In 2019, the city of Denver became the first in the United States to decriminalize psilocybin, the hallucinogenic compound in so-called magic mushrooms. What began as a local experiment has now rippled across the country.
According to a new study, the use of psilocybin has surged nationwide in recent years. Researchers from the University of Colorado Anschutz Medical Campus and Rocky Mountain Poison and Drug Safety combed through five major national datasets and found that more Americans than ever are turning to psilocybin, particularly those struggling with depression, anxiety, and chronic pain.
“We found that since 2019, the number of people using psilocybin has gone up sharply,” Karilynn Rockhill, co-lead author of the study, said in a press release. “This seems to line up with when some U.S. states began to decriminalize or legalize it.”
From Taboo to Therapy
Psilocybin is a Schedule I drug, classified as having no accepted medical use and a high potential for abuse. But mounting research, much of it from respected institutions like Johns Hopkins and Imperial College London, is putting this designation into question.
Studies have shown that psilocybin, under carefully controlled conditions, may help people with treatment-resistant depression, post-traumatic stress disorder, or substance use disorders. Enthusiasts like Michael Pollan, whose bestselling book How to Change Your Mind familiarized Americans with psychedelic science, have helped normalize the idea that mushrooms could have medical properties.
“The growing interest in psilocybin is largely fueled by increasing evidence of its therapeutic potential,” Dr. Alexander Joshua Eisenberg, a Florida-based physician, told Newsweek. “These findings have opened the door for many individuals, across age groups, to explore alternative approaches to managing emotional distress.”
And the numbers reflect that shift. Lifetime psilocybin use among adults rose from 10% in 2019 to 12.1% in 2023—an increase of more than six million people. Among young adults aged 18 to 29, past-year use jumped by 44%. Among adults over 30, the increase was even more dramatic: 188%.
Perhaps more strikingly, the data suggests that people nowadays take psilocybin more commonly than cocaine, LSD, methamphetamine, or illegal opioids. According to a 2016 medical survey, magic mushrooms are the safest recreational drug; just 0.2% of 12,000 participants who reported taking psilocybin in the past year said they needed emergency medical treatment – a rate at least five times lower than that for MDMA, LSD and cocaine.
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Risks Down the Rabbit Hole
But this newly found appreciation for the psychedelic is not just fun and games.
Emergency calls related to psilocybin exposure have skyrocketed. Between 2019 and 2023, poison center calls rose 201% among adults, 317% among teens, and a staggering 723% among children under 11. In 2023 alone, more than 1,500 people sought medical care because of psilocybin exposure. Bad trips?
“The calls to poison control for the children under 11 in the report were almost certainly due to kids getting into psilocybin edibles that were not meant for them,” Dr. Todd Korthuis of Oregon Health and Science University told NBC News. “An unregulated market of edibles can lead to people ingesting things other than psilocybin, even if the packaging does not list them.”
Despite its promising safety profile in clinical settings, psilocybin in the wild is a different story. Without guidance or dosage control, some users—especially those with underlying psychiatric conditions—may experience acute psychological distress.
“It can lead to acute psychological distress, particularly in those with pre-existing mental health conditions,” warned Eisenberg. “As interest grows, it’s important that people approach its use thoughtfully, ideally in structured, supportive settings that prioritize safety and integration.”
Health systems, the researchers argue, are playing catch-up. Poison centers may be fielding more calls, but hospitals often don’t code cases properly, meaning psilocybin-related issues are undercounted in emergency department data. “If hospitals and public health systems aren’t seeing the full picture, they can’t respond appropriately,” said Joshua Black, PhD, the study’s co-lead author.
A Cultural Crossroads
Psilocybin is still illegal in most of the country—33 states in total—but that hasn’t stopped cities and states from pushing boundaries. Oregon has legalized it for medical use. California and several municipalities in Michigan and Massachusetts have decriminalized it. Colorado, where the trend began, extended decriminalization statewide in 2022.
With legal penalties waning and curiosity rising, psilocybin is gaining traction in the American psyche. Still, only 2% of adults reported using it in the past year, suggesting that while the numbers are rising fast, the overall prevalence remains modest.
Researchers say they’re watching closely as adolescents join the wave. Among 12th graders, past-year use increased by 53% from 2019 to 2023.
“It is interesting to see the rise in adolescents,” said Andrew Yockey, an assistant professor of public health at the University of Mississippi. “I want to see where they are getting it from, why they are taking it.”
Those are questions that health officials and educators will need to answer quickly, before psilocybin, like cannabis before it, becomes a permanent fixture of the American landscape.
“We saw a similar phenomenon with cannabis when it started to be legalized,” Rockhill noted. “There is probably a stigma around this that is going down.”
But she and her colleagues stress caution. In the race to embrace psilocybin’s promise, society may be outpacing the systems designed to manage its risks.
The findings were reported in the Annals of Internal Medicine.
