having been listed as a Schedule I controlled substance since 1970, psilocybin actually has a low abuse potential, and withdrawal effects have not been documented to date.56 While psilocybin itself is relatively safe when used in a licensed medical or therapeutic setting, it can be unsafe when procured from unregulated or illegal sources, used by people with certain mental health and medical conditions, or used in combination with other drugs and/or medications.
Can You Become Addicted to Psychedelic Mushrooms?
Even though psilocybin does not seem to be addictive, one can build up a tolerance with repeated use, needing a higher dosage to achieve the same effect, with the mental effects capping after four consecutive doses. Therefore, individuals who find the mind-altering effects pleasurable – particularly the feelings of dissociation it induces – may grow psychologically dependent and show limited motivation for doing anything besides using. Also, procuring psilocybin from a questionable source can also introduce the risk of it being laced with other drugs of misuse that may be addictive.
Getting Help For Psilocybin Misuse
Psilocybin has shown therapeutic potential for individuals diagnosed with substance use disorder (e.g., alcohol, nicotine) when combined with psychotherapy, and it doesn’t seem to hold a significant risk of addiction.39,59 Nonetheless, misuse is possible when a person uses magic mushrooms too frequently, prefers its intoxicated state over sobriety, uses increasingly larger doses to achieve the same effect, and/or struggles to refrain from use when it interferes with daily functioning.
If you or someone you care about is misusing psilocybin, psychotherapy can help to identify the underlying causes of misuse and its correlates. It can also be beneficial to discuss the risks involved with unregulated sources (e.g., misidentification of a poisonous specimen) and why they are choosing to use the substance.
Here are some signs that someone may be misusing psilocybin:
- Dissociative states
- Depersonalization
- Derealization
- Illogical thinking
- Dangerous behavior
- Withdrawal from relationships
- Desires for radical change
- Rapid change to one’s life goals
- Existential depression
How Can I Try Psilocybin-Assisted Therapy?
While psilocybin and other psychedelics (e.g., ketamine) are illegal in many areas, there is a burgeoning of clinical research studies that are seeking participants. Government-approved research will use reputably sourced psilocybin with reliable purity. You can search the government’s clinical trials database for enrollment opportunities. Alternatively, there are therapists who specialize in psychedelic therapy, who can guide you through applying for a study, as well as supply you with supplementary therapy to make the most of your treatment.
If you need help finding a therapist, an online therapist directory or online therapy platform can be a useful starting point.
In My Experience
Psilocybin is a drug that offers promise to treat a wide range of physical and psychological conditions. Though clinical research trials investigating its efficacy and safety are still few, the research that does exist, combined with centuries of anecdotal reports of its medicinal benefits from indigenous peoples, suggests that psilocybin can be used safely, under supervised conditions, with minimal adverse effects.
The psychedelic effects of psilocybin – particularly the dissociation that it induces – aren’t for everyone, and it shouldn’t be considered until other traditional treatments have been tried. However, for those who may be candidates, psilocybin can offer a beneficial therapeutic experience, particularly when paired with psychotherapy.
Though other forms of therapy, like cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT), have been paired successfully with psychedelic treatments, psychodynamic therapy is ideal for pairing with psilocybin treatment as it regularly involves an assessment of the unconscious elements that typically manifest during psilocybin use.
Remember that, like psychotherapy, just because a psilocybin experience is uncomfortable, it doesn’t mean a positive transformation can’t result. A patient of mine summed this up perfectly, saying this about a recent trip: “I either fixed something that needed to be fixed, or I broke something that needed to be broken.”
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