In spring 2024, America's Poison Centers and the Arizona Department of Health Services alerted CDC to four people who had become seriously ill — with seizures or central nervous system depression — after eating Diamond Shruumz mushroom-containing "microdosing" chocolate bars. These products are sold so that small doses of mushroom-derived psychoactive compounds and other psychoactive ingredients can be eaten a pre-cut piece at a time. CDC and the Food and Drug Administration (FDA) launched a national investigation.
How cases were found
A case was an illness with moderate or major effects, as defined by America's Poison Centers — including death — in someone who ate any Diamond Shruumz product (chocolate bars, gummies or cones) or another brand of mushroom-containing chocolate between January 1 and October 11, 2024. Investigators drew on the National Poison Data System, which gathers data from the country's 53 poison centers, along with reports to FDA, health departments and health care providers. Health departments completed a standard questionnaire for each case.
Who got sick
The investigation found 180 cases in 179 people across 34 states (one person fell ill twice).
- 46% were adults aged 18–29, and 59% of those with known sex were male.
- 87% needed emergency or urgent care; 44% were hospitalized; 23% went to intensive care; and 18% needed a breathing tube (endotracheal intubation). Two people (1.1%) died.
- The most common symptoms were confusion (66%), drowsiness (47%) and agitation (45%); 29% had seizures.
- Symptoms began a median of 90 minutes after eating.
What they ate
- 118 cases (66%) involved a Diamond Shruumz product: 85 a chocolate bar, 14 gummies and 11 cones.
- 62 (34%) involved only other brands of mushroom chocolate; a brand was named in 26 of these.
- Two involved both.
Compared with people who ate only other brands' chocolates, people who ate only Diamond Shruumz chocolate bars had much higher odds of:
| Outcome | Odds ratio |
|---|---|
| Seizures | 8.45 |
| Endotracheal intubation | 8.04 |
| Intensive care | 6.30 |
| Hospitalization | 3.29 |
And the more bar people ate, the likelier they were to be hospitalized, admitted to intensive care or intubated.
What was in the products
FDA tested 54 samples at its National Forensic Chemistry Center. As of November 15, 2024, testing had found, in various samples:
- muscimol and psilocin — chemicals found in psychoactive mushrooms (psilocin is a Schedule I controlled substance);
- kavalactones, from the kava plant;
- acetylpsilocin, a synthetic hallucinogen;
- pregabalin, a pharmaceutical.
A raw ingredient reportedly used to make some Diamond Shruumz products contained muscimol and ibotenic acid. Samples of the same product and flavor contained different substances.
Several of these may have caused harm by acting on the nervous system: muscimol and certain kavalactones act on the GABA-A receptor and are linked to central nervous system depression, and seizures have been reported with poisoning from Amanita muscaria (a mushroom containing muscimol and ibotenic acid), pregabalin and tryptamines such as psilocin. Because the products and symptoms varied so much, the exact cause remains unclear.
The recall
| Date (2024) | Action |
|---|---|
| June 7 | FDA announced its investigation |
| June 12 | CDC issued a Health Alert Network advisory to clinicians |
| June 18 | FDA asked the brand owner to recall all Diamond Shruumz products, and it issued a nationwide recall |
| July 16 | States reported recalled products still on sale in some smoke and vape shops; FDA worked with convenience-store and smoke-shop associations to spread the word |
| July 20 | FDA published a list of Diamond Shruumz suppliers, later updated |
| December 18 | FDA declared that Amanita muscaria, its extracts and certain constituents, such as muscimol and ibotenic acid, are not authorized as ingredients in conventional food |
Not just one brand
About a third of cases involved only other brands, suggesting the risk may not be limited to Diamond Shruumz — though some people may have misremembered what they ate. A Virginia poison center had separately described five people who needed care after eating various mushroom gummies; testing of brands bought by investigators found undisclosed, potentially harmful ingredients and Schedule I drugs.
Limitations: the investigation likely undercounts poisonings, because people may be reluctant to report eating these products, especially after milder illness; it excluded other brands' non-chocolate products; and it had no comparison group of people who didn't eat them.
What consumers should know
Microdosing psychedelic products can cause severe illness or death. Recalled products should not be sold, bought or eaten, and any Diamond Shruumz products should be thrown away. For help with a possible poisoning, call the Poison Help Line at 1-800-222-1222 or visit PoisonHelp.org.
Sources
- Rumph JT, Winquist A, Troeschel AN, et al. "Severe Illness Associated with Eating Mushroom-Containing Chocolate Products — United States, January–October 2024." Morbidity and Mortality Weekly Report 75(13), Centers for Disease Control and Prevention.
- The report gives two slightly different p-values for the trend in hospitalization with amount eaten; this page gives neither.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
1
0
0
0
Comments
