Magic mushrooms are rapidly growing in popularity, sparking a “psychedelic renaissance” as people become more interested in their mental health benefits. But experts have warned that using them recreationally risks doing more harm than good.
Trials exploring psilocybin as a groundbreaking treatment for mental health conditions has spawned a proliferation of psychedelic companies and retreats in countries where they are legal, while more people are buying the drug, which is class A in the UK, on the hidden market.
The latest Office for National Statistics data shows that psilocybin was the only illegal drug that grew in popularity in 2024, increasing by 37.5% to reach 1.1% of 16- to 59-year-olds, representing about 300,000 people and making the drug nearly as popular as ecstasy.
Experts said while clinical trials were showing promising results, emerging evidence suggests that people who take psilocybin outside these environments can experience harm, including anxiety, trauma, insomnia, continued visual distortion known as Hallucinogen Persisting Perception Disorder (HPPD), and feelings of depersonalisation.
Mainstream GPs, psychiatrists and therapists lack the knowledge to treat this and occasionally misdiagnose patients with psychosis or mania, the experts added.
Jules Evans, the director of the Challenging Psychedelic Experience academic research project, which aims to improve monitoring of adverse events, has interviewed people “in terrible crises who say they had no awareness they could endure severe difficulties for days, weeks, months or years after”, including some who were sectioned after discussing mythical experiences with a psychiatrist.
“You get people who are retraumatised by very challenging psychedelic experiences or they get traumatised by having really bad trips in suboptimal settings,” he said.
Distress can be compounded by the psychedelic integration coaches from whom people seek support, he said. “They have a certain dogmatic worldview where psychedelics are all knowing benevolent intelligences that always know what’s good for you – listen to the mushrooms, listen to mama ayahuasca.”
Although it is difficult to establish the prevalence of people who encounter post-psychedelic harms, recent research found that 8.9% of respondents who had used psychedelics regularly over their lifetime reported impairments lasting longer than one day.
Ed Prideaux, who has researched adverse effects after experiencing HPPD, said years later he still sees a “strange sparkle”, melting wallpaper and other optical illusions. He said “basically everyone” in the psychedelic community has had at least one similar experience.
While myths circulated about psychedelics when they were last popular in the mid-20th century, Prideaux thinks cases such as the US pilot Joseph Everson, who crashed a plane two days after ingesting magic mushrooms, suggest flashbacks need more research.
There are four clinics in Europe that offer specialist help. The most established is Ambulanz psychedelische Substanzen, a psychedelic outpatient clinic at Charité, a university hospital in Berlin, which offers online consultations for international clients.
Tomislav Majić, a psychiatrist, created the clinic in 2018 after observing that people had bad experiences with clinicians who were not familiar with the “specific effects, risks and complications of psychedelics”. Most patients use them as “self-medication for mental health issues” and need psychological support, though some need psychiatric help, he said.
“There has been an increase in problems related to psilocybin and other classic psychedelics, most likely due to the growing popularity and often overenthusiastic portrayal of these substances in the media and, in some cases, in scientific discourse. Statistically, there has been an increase in psychedelic-related presentations in emergency departments in some countries,” he said.
The Psychedelic Experience Clinic has recently become the UK’s first specialist service. Its founder, Timmy Davis, the director of psychedelic policy at the Centre for Evidence Based Drug Policy, observed while working on clinical trials a lack of “post-trial provision of care”, and that recreational users were looking for non-stigmatising support.
“Some people see psychedelics as a route to dealing with mental health conditions which they don’t really understand. They read things like The Body Keeps the Score and learn about trauma and end up thinking the root of my suffering is a traumatic childhood experience. It’s quite a naive notion of mental health, and they seek out retreats in Costa Rica or Jamaica, where they meet facilitators with the same naive conceptions,” he said.
David Erritzoe, an associate professor in psychedelic research at Imperial College London, said an “achilles heel” of psychedelics is that experiences can be dream-like and feel extremely real, partly because the drugs heighten suggestibility. People can believe they have surfaced a “hidden memory”, and erroneously conclude they should use it to “understand myself and my relationships and difficulties”.
“We need more strategies for informing people about these phenomena and providing support when this happens,” he said, adding that the fact that recreational use is now “extremely popular” suggests that healthcare workers should receive guidance.
Psilocybin is relatively safe from a physical perspective, with headaches and nausea the most common side-effects, but he added: “There can be a lot of difficult psychological material, it can be relational, autobiographical, dreamlike in symbolic forms, elements deep from the psyche – that can be challenging, and sometimes even anxiety provoking or fear inducing.”
The main risk factors include being young, scoring high for neuroticism, being underprepared, and being in a space that feels unsafe, he said.
Erritzoe said there was a “hype that isn’t helpful” around psilocybin, including microdosing, for which there is no good evidence beyond a placebo effect. But he is “very optimistic” about its therapeutic potential, with a low risk of adverse effects in clinical trials because here they screen participants and take great care with setting and dosage, while researchers “continuously try to improve” aftercare.
More data is required before psilocybin can be licensed for medical use, though if regulators are satisfied with its safety and efficacy, Erritzoe suggested it could join ketamine as a psychedelic treatment in the UK in three years’ time.
