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The Effects of Psilocybin Use

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Is Psilocybin Harmful?

Psilocybin is a compound that is naturally occurring fungal alkaloid—a chemical compound that is found in more than 100 species of mushrooms (also known as magic mushrooms or shrooms).1 When ingested, psilocybin is metabolized into a substance known as psilocin, the primary psychoactive component of hallucinogenic mushrooms, which produces mind-altering effects similar to drugs such as mescaline and LSD.1-4 Psilocybin is classified as a hallucinogenic or psychedelic drug.3,4

While the drug effects may not be directly life-threatening, most classic hallucinogens like psilocybin can produce profoundly unpleasant experiences when taken at high doses.2 Though significant psilocybin toxicity is unlikely, there are some risks associated with mushrooms that may include:1,2,5

  • Impaired judgment and feelings of detachment while one is under the influence of psilocybin.
  • The development of anxiety or panic attacks as a result of psilocybin-related experiences.
  • The experience of having “a bad trip” or unpleasant reaction to hallucinogenic effects.
  • The potential for poisoning and death as a result of consuming the wrong type of mushroom.
  • Flashbacks, which are reoccurrences of psilocybin experiences long after use. Persistent, recurring, and significantly impairing flashbacks may signal the presence of a condition known as hallucinogen persisting perceptual disorder (HPDD). These experiences can be quite distressing and interfere with daily functioning.

Persistent psychosis may occur in psilocybin users.2 This condition may manifest with a number of mental symptoms, such as paranoia, volatile mood, disorganized thought patterns, and visual disturbances.2,5

Short-Term Effects

The effects of taking psilocybin can vary and often depend on the person and the context in which the drug is used. The effects may include the following:1,2,5
  • Intense emotions and sensory experiences.
  • Spiritual experiences.
  • Psychological regression to earlier experiences/states.
  • Hallucinations (most often visual but can occur in any sensory domain).
  • Synesthesia, which is the experience of mixed perceptions, such as seeing sound or hearing colors.
  • Changes in perception of time.
  • Impaired judgment and potential for harm or death due to accidents.
  • Psychosis, including paranoia and disordered thinking.
  • Acute mood changes (anxiety/panic or depression).
  • Increased risk of having a “bad trip,” which may be emotionally disturbing.
  • Relaxation.
  • Muscle weakness/twitches.
  • Coordination problems.
  • Excessive sweating.
  • Dilated pupils.
  • Increased blood pressure, irregular breathing, irregular heartbeat.

  • Long-Term Effects

    Though the following have been reported to develop even after a single use of psilocybin, the risks of experiencing these adverse effects may be increased with long-term use:1,2

    • Drug-induced psychosis, a condition in which a person’s thoughts become disorganized and they may experience paranoia and a breakdown in communication with others. The user may have dramatic mood swings and experience visual disturbances. Such a psychosis may persist beyond the acute period.
    • Hallucinogen-persisting perception disorder (HPPD), in which the person has flashbacks where they experience recurrences of some of the sensory distortions they experienced while under the influence. These flashbacks may occur for years after stopping use of the drug.

    Drug Dependence and Problematic Use

    One research review concluded that the risk of developing a physical or psychological dependence to psilocybin is relatively low, although problematic use can develop.7

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines other hallucinogen use disorder (a designation that psilocybin use disorder would fall under) as a pattern of maladaptive use that results in significant distress in the user’s life.8 Below are common signs and symptoms of this disorder:8

    • Psilocybin is taken in larger amounts than originally intended.
    • Attempts to quit or cut down on use have failed.
    • An inordinate amount of time is spent obtaining psilocybin, using the drug, and recovering from intoxication.
    • The individual has strong cravings or urges to use psilocybin.
    • Psilocybin use leads to inability to fulfill school, home, or work responsibilities.
    • The individual continues to use despite interpersonal and social problems resulting from use.
    • Psilocybin use is prioritized over recreational, social, or occupational activities.
    • Psilocybin is used in dangerous situations, such as while driving.
    • The individual keeps using psilocybin despite physical or psychological consequences.
    • The individual needs increasing amounts of the drug to feel intoxicated.

    Addiction Treatment

    The DSM-5 and NIDA do not recognize a withdrawal syndrome associated with psilocybin use, although it is likely that individuals may develop significant tolerance to the hallucinogen with repeated use.2,8 Thus, despite some sources on the internet listing withdrawal symptoms for hallucinogenic drugs, the symptoms of a withdrawal syndrome for psychedelic drugs are not officially recognized.

    Individuals can learn to utilize healthy coping skills and rectify negative thought patterns, beliefs, and behaviors associated with problematic psilocybin use. Individuals who have severe issues with stress may require a combination of medication and psychotherapy to assist them to manage their stress without drug use 8.

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    Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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