New research on the experiences of people who took magic mushrooms through Oregon's homegrown psychedelic industry — the first program of its kind in the U.S. — is offering a largely favorable picture.
The study, based on almost 350 people who took the drug at state-licensed centers, is the most rigorous analysis yet of the real-world implications of regulated psilocybin, the active ingredient in magic mushrooms.
Most of the participants described their trip as beneficial, and more than half ranked it among the most meaningful experiences of their lives. Meanwhile, the data suggests the program was overall quite safe.
Only a very small number had "serious adverse reactions," according to the analysis published on Wednesday in the medical journal JAMA Network Open.
Dr. Todd Korthuis, who led the research team based at Oregon Health & Science University, said that initially, even he was skeptical about dosing people with psilocybin outside of a tightly controlled medical setting.
"The data has swayed me," he told NPR. "These results are very reassuring."
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Much of the recent momentum around psychedelics has centered on running drug development trials, with the aim of eventually winning approval from the Food and Drug Administration so that psilocybin, LSD and other substances can be used to treat mental health conditions.
Psilocybin has a shot at being approved as soon as next year, based on results from large human studies that used a synthetic form of the drug for hard-to-treat depression
The new Oregon data represents a very different pathway.
In 2020, the state's voters approved a nonmedical model for psilocybin, meaning most people over 21 can take the drug under the supervision of a facilitator at a designated center, without a prescription or medical referral.
(Colorado has also launched its own psychedelic program, although adults there do have the option of using the drug outside of a supervised setting.)
Other scientists involved in psychedelics research were surprised that the real-world results out of Oregon look so promising.
The number of adverse events is roughly what you'd expect from other psychiatric interventions, says Balázs Szigeti, a clinical data scientist at the University of California, San Francisco, who wasn't involved in the study.
"In clinical settings, there are a lot of eyes on the patients, a lot of medical attention," he says. "To see that the whole thing did not blow up in this regulated business environment is definitely good news for psilocybin."
Participants' rationale for taking psilocybin varied — curiosity, self-improvement, mental health and trauma were the most common reasons given.
The average dose was about 30 milligrams, which is a bit higher than what tends to be administered in clinical trials.
More than half of people in the new report said their mental health symptoms improved afterward, but Szigeti says those findings are hard to interpret because the study was uncontrolled and people had varying degrees of symptoms at baseline.
However, the positive change in mental well-being — another measure used in the study — is similar to what's reported in studies looking at the effect of meditation, he adds.
In terms of safety, the most significant issues were related to behavioral health, not physical health.
For example, one person was transported to the hospital after having a "violent reaction" while on the drug; another later went to the emergency room due to anxiety.
Korthuis notes that the four people who had what were classified as "serious adverse reactions" were all trying psilocybin for the first time.
Alongside these incidents were some other concerning data points. One week after their session, three participants said they had new thoughts of dying or suicide. That number doubled by the three-month mark.
Those in the study represent only a small fraction of the more than 20,000 people who've gone through Oregon's program since it launched about three years ago.
Many in the study were white and college-educated. About a third had a household income over $200,000.
Korthuis says the demographics of their study closely mirror the larger population that has visited the state's licensed psilocybin service centers, which are concentrated in the Portland area.
It's possible the low number of adverse events may be an "artifact" of who decided to join the study, or how those incidents are reported, says Albert Garcia-Romeu, a professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine.
"This is a very small group of people and a rarified sample," he says.
Garcia-Romeu says he has personally spoken with numerous people from Oregon who have struggled in the aftermath of their psilocybin experience and contacted the Johns Hopkins psychedelic center.
"I would say that we really can't generalize based on this study that it's going to be this safe and look this way for everyone," he adds.
Korthuis says his group plans to track a much larger sample of people as part of the research initiative, known as the Open Psychedelic Evaluation Nexus, or OPEN.
But he's confident the results can be generalized — and that they bode well for the future of a regulated psychedelic industry.
"For whatever reason, psychedelics like psilocybin appear to be cross-cutting and help people revisit a host of issues in their lives," he says. "Sometimes people come in for one thing and come out with three others."
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