“Amanita” Mushroom Gummies Sold in Virginia Held Hidden Psilocybin

Since late 2023, gas stations and smoke shops in Virginia have been selling mushroom gummies marketed as "nootropics" — supposed brain boosters — or as legal psychedelics, labeled as containing the mushroom Amanita muscaria or proprietary mushroom blends. A. muscaria, unlike psilocybin mushrooms, is legal. But when investigators in Charlottesville bought and tested such gummies, most contained drugs that weren't on the label — including the Schedule I substances psilocybin and psilocin.

The patients

From September 1 to November 20, 2023, the Blue Ridge Poison Center in Charlottesville managed four adults who had deliberately eaten mushroom gummies labeled as A. muscaria and ended up in an emergency department.

• All had a racing heart, confusion, anxiety or drowsiness, and nausea; one had chest pain.
• Two were given benzodiazepines, three anti-nausea drugs, and all four intravenous fluids. All went home within 12 hours.

In June 2024, a 3-year-old accidentally ate two of the gummies and was hospitalized with drowsiness and vomiting. The child needed no treatment and went home the next day.

What was in the gummies

The patients had eaten different brands, all labeled as containing muscimol, ibotenic acid and muscarine — compounds from A. muscaria, which can cause hallucinations, agitation, stomach upset and seizures. Because those exact brands weren't available, investigators bought six packages of five other brands at nearby gas stations and smoke shops: three with the same listed ingredients and two labeled only with unspecified mushroom nootropics. The University of Virginia Health Toxicology Laboratory analyzed them with high-resolution mass spectrometry.

Four of the six packages — three brands — contained unlabeled psilocybin or psilocin, which are not legal in Virginia. The lab couldn't test for the A. muscaria compounds themselves. The mitragynine in one product is also concerning, since repeated use can raise the risk of opioid dependence. Whether buyers know they may be getting psilocybin instead of, or as well as, A. muscaria is unknown.

What to know

• For consumers: labels on psychedelic or nootropic mushroom gummies may not reflect what's inside, and the products can cause unexpected and toxic effects. Anyone with symptoms after eating them should get medical care right away.
• For clinicians: symptoms can include hallucinations, altered mental status, a fast heart rate and stomach upset. In children with unexplained drowsiness or altered mental status, mushroom gummy intoxication can look like cannabis intoxication. Standard urine drug screens usually miss these substances; a poison center or local health authority can advise on further testing.

Separately, on June 12, 2024, CDC issued a health advisory about severe illnesses possibly linked to one brand of mushroom gummies and chocolate bars, investigated with the Food and Drug Administration and America's Poison Centers.

Sources

Based on Avery Michienzi, Jeremy Hamlin, Rita Farah and Lindsay Bazydlo, "Notes from the Field: Schedule I Substances Identified in Nootropic Gummies Containing Amanita muscaria or Other Mushrooms — Charlottesville, Virginia, 2023–2024," Morbidity and Mortality Weekly Report, volume 73, Centers for Disease Control and Prevention; a work of the United States government in the public domain.