Use of psilocybin, a psychedelic compound found in “magic mushrooms,” is on the rise in the United States, paralleling decriminalization efforts in several states and local governments and growing public concern. Researchers are also interested in the drug as a potential treatment for depression. A new study by researchers at the University of California, San Diego School of Medicine and the New York University Grossman School of Medicine found that about 2.8% of U.S. residents over the age of 12, or about 8 million people, have used psilocybin in the past year.
The research team analyzed data from the 2024 National Survey on Drug Use and Health (NSDUH). This is the first year that the large, nationally representative survey asked questions specifically about psilocybin, allowing researchers to better understand past-year usage among 58,633 respondents. Previous national surveys classified psilocybin with other psychedelics and focused on lifetime use rather than use in the past 12 months.
“Previous studies have only captured lifetime use, which tells us little about current patterns of use. People who tried psilocybin once in college 10 years ago and people who use it regularly now look identical in that data. “This gives us a more clinically meaningful picture of who is using psilocybin and what factors are associated with its use,” said lead author Kevin Yang, MD, a resident in the Department of Psychiatry at the University of California, San Diego School of Medicine.
As a result of our research, we found the following:
- Those aged 18 to 25 were 1.4 times more likely to have used psilocybin than those aged 35 to 49, but those aged 50 and older were about a third less likely to use psilocybin.
- Men had 1.7 times the odds compared to women, white respondents had 2.5 times the odds of black respondents, and Hispanic respondents had 1.4 times the odds.
- Use of psychedelics such as cannabis, LSD, MDMA, and ketamine was strongly associated with past-year psilocybin use.
- Alcohol use disorder and prescription stimulant misuse were also correlated with psilocybin use.
- People who had a major depressive episode in the past year were more likely to use psilocybin.
This finding has implications for clinical practice. Clinical trials over the past decade have shown that psilocybin has promising therapeutic effects for depression and treatment-resistant depression, but its safety profile when used naturalistically without supervision remains unclear. Unlike controlled clinical settings, where participants are carefully screened, doses are standardized, and psychological support is provided, naturalistic use lacks these safeguards.
“When psilocybin is used outside of a clinical setting, the risks look very different. We are seeing reports of anxiety, paranoia, and long-term psychological distress. There are also potential interactions with antidepressants, so clinicians need to be careful,” Yang said.
He said the findings highlight the need for clinicians to be aware of psilocybin use in patients, especially those with depression.
“With 8 million Americans using psilocybin in the past year, these are questions that psychiatrists and other clinicians should be asking, including why patients are using psilocybin, what benefits they perceive, and whether they are prepared to counsel patients about harm reduction and potential risks,” Yang said.
Looking forward, Yang says longitudinal studies are needed to track the mental health of people who use psilocybin over time, as well as increased public health oversight as decriminalization and possible FDA approval of the substance moves forward.
Other co-authors on the study include Avery Eun, University of California, San Diego School of Medicine, and Joseph J. Paramar, New York University Grossman School of Medicine.
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University of California, San Diego
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DOI: 10.1176/appi.ajp.20251343
