Background. Interest in intoxicating mushrooms with psychedelic effects is rising among American adults, coinciding with a resurgence in research. However, products on the market and naturally occurring sources are not regulated for safety, may be adulterated, and may provide inaccurate/incomplete label information. Data from NPDS case reports of adverse events associated with intoxicating mushrooms were assessed by sex and age group.

Methods. Using SAS 9.4, we analyzed 2020-2024 NPDS single-exposure case data for naturally occurring or processed foods reported to contain amanita or psilocybin, muscimol/ibotenic acid, or hallucinogens (psilocybin or psilocin) (age groups considered: 17-29, 30-39, 40-49, 50-59, ≥60).

Results. Among 3930 (n=2793 men, n=1137 women), men were 2.46 times (95%CI=2.29-2.63, p<0.0001). Specifically, 50.5% of cases involved men aged 17-29 (n=1984), significantly higher than any other age group (χ²=61.03, p<.0001). Total case number grew significantly over time: 486 in 2020 to 1119 in 2024 (χ²=406.6, p<.0001). Top clinical symptoms were hallucinations/delusions (n=1075, 27.4%), agitation (n=903, 23%), tachycardia (n=642, 16.3%), and vomiting (n=616, 15.6%). Most cases (n=3840, 97.7%) specified ingestion as the route of administration.

Conclusions. NPDS intoxicating mushroom exposure cases increased significantly since 2020 and were significantly more prevalent among young men compared to older men and women of any age group. Adults reported similar clinical symptoms, with hallucinations/delusions specified in >25% of the cases. Consumers should exercise caution if they consume intoxicating mushrooms.