Psilocybin (Magic Mushrooms)
Medically reviewed by L. Anderson, PharmD Last updated on Dec 11, 2016.
Common or street names: Magic Mushrooms, Mushrooms, Sacred Mushroom, Shrooms, Little Smoke, Purple Passion
What is Psilocybin (Magic Mushrooms)?
Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) and psilocin are both indole chemical compounds obtained from certain types of dried or fresh hallucinogenic mushrooms found in Mexico, Central America and the United States. These compounds have similar structure to lysergic acid diethylamide (LSD), and are abused for their hallucinogenic and euphoric effects. Hallucinogenic effects are probably due to effects on central nervous system serotonin (5-HT) receptors.
There are over 180 species of mushrooms that contain the chemicals psilocybin or psilocin. Like the peyote, hallucinogenic mushrooms have been used in native rites for centuries. Both psilocybin and psilocin can also be produced synthetically in the lab. There have been reports that psilocybin bought on the streets can actually be other species of mushrooms laced with LSD.
Methods of Psilocybin Use
Mushrooms are ingested orally and may be made into a tea or mixed into other foods. The mushrooms may be used fresh or dried. Psilocybin has a bitter, unpalatable taste.
"Magic Mushrooms" have long, slender stems which may appear white or greyish topped by caps with dark gills on the underside. Dried mushrooms are usually a reddish rust brown color with isolated areas of off-white.
What is the Usual Dose of Psilocybin Mushrooms?
Dried mushrooms contain about 0.2 to 0.4 percent psilocybin and only trace amounts of psilocin. The typical dose of psilocybin is 10 to 50 milligrams (roughly 20 to 30 grams of fresh mushroom, or 1 to 2.5 grams of dried mushroom powder) with peak effects occurring in 1 to 2 hours, and lasting for about six hours. However, dose and effects can vary considerably depending upon mushroom type, method of preparation, and tolerance of the individual.
Effects of 'Magic Mushroom' Use
Psilocybin effects are similar to those of other hallucinogens, such as mescaline from peyote or LSD. The psychological reaction to psilocybin use include visual and auditory hallucinations and an inability to discern fantasy from reality. Panic reactions and psychosis also may occur, particularly if large doses of psilocybin are ingested.
Hallucinogens that interfere with the action of the brain chemical serotonin may alter:
- sensory perception
- body temperature
- sexual behavior
- muscle control
Physical effects of psychedelic mushrooms may include a feeling of nausea, vomiting, muscle weakness, confusion, and a lack of coordination. Combined use with other substances, such as alcohol and marijuana can heighten, or worsen all of these effects.
Other effects of hallucinogenic drugs can include:
- intensified feelings and sensory experiences
- changes in sense of time (for example, time passing by slowly)
- increased blood pressure, breathing rate, or body temperature
- loss of appetite
- dry mouth
- sleep problems
- mixed senses (such as "seeing" sounds or "hearing" colors)
- spiritual experiences
- feelings of relaxation or detachment from self/environment
- uncoordinated movements
- lowered inhibition
- excessive sweating
- paranoia - extreme and unreasonable distrust of others
- psychosis - disordered thinking detached from reality
Larger psilocybin doses, including an overdose, can lead to intense hallucinogenic effects over a longer period of time. An intense “trip” episode may occur, which may involve panic, paranoia, psychosis, frightful visualizations ("bad trip"), and very rarely death.
Abuse of psilocybin mushrooms could also lead to toxicity or death if a poisonous mushroom is incorrectly thought to be a psilocybin mushroom and ingested. If vomiting, diarrhea, or stomach cramps begin several hours after consuming the mushrooms, the possibility of poisoning with toxic mushrooms should be considered.
Tolerance to the use of psilocybin has ben reported, which means a person needs an increasing larger dose to get the same hallucinogenic effect. "Flashbacks", similar to those occur in some people after using LSD, have also been reported with mushrooms.
How Long Do Mushrooms Stay in Your System?
Common hallucinogens are not detected by standard drugs-of-abuse screens. If desired by legal authorities or medical personnel, it is possible to perform laboratory assays that can detect any drug or metabolite, including psilocybin, via advanced techniques.
When tested via urine, the psilocybin mushroom metabolite psilocin can stay in your system for up to 3 days. However, metabolic rate, age, weight, age, medical conditions, drug tolerance, other drugs or medications used, and urine pH of each individual may affect actual detection periods.
Extent of Hallucinogenic Mushroom Use
Based on a 2014 survey from SAMHSA’s National Survey on Drug Use and Health (NSDUH), 1.2 million people, or less than 1% of the population, reported using hallucinogens in the month prior to the survey, a figure that has remained steady since 2002. Past month usage was higher among males than females (748,000 vs. 426,000). In 2014, there were 936,000 people aged 12 and older who had used hallucinogens for the first time within the past year. Hallucinogens include not only psilocybin from mushrooms, but also other psychedelic drugs like LSD, MDMA (Ecstacy, Molly), and peyote. In particular, college students may choose mushrooms as a drug of abuse.
Are Mushrooms Legal in the U.S.?
Psilocybin is a Schedule I substance under the DEA's Controlled Substances Act, which means that it has a high potential for abuse, no currently accepted medical use in treatment in the U.S., and a lack of accepted safety for use under medical supervision.
Currently, psilocybin is not available to doctors in the clinical setting because it is listed as a Schedule I drug by the US Drug Enforcement Agency (DEA). Researchers for the study were only able to get access to the illegal compound for the study through special waivers from the U.S. Food and Drug Administration (FDA). Other drugs found in Schedule I include marijuana, LSD, and heroin. In order for psilocybin to be prescribed for patients, it would have to be reclassified as a Schedule II medication, meaning it has a currently accepted medical use, but with severe restrictions due to addiction potential.
Medical Uses for Psilocybin
Although psilocybin has been used for centuries in rituals, modern medicine has recently reported uses, as well. In December 2016, a report was published in the Journal of Psychopharmacology detailing two small studies that noted the ingredient in "magic mushrooms" - psilocybin - can reverse the feeling of "existential distress" that patients often feel after being treated for cancer. Reportedly, cancer can leave patients with this type of psychiatric disorder, feeling that life has no meaning. Typical treatments such as antidepressants may not be effective. However, use of a single dose of synthetic psilocybin reversed the distress felt by the patients and was a long-term effect. Some advanced cancer patients described the effect from the drug as if "the cloud of doom seemed to lift."
Two studies using psilocybin were completed: one at New York University (NYU) Langone Medical Center in New York City and one at Johns Hopkins Medical School in Baltimore. For both studies, trained monitors were with patients as they experienced the effects of the drug, which can lead to hallucinations.
In the NYU study, 29 patients with advanced cancer were given either a single dose of psilocybin or the B vitamin known as niacin. After seven weeks, the patients switched treatments (a cross-over study). In 80 percent of the patients receiving psilocybin, a relief from distress occurred rapidly and lasted over six months. The long-term effect was evaluated by researchers looking at test scores for depression and anxiety.
At Johns Hopkins, the researchers treated 51 adults with advanced cancer with a small dose of psilocybin followed five weeks later with a higher dose. As with the NYU study, most patients experienced relief from their anxiety and depression that lasted up to six months.
Larger studies with psilocybin are expected. Researchers at NYU are waiting on the FDA to approve a Phase III trial. However, even if approved by the FDA, psilocybin would have to be reclassified by the DEA for it to be available for patients.
A study from Johns Hopkins University School of Medicine in Baltimore in 2011 involved small groups of patients in a strictly controlled and monitored clinical setting. The active ingredient found in "magic mushrooms" -- psilocybin, was administered randomly to patients. Researchers found that a single dose of the drug prompted an enduring but positive personality change in almost 60 percent of patients. One round of psilocybin exposure successfully boosted many individual's sense of "openness" and lasted at least a year in some cases.
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