Magic mushrooms and the mind

A growing number of states and cities are legalizing the use of psychedelic fungi in therapy. Some experts think that’s a big risk.

A laboratory technician holds a bag of psilocybin mushrooms.
Research suggests that psilocybin can rewire the brain
(Image credit: Bloomberg / Getty Images)

A growing number of states and cities are legalizing the use of psychedelic fungi in therapy. Some experts think that’s a big risk. Here's everything you need to know: 

Not under federal law, which has classified the fungi as a highly dangerous Schedule 1 drug since 1970. But a campaign to decriminalize psilocybin, the mind-altering compound in magic mushrooms, is gaining pace at the state and local level. This summer, Oregon became the first state to allow the use of psilocybin in mental health care. Colorado intends to follow suit in 2025 and San Francisco; Detroit; Washington, D.C.; and other cities have voted in recent years to decriminalize psilocybin. At licensed therapy facilities in Oregon, patients take mushrooms from a state-approved grower under the guidance of a certified facilitator, or "trip sitter." The effect is much more than "rainbows and unicorns," Josh Goldstein, a psilocybin facilitator in Bend, told The New York Times. At one recent session overseen by Goldstein, a Marine veteran struggling with PTSD said the psilocybin triggered visions of colorful ribbons wrapping around painful thoughts. "It was like a massive weight had been released," said the veteran. It sounds rather trippy, but a growing body of research indicates psilocybin could help relieve depression, addiction, anxiety and many other mental health conditions. "There is a lot of hype," said Dr. Joshua Gordon, director of the National Institute of Mental Health, "and a lot of hope."

How does psilocybin therapy work?

Research suggests that psilocybin can rewire the brain by generating new connections between neurons. The feeling of altered consciousness experienced during a mushroom trip — including kaleidoscopic visions and hallucinations — is a result of unusual linkages forming among parts of the brain that handle auditory and visual information, and executive and sense-of-self functions. Such disruption can be therapeutic, said David Nutt, a psychopharmacologist at Imperial College London. "Depressed people are continually self-critical and they keep ruminating, going over and over the same negative, anxious, or fearful thoughts," he explains. Psilocybin breaks the brain out of that familiar pattern so "critical thoughts are easier to control and thinking is more flexible."

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How long do the effects last?

Psilocybin’s immediate psychedelic effects typically peak about 60 to 90 minutes after the drug has been consumed, but can go on for up to eight hours. The new brain connections forged during those trips last much longer — at least a month in mice treated with psilocybin. Such long-lasting effects might eventually allow people with depression to curb their use of traditional antidepressants, perhaps taking the medications only once a week or month, said David Olson, a psychedelics expert at University of California, Davis. Growing awareness of psilocybin’s possible mental health applications has led the FDA to label the chemical a "breakthrough therapy" for depression and anxiety, and the Department of Veterans Affairs is now participating in at least five trials of psilocybin and other psychedelics for treating PTSD and other conditions. Still, some researchers see dangers in the push to make psilocybin more widely available.

Why are they worried about?

Psilocybin can trigger psychotic episodes and lead people to make dreadful decisions. An off-duty pilot riding in an extra cockpit seat on a Horizon Air flight last month tried to cut off the San Francisco-bound plane’s engine mid-flight. Joseph Emerson — who was charged with 83 counts of attempted murder, one for each person onboard — told police afterward that he’d been severely depressed and had taken magic mushrooms for the first time 48 hours earlier. He grabbed the emergency handles, he said, because he was trying to wake up from a dream. Some experts were skeptical, saying the drug should have been long gone from his system. Yet The American Journal of Psychiatry last year published a case study describing how a 32-year-old accountant suffered weeks of delusions, mania and psychosis after taking mushrooms with friends. She required months of intense psychiatric treatment to emerge from crippling depression. "I [am] shocked at the legislative momentum" for expanding psychedelics access, said Washington University psychiatrist Joshua Siegel.

Is broader legalization imminent?

The push suffered a setback in early October when California Gov. Gavin Newsom vetoed a bill to decriminalize mushrooms and two other plant-based hallucinogens. "Do you really want people that are tripping on mushrooms driving cars?" asked Brian Marvel, president of an 80,000-member law enforcement organization that opposed the bill. The Horizon Air incident, which occurred two weeks after Newsom’s veto, has only added fuel to such arguments. Psilocybin advocates in the U.S. are divided over the best path forward. Medicalized regulation is safer, but more expensive: In Oregon, a six-hour guided trip can cost more than $3,000. Decriminalization, however, might lead many people to think they can solve their problems by popping a shroom, something health experts say should occur in supervised settings in conjunction with talk therapy. The FDA is widely expected to approve psilocybin for depression by the end of the decade. But that will require clinical studies much larger than any conducted to date; the largest trial so far included 233 patients in North America and Europe. "What we don’t know," said Fred Barrett, director of the Johns Hopkins Center for Psychedelic and Consciousness Research, "way outstrips what we do know."

The ancient roots of 'God’s flesh'

Humanity’s relationship with psychedelic fungi goes way back. Some researchers believe the first evidence of psilocybin use can be seen in 10,000-year-old cave paintings in Western Australia, which depict people with mushroom-like heads. There’s much stronger evidence of Indigenous Americans incorporating psilocybin in rituals. The Aztecs of Mexico called the mushroom teonanácatl, or "flesh of the gods." In the 16th century, the Dominican friar Diego Durán recorded the fungi being consumed at Aztec religious feasts. "Those who eat them see visions and feel a fluttering of the heart," he wrote. "Those few who eat them in excess are driven to lust." Psilocybin entered the U.S. consciousness in the 1950s, after R. Gordon Wasson, a vice president of J.P. Morgan and an amateur ethnobotanist, traveled to Oaxaca to sample "divine mushrooms" prepared by a Mexican medicine woman. Wasson detailed the experience in a 1957 Life article titled "Seeking the Magic Mushroom." His travelogue inspired other Americans to visit Oaxaca and scarf shrooms; among them was Harvard psychologist and soon-to-be psychedelic evangelist Timothy Leary. That first psilocybin trip, said Leary, was "the deepest religious experience of my life."

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