Precipitous Increases in Psilocybin Exposure in Youths

Source: Farah R, Kerns AF, Murray AC, et al. Psilocybin exposures reported to U.S. poison centers: national trends over a decade. J Adolesc Health. 2024;74(5):1053-1056; doi: 10.1016/j.jadohealth.2024.01.027.Investigators from the University of Virginia, Charlottesville, VA, conducted a retrospective study to describe trends in psilocybin exposure in adolescents (13-19 years old) and young adults (20-25 years old) during the period 2013-2022. Psilocybin is a psychoactive alkaloid contained in hallucinogenic mushrooms. For the study, they reviewed data in the National Poison Data System (NPDS), which includes reports from poison control centers in the US. Psilocybin exposures were identified by a specific code number and reported as all exposures or single-substance. Data abstracted on identified cases included age, sex, reason for exposure (eg, intentional), clinical effects, level of health care received, and severity. Severity was categorized as none, minor effect, moderate effect (prolonged symptoms that usually required treatment), major effect, or death. Poisson regression was used to assess trends in reported exposure during the study period. Analyses were stratified by sex, age group, and single- vs multiple-substance exposure.A total of 4,055 psilocybin exposures were reported to NPDS during the study period, including 2,667 (65.8%) single-substance exposures. Among all psilocybin exposures, 2,372 (58.5%) occurred in adolescents, and 74.8% of the adolescents were males. The most frequently co-occurring exposures were marijuana and alcohol. Exposures were intentional in 81.1% of cases involving adolescents and 78.3% in young adults. The most commonly reported clinical effects in single-substance psilocybin exposures were hallucinations/delusions (36.6%), agitation (27.6%), tachycardia (20.2%), and confusion (16.0%); seizures were reported in 49 (1.8%) cases. Overall, most exposures resulted in health care encounters for both adolescents (75.3% of cases) and young adults (72.1%), and effects were characterized as moderate in 47.1% of cases in adolescents and 45.3% in young adults. Two deaths occurred in adolescents. Both cases were multi-substance exposures, with fentanyl and hallucinogenic amphetamine listed as the primary cause of death. Between 2013 and 2018, the yearly number of psilocybin exposures reported to NPDS did not change significantly. Subsequently, the yearly number of cases increased significantly in adolescents beginning in 2019, and in young adults beginning in 2020 (P