The use of psilocybin—the active compound in so-called “magic mushrooms”—has increased significantly in the United States since 2019, according to a new study published in the Annals of Internal Medicine. Drawing on data from five national sources, researchers found sharp increases in both lifetime and recent use, especially among adults with symptoms of anxiety, depression, and chronic pain.
Psilocybin is a naturally occurring hallucinogen found in certain species of mushrooms. It has attracted growing scientific and public attention due to promising early studies suggesting it may help treat depression, post-traumatic stress disorder, and substance use disorders. Although not currently approved by the U.S. Food and Drug Administration, psilocybin has entered clinical trials and has been decriminalized or legalized in parts of Oregon, Colorado, and several municipalities. This shifting legal landscape has raised questions about whether broader public use is increasing—and what the public health consequences might be.
“With efforts to legalize psilocybin mushrooms in Colorado, Oregon, and elsewhere ongoing, we wanted to determine whether there were more people using psilocybin mushrooms now than when legalization first passed here in Denver in 2019,” said Joshua Black, the co-lead author and senior scientist at Rocky Mountain Poison and Drug Safety, a division of Denver Health.
To investigate these trends, the researchers analyzed five major U.S. data sources to examine psilocybin use from 2014 to 2023: the National Survey on Drug Use and Health, the Survey of Non-Medical Use of Prescription Drugs, Monitoring the Future, the National Poison Data System, and the National Hospital Ambulatory Medical Care Survey. By comparing responses across these sources, the team aimed to track changes in who is using psilocybin, how often, and whether they’re showing up in healthcare settings as a result.
The researchers chose 2019 as a key benchmark, since that year marked the first legal policy changes regarding psilocybin in the United States. Until then, use patterns were relatively stable. But after 2019, things began to shift. According to the National Survey on Drug Use and Health, lifetime use of psilocybin among adults rose from 10 percent (around 25 million people) in 2019 to 12.1 percent (over 31 million people) in 2023. Among adolescents aged 12 to 17, lifetime use rose more modestly, from 1.1 percent to 1.3 percent.
The increases were even more dramatic when looking at recent use. Among adults aged 18 to 29, past-year use rose 44 percent from 2019 to 2023. Among adults 30 and older, it jumped 188 percent. By 2023, 2.1 percent of adults reported using psilocybin in the past year—more than the number who reported using cocaine, LSD, methamphetamine, or illegal opioids.
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