Psilocybin use among Basotho healers and non-healers in southern Africa

Reliable documentation of the traditional use of serotonergic psychedelics has long been confined to the Americas. Prevailing narratives often overstate the global prevalence and uniformity of traditional psychedelic use, extrapolating from a limited set of well-documented cases. Here, we report evidence of psilocybin mushroom use among Basotho traditional healers and non-healers in Lesotho and South Africa. Through semi-structured interviews with 26 healers (one subsequently excluded) and 8 non-healers, we found that 15 healers and 6 non-healers independently identified Psilocybe maluti, a recently described psilocybin-producing species endemic to southern Africa, and reported uses spanning four categories: incorporation into a psychoactive initiation brew, treatment of physical, mental, and spiritual ailments, recreation, and magical protection. Unlike the large ritualized doses characteristic of Mesoamerican psilocybin use, Basotho healers primarily apply small doses of P. maluti alongside other psychoactive plants, most notably the hallucinogenic bulb Boophone disticha. Multiple lines of evidence suggest these practices predate the mid-twentieth-century popularization of psilocybin. These findings expand the known geographic scope of traditional psilocybin use and reveal a mode of psychedelic application distinct from existing ethnographic models. More broadly, they underscore the importance of grounding contemporary interpretations of non-clinical psychedelic practices in careful empirical documentation rather than widely circulated but weakly supported generalizations.