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Emergency Medicine25 papers

Psychoactive substance dependence

Last edited: 4/15/2026

Overview

Psychoactive substance dependence, exemplified by "magic mushroom" (psilocybin mushroom) use, involves compulsive use despite harmful consequences, characterized by perceptual and affective disturbances 12.

Diagnosis

  • Clinical Features: Mydriasis, hyperreflexia, perceptual disturbances, and affective changes 1.
  • History and Physical: Detailed history of substance use patterns and physical examination focusing on neurological status 12.
  • Laboratory Tests: Not typically required for diagnosis but may include toxicology screens to rule out other substances 1.
  • Management

  • Supportive Care: Monitoring and supportive management for acute symptoms, including hydration and safety precautions 12.
  • Psychological Support: Counseling and psychological support to address underlying issues and prevent relapse 2.
  • No Specific Pharmacological Treatment: No specific pharmacological antidotes for psilocybin intoxication; treatment is largely supportive 1.
  • Special Populations

  • Awareness and Education: Special emphasis on educating participants, particularly in areas where mushrooms are abundant (e.g., parts of Wales), about potential dangers and sequelae 2.
  • Key Recommendations

  • Educate Participants: Increase awareness among festival attendees and communities about the risks associated with magic mushroom use to mitigate harm 2 (Evidence: Expert opinion).
  • Supportive Monitoring: Implement supportive monitoring and care protocols for individuals experiencing acute intoxication to ensure safety and manage symptoms 1 (Evidence: Weak).
  • Psychosocial Interventions: Offer psychosocial interventions and counseling to address substance use dependence and reduce relapse risk 2 (Evidence: Expert opinion).
  • References

    1 Peden NR, Bissett AF, Macaulay KE, Crooks J, Pelosi AJ. Clinical toxicology of "magic mushroom" ingestion. Postgraduate medical journal 1981. link 2 Harries AD, Evans V. Sequelae of a 'magic mushroom banquet'. Postgraduate medical journal 1981. link

    Original source

    1. [1]
      Clinical toxicology of "magic mushroom" ingestion.Peden NR, Bissett AF, Macaulay KE, Crooks J, Pelosi AJ Postgraduate medical journal (1981)
    2. [2]
      Sequelae of a 'magic mushroom banquet'.Harries AD, Evans V Postgraduate medical journal (1981)

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