On 1 July, 2023, the Therapeutic Goods Administration amended its scheduling of psychedelic substances to allow the prescription of psilocybin for use in psychedelic assisted psychotherapy for treatment-resistant depression. Trials as to their effectiveness and safety in treating various psychiatric conditions are ongoing.

Magic mushrooms look similar to poisonous mushrooms that can cause a person to become very sick and can result in death.

Bad trips
Magic mushrooms and other hallucinogens have the potential to give rise to psychotic symptoms which may be distressing when experienced as a “bad trip”. Features include:

• Anxiety
• Panic
• Paranoid ideas or delusions

Psychotic symptoms lasting longer than 24 hours are rare but have been reported.

Hallucinogen persisting perception disorder
Regular use of magic mushrooms may cause hallucinogen persisting perception disorder, in which a person can experience flashbacks weeks, months or even years after the drug was last taken. They are usually visual distortions that involve changes in emotions or perception.

These flashbacks can be disturbing, especially if a frightening experience or hallucination is recalled, and usually last a minute or two. Individuals with a history or family history of psychological issues appear to have a greater vulnerability of developing hallucinogen persisting perception disorder.

The effects of taking magic mushrooms with other drugs − including over the counter or prescription medications − can be unpredictable anddangerous.

For instance, magic mushrooms taken with methamphetamine or ecstasy can increase the chances of a bad trip and lead to panic, and mixing magic mushrooms with some psychiatric medications can lead to relapse or worsening of mental health conditions.

Unlike opioids, magic mushrooms tend not to produce long-term chronicity due to their infrequent use. Despite this, there is a recognised hallucinogen dependence syndrome.

Although deaths related to magic mushroom use are rare, they have been documented in Australia and overseas. Most of these deaths are due to traumatic injury, such as falls and motor vehicle accidents. Taking magic mushrooms can result in extremely distorted perception, unstable or depressed mood, or intense fear, which can lead to suicidal behaviour or misadventure.

Magic mushrooms were the most commonly used hallucinogen in 2022–‍2023, according to the Australian Institute of Health and Welfare, with 1.8% of people in Australia having used them in the last 12 months. This is double the proportion who had done so in 2019 (0.9%).

The Illicit Drug Reporting System (IDRS) is an Australian monitoring system run by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney that identifies emerging trends of local and national concern in illicit drug markets.

The Ecstasy and Related Drugs Reporting System (EDRS) is an Australian monitoring system run by NDARC that identifies emerging trends of local and national interest in ecstasy and related drug use, markets and harms.

The Pocket Guide to Drugs and Health is a publication authored by experts from NDARC that provides information for health professionals on the impact of drug use.

The Australian Institute of Health and Welfare collects information on alcohol and tobacco consumption, and illicit drug use among the general population in Australia.

The Australian Bureau of Statistics is Australia’s national statistical agency, providing official statistics on a range of economic, social, population and environmental matters of importance to Australia.

Alcohol and Drug Foundation (2024). Psilocybin (magic mushrooms). Retrieved from: adf.org.au/drug-facts/psilocybin/

Australian Institute of Health and Welfare (2024). Hallucinogens in the NDSHS, Retrieved from: aihw.gov.au/reports/illicit-use-of-drugs/hallucinogens-ndshs

Darke, S., Lappin, J., & Farrell, M. (2024). The Clinician’s Guide to Illicit Drugs and Health (Revised Edition); London: Silverback Publishing.

Darke S, Duflou J, Peacock A, et al (2024). A retrospective study of the characteristics and toxicology of cases of lysergic acid diethylamide (LSD)- and psilocybin-related death in Australia. Addiction. doi.org/10.1111/add.16518

Department of Health and Aged Care (2023). Update on MDMA and psilocybin access and safeguards from 1 July 2023. Australian Government. Retrieved from: tga.gov.au/news/news/update-mdma-and-psilocybin-access-and-safeguards-1-july-2023