Psychoactive mushroom edibles: trends and toxicities reported to the United States National Poison Data System®,...

Psychoactive mushroom edibles are gaining popularity, yet little is known of their clinical effects. These unregulated products are widely available, often with unlisted ingredients and inconsistent formulations, underscoring the need for more research to address public health concerns. We aimed to investigate recent trends in demographics and clinical effects associated with these products.

We conducted a retrospective observational analysis of psychoactive mushroom edible exposures reported to the United States National Poison Data System® between 2023 and 2024. We included both single and polysubstance cases from all ages, using the generic codes identifying edible preparations containing Amanita muscaria, psilocybin, or unspecified. We described demographic and clinical characteristics (e.g., management site, related clinical effects) stratified by mushroom type. Our primary outcome was medical admission, and secondary outcomes were the severity of reported toxicity (moderate or worse compared to minimal or non-toxic exposures). Multivariable logistic regression, odds ratios, and 95% confidence intervals were used to measure the association between demographic and clinical factors with each outcome.

Of the 362 total psychoactive mushroom edible exposures identified, the majority were single-substance (78%) and intentional (58%). Factors associated with admission were polysubstance exposures (aOR: 2.58; 95% CI: 1.23-5.40), confusion (aOR: 3.06; 95% CI: 1.36-6.86), and central nervous system depression (aOR: 2.55; 95% CI: 1.29-5.06). These factors were also associated with moderate or worse toxicity (poly-substance exposure [aOR: 2.88; 95% CI: 1.35-6.13], confusion [aOR: 3.05; 95% CI: 1.14-8.13], and central nervous system depression [aOR: 4.92; 95% CI: 2.45-9.88]). No deaths were reported from exposure.

The effects of mushroom edible ingestion are unpredictable, and clinical presentations vary widely. Polysubstance exposures involving mushroom edibles are associated with higher hospital admission rates and more severe toxicity.

Psychoactive mushroom edibles are an emerging public health concern that necessitates continued epidemiological and clinical monitoring as the trend evolves.