For years, psilocybin was mainly viewed as a party or recreational drug linked to the hippie community of the 1960s. However, over the past ten years or more, this mind-altering compound has been receiving a lot of attention for its potential to treat mental health and substance use disorders. Here are some facts to consider:
Found in more than 200 kinds of mushrooms, it’s commonly known as “magic mushrooms” or “shrooms”. Typically, psilocybin mushrooms have long, slender stems topped by caps with dark gills on the underside. They can be taken by mouth fresh or dried, brewed as tea or added to other foods, like chocolate or smoothies, to mask the bitter flavor. As chocolate, it can come in packages that resemble commercial candies. Their effects usually begin within 20 to 90 minutes and can last as long as 12 hours.
Psilocybin is a member of the psychedelic family of drugs which includes LSD and ayahuasca. When a person takes a psychedelic, sometimes called “tripping”, it can change the way they experience sight, sound and thoughts.
Psilocybin works in the brain on the serotonin receptors, often called the “feel-good” receptors. These receptors play an important role in managing a person’s mood. It is considered to be relatively safe to use and does not cause dependence or addiction.
Mushrooms have been used for thousands of years in religious, spiritual and recreational settings across many cultures.Its use in special ceremonies is still common in several native communities in Mexico.
Clinical research into psilocybin treatment of various mental health and substance use problems started to gain steam in the 1990s. Promising early results led to the foundation in 2006 of the Center for Psychedelic and Consciousness research at Johns Hopkins University. Researchers have published thousands of scientific articles on the compound.
Patients who have taken psilocybin in clinical trials have reported:
People in clinical trials also report what scientists define as “ego-dissolution” or a reduced sense of self. This can increase the feeling of being at one with the universe and be a rewarding experience. A pleasant experience is not always the case. Some people feel disoriented, experiencing anxiety and fear.
Psychedelics, including psilocybin, have been illegal in the United States since 1970. They are considered to be Schedule 1 drugs. This means they are thought to have no medical value and are ripe for misuse. As a result, magic mushrooms are illegal under federal law.
However, due to promising results in early clinical trials and its relative safety, in 2018, the Food and Drug Administration named psilocybin as a “breakthrough therapy” for treating severe depression. In early trials, it resulted in a great deal of improvement over existing treatments.
Consequently, in June 2023, this agency published a first draft of guidelines for researchers to investigate the potential therapeutic value of these substances.
Due to the earlier positive initial results, in 2020, Oregon became the first state to legalize psilocybin. Voters approved the creation of a regulatory and licensing framework that will allow patients to take psilocybin under supervision in Oregon’s largest cities starting in 2023.
In November 2022, Colorado decriminalized possessing, cultivating and sharing psilocybin and other psychedelics such as ibogaine, mescaline and DMT for people 21 and older. Moreover, in June 2023, Colorado governor Jared Polis said he would issue pardons for all criminal convictions related to psychedelic drugs, similar to what he did for marijuana possession. He also said he wants insurance companies, including federal Medicare and Medicaid, to cover the cost of psychedelic treatments.
Other states are moving in a similar direction. In 2022, the Connecticut legislature started the process of legalizing centers in which veterans and first responders could take psilocybin. Texas, Utah, Maryland and Washington state have funded research on the medical use of psilocybin, while Arizona’s legislature introduced in 2023 a bill to allow clinical trials of psilocybin treatment for mental health conditions like depression and PTSD. In California, there is an initiative that would legalize psychedelics, including psilocybin, while in New Jersey, a bill aims to legalize the compound to treat certain disorders.
Cities including Washington, D.C.; Ann Arbor, Michigan; Seattle, Washington; and Oakland, San Francisco and Santa Cruz in California have passed measures that essentially decriminalize psilocybin mushrooms and sometimes other psychedelics found in nature. The cities make no distinction between medical and recreational uses.
Psilocybin has been used in clinical trials to treat mental health problems such as depression, anxiety, post-traumatic stress disorder and obsessive-compulsive disorder. In addition, trials have focused on the treatment of nicotine (tobacco) and alcohol use disorders.
Even when given only a few times (1 to 3), these studies have shown that psilocybin is effective in treating mental health and substance use disorders compared to traditional treatments.
It must be stressed that most of the studies involving psilocybin have been conducted with a small number of participants. Larger studies are needed to confirm their findings before routine medical use of psilocybin can be considered.
Here are some of the studies’ results:
Considering these initial results, dozens of pharmaceutical companies are investing in psychedelics. They are working on changing the structure as well as designing similar compounds. In some cases, they are trying to get rid of the “trips,” which produce spiritual experiences and meaningful insights, even though they appear to be an essential part of the success of the clinical trials.
Some people are using psilocybin and other psychedelics in microdoses. This means taking the substance in amounts small enough to avoid impairment. People who do it claim that microdosing has helped them treat anxiety, depression, PTSD or to attain spiritual growth. 
Scientific evidence for microdosing, though, is scarce and has been mixed on if it works. According to several recent studies conducted in Europe, people who microdosed reported improvement in their mood, creativity and thinking. It also reduced anxiety and increased energy and friendliness.
In one of these studies, researchers were able to measure increased changes in a blood marker related to neuroplasticity, which is the ability of the brain to rewire itself. These changes are often needed in order to effectively treat depression.
However, some researchers have found similar positive outcomes of microdosing with LSD in individuals who were given placebos. Placebos are substances that cause no effect on the body – like a sugar pill. These results have led some to claim that the positive effect of microdosing is only the belief that there will be improvement instead of the actual microdose. 
Although generally considered safe, microdosing can actually carry some risks. Psychopharmacologist Kelan Thomas says there also are other risks, such as the potential for developing valvular heart disease (VHD), a condition resulting from damage to heart valves.
In any case, experts agree that the promising early results warrant more research on microdosing.
Although it does not cause physical dependence, psilocybin does carry some risks. A psilocybin experience can produce vastly different outcomes —from frightening to significant and positive, life-changing experiences.
A person’s response to psychedelics depends a great deal on how strong or potent the mushrooms are and the amount ingested. The experience also depends on set and setting. This means that it may vary widely according to the user’s state of mind and beliefs. In addition, the people with the person, and the music, art or spiritual imagery used can make a difference.
Physically, psilocybin can cause:
Psychologically, psilocybin also carries risks, particularly if a person ingests a high dose. It can cause: 
In general, alcohol and other drugs may worsen the psychological and physical risks of psilocybin misuse. In most cases, a doctor will treat the negative effects with medication, such as benzodiazepines (e.g., Xanax, Ativan, Klonopin).
No serious, long-term adverse events have been reported that are directly tied to taking psilocybin.
If you or a loved one decide to try psilocybin, consider enrolling in a clinical trial. You can use this database of privately and publicly funded clinical studies conducted worldwide to find a trial involving psilocybin.
Otherwise, you can wait until psilocybin therapies are available for the general public. For example, the use of psilocybin in facilities with trained specialists are scheduled to open by late 2023 in Oregon and in 2024 in Colorado.
Most likely, these sessions will not be covered by insurance, regardless of their potential benefits. It is also important to know that if you decide to try psilocybin in any of the cities across the United States where the compound has been decriminalized or legalized, a guide, professional or therapist who is not authorized to conduct psilocybin sessions will be legally liable if something happens to you.
In a clinical trial setting you will be screened for your personal and family history. If you are a good candidate for psilocybin treatment there are several steps in the process:
If you’d like to learn about others’ experiences and “trips” check out Shroomery, a website offering information about psilocybin mushrooms.
You can detect if your child is using psilocybin by some signs common to psychedelics, which may include:
It’s worth noting that only adults have participated in clinical trials of psilocybin treatment, so the research on the effects of the compound on teenagers’ brains is scant. However, teenagers should be discouraged from using psychedelics as the brain is not fully mature until the mid-to-late 20’s.
If you suspect that your child is using psilocybin or any other substance, talk with them. Here are some techniques to help you establish positive and fruitful communication.
If you think that your loved one is using mushrooms, talk to them. Here are some useful ideas about how to approach the conversation.
The best course of action is not to use mushrooms. If your loved one insists on using it despite its downsides, consider sharing ways to reduce the risks. Remember that the most important thing is to keep them safe. Reducing the risks is not encouraging the use of substances. Instead, it recognizes that there are ways to minimize the consequences of mushrooms use.
Here are some risk reduction measures you may wish to share with your loved one. The recommendations are from a survey of people who use mushrooms and what they do to reduce risks: