Magic mushrooms are undergoing a transformation from illicit recreational drug to promising mental health treatment. Numerous studies have reported positive findings using psilocybin—the mushrooms' main psychoactive compound—for treating depression as well as smoking and alcohol addiction, and for reducing anxiety in the terminally ill. Ongoing and planned studies are testing the drug for conditions that include opioid dependence, PTSD and anorexia nervosa.
This scientific interest, plus growing social acceptance, is contributing to legal changes in cities across the U.S. In 2020 Oregon passed statewide legislation decriminalizing magic mushrooms, and the state is building a framework for regulating legal therapeutic use—becoming the first jurisdiction in the world to do so. For now psilocybin remains illegal and strictly controlled at the national level in most countries, slowing research. But an international push to get the drug reclassified aims to lower barriers everywhere.
After a flurry of research in the 1950s and 1960s, psilocybin and all other psychedelics were abruptly banned, partly in response to their embrace by the counterculture. Following the 1971 United Nations Convention on Psychotropic Substances, psilocybin was classed in the U.S. as a Schedule I substance—defined as having “no currently accepted medical use and a high potential for abuse.” Psilocybin production was limited, and a host of administrative and financial burdens effectively ended study for decades. “It's the worst censorship of research in history,” says David Nutt, a neuropsychopharmacologist at Imperial College London.
Despite these legal hurdles, the current research resurgence has seen Nutt and others exploring how psilocybin changes the brain's connectivity patterns: reducing connections within the usual networks while increasing links between less connected regions. Just this year a study showed that treatment involving psilocybin led to sustained network alterations, which seemed to correlate with reduced depression symptoms. Two organizations are beginning final rounds of trials for psilocybin's use for depression, which could lead to the substance's first approval by the U.S. Food and Drug Administration.
As news of psilocybin's promise spreads, several U.S. cities have passed measures decriminalizing magic mushrooms. This is not the same as legalization; the molecule and the mushrooms themselves remain illegal, but prosecuting people for their possession or use is deprioritized or discouraged.
In 2019 Denver voters passed a ballot measure that prohibits using city money to prosecute people for magic mushroom–related offenses. City councils soon took similar steps in Oakland and Santa Cruz in California and in Ann Arbor, Mich. In November 2020 voters in Washington, D.C., passed a ballot measure making natural psychedelics one of law enforcement's lowest priorities. Cities and counties in Michigan, Massachusetts, California and Washington State have followed suit.
As part of Oregon's legislation, the state health authority created a scientific advisory board to recommend regulations for psilocybin service centers, such as designating mushroom species and preparations to use and production standards to follow. These centers, which can apply for licenses starting next January, will not claim to treat depression but will aim to improve general well-being.
“My worry is that people won't necessarily get that distinction ... and turn up with horrible, treatment-resistant depression, expecting an expert in treating that condition,” says Johns Hopkins University psychiatrist Natalie Gukasyan, who led a recent psilocybin trial.
Oregon's advisory board is determining how best to train facilitators and screen clients for risk factors, such as a family history of schizophrenia or bipolar disorder. “All our decisions revolve around consumer safety,” says Oregon State University mycologist Jessie Uehling, who chairs the board's product subcommittee. “We want to know that we're avoiding all the potential risks and creating the safest environment for people.” The centers will focus on fungi and natural preparations rather than the synthetic psilocybin used in clinical trials so far, Gukasyan notes.
Regardless of local decriminalization, U.S. researchers must still abide by federal Schedule I regulations. The International Therapeutic Psilocybin Rescheduling Initiative, a coalition of research and advocacy organizations, aims to get the World Health Organization to conduct a review of the relevant evidence for reclassifying the drug. “It's inconceivable the WHO could now say psilocybin doesn't have medical value. It can work where other drugs have not,” Nutt says.
Various laws already facilitate research and treatment in some countries. Canada classifies magic mushrooms as Schedule III, so penalties are lower, and certain research and trials are granted exceptions. A Canadian charity called TheraPsil has a fast-track process for end-of-life psilocybin therapy.
Some countries such as Jamaica never made magic mushrooms illegal, although the psilocybin molecule often is. Research is limited in most of these places, but many have thriving “psychedelic retreat” industries that are not medically regulated. The Netherlands has specifically banned the mushrooms—but its laws don't mention the psilocybin-containing lumps of underground material that eventually sprout them, better known as truffles. This loophole has paved the way for numerous therapeutic retreats, but little organized research.
Portugal has famously decriminalized all drugs. Some countries ban the mushrooms but not their spores, because the latter do not contain psilocybin. Others simply do not enforce their laws on magic mushrooms.
The 1971 U.N. treaty has a clause allowing countries to exempt traditional Indigenous uses of psychedelic plants. Indigenous people in some South American countries have used psychedelics for centuries and have fought governments for their right to engage in related ceremonies. There is even a religious organization in New Mexico, the Oratory of Mystical Sacraments, that claims members can legally use magic mushrooms in certain circumstances.
“This idea that psilocybin is helpful for mental health conditions is not a new one. There are thousands of years of history of efficacious treatment; it's just in a different knowledge format,” Uehling says. “We're trying hard here in Oregon to honor that knowledge system.”
Public perceptions of psilocybin are changing, and as increasing interest generates more evidence, this trend looks set to accelerate. “It's a thrilling time to be a mycologist,” Uehling says. Many are waiting to see what happens in Oregon, she adds: “Other states will come up with variations on—hopefully—what we get right, and also on what needs to be changed.”