Notes from the Field: Schedule I Substances Identified in Nootropic Gummies Containing Amanita muscaria or Other Mushrooms — Charlottesville, Virginia, 2023–2024

Preliminary Conclusions and Actions

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The presence of the DEA schedule I substances psilocybin and psilocin in products legally sold at retail shops in Virginia represents a potential risk to the public. Further, the presence of mitragynine in one product is concerning because repeated mitragynine ingestion can increase the risk for opioid dependence (4). Whether persons who ingest gummies indicated to contain A. muscaria or other nootropics are aware that they might be receiving psilocybin or other substances represented as A. muscaria or if they desire the A. muscaria itself is unknown. Separate from the investigation described in this report, on June 12, 2024, CDC released a health advisory reporting that CDC, the Food and Drug Administration, and America’s Poison Centers†† are investigating cases of severe acute illnesses potentially associated with consuming one brand of mushroom gummies and chocolate bars, and are providing guidance for clinicians, public health practitioners, and the public.§§ Persons who believe they are purchasing gummies containing A. muscaria or other mushroom-containing gummies sold as psychedelics or nootropics should be aware that these products might contain undisclosed and potentially harmful substances. Clinicians should be aware that adults who consume these gummies can experience signs and symptoms that include hallucinations, altered mental status, tachycardia, and gastrointestinal upset. Mushroom gummy intoxication might appear similar to cannabis intoxication and can be included in the differential diagnosis of pediatric patients with unexplained somnolence or altered mental status (5). Urine drug screens commonly used in health care facilities do not usually detect the substances identified in these gummies¶¶; additional testing could be considered based on discussions with a poison control center or local health authorities.

Persons who purchase products advertised as psychedelic or nootropic mushroom gummies should be aware that package labels might not accurately represent the contents and that these products could contain substances that might produce unexpected and potentially toxic effects. Health care providers should counsel patients and caregivers that mushroom-containing edible products marketed with claims of health benefits might contain undisclosed ingredients and have been linked to illness requiring hospital care. Persons who experience symptoms after consuming these products should seek immediate medical attention.

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