This multi-dataset observational study (n=5 nationally representative surveys) quantifies changes in psilocybin use and healthcare utilisation in the United States between 2014 and 2023. It finds that adult lifetime use increased from 10.0% (25 million) in 2019 to 12.1% (31.3 million) in 2023, while adolescent use rose modestly from 1.1% to 1.3% during the same period.
Abstract of The Rise of Psilocybin Use in the United States
“Background Psilocybin is being studied as a potential treatment of mental health and substance use disorders. As the first hallucinogenic substance decriminalized in some states within the United States, patterns of psilocybin use have likely changed.
Objective To quantify change in prevalence and health care utilization of psilocybin users between 2014 and 2023. Methods: We included 5 nationally representative data sets: the National Survey on Drug Use and Health (NSDUH), the Survey of Non-Medical Use of Prescription Drugs (NMURx), Monitoring the Future (MTF), the National Poison Data System (NPDS), and the National Hospital Ambulatory Medical Care Survey (NHAMCS) (Table) (1–5). Psilocybin use prevalence estimates were calculated annually and plotted using the appropriate design-based adjustments. The relative change and 95% CI in estimates between 2019 and 2023 were calculated; 2019 was selected as the reference for change over time because this was the first year that psilocybin legalization policy changed anywhere within the United States.
Findings Psilocybin use across data sets was relatively stable before 2019. Lifetime use among adults (aged ≥18 years) increased from 10.0% (95% CI, 9.7% to 10.3%) in 2019 to 12.1% (CI, 11.6% to 12.6%) in 2023, from 25 to 31.3 million (NSDUH). Lifetime use among adolescents (aged 12 to 17 years) increased from 1.1% (CI, 0.9% to 1.3%) in 2019 to 1.3% (CI, 1.0% to 1.6%) in 2023, from 285 000 to 344 000 (NSDUH).“
Authors: Karilynn M. Rockhill, Joshua C. Black, Michael S. Ladka, Kanku B. Sumbundu, Heather A. Olsen, Jennifer S. Jewell, Joshua Hunt, R. Cameron Wolf, Karuna Nerurkar, Richard C. Dart & Andrew A. Monte
Summary of The Rise of Psilocybin Use in the United States
Rockhill and colleagues set out to examine changing patterns in psilocybin use across the United States, especially in light of shifting legal landscapes. Psilocybin, a naturally occurring psychedelic compound found in certain species of mushrooms, has gained increasing attention for its potential mental health benefits. By 2019, it became the first hallucinogen to be decriminalised in some U.S. jurisdictions, making this an ideal reference point for assessing evolving trends. The researchers aimed to assess not only the prevalence of psilocybin use but also its associated healthcare utilisation by drawing on multiple large-scale datasets.
The study employed data from five major sources: the National Survey on Drug Use and Health (NSDUH), the Survey of Non-Medical Use of Prescription Drugs (NMURx), Monitoring the Future (MTF), the National Poison Data System (NPDS), and the National Hospital Ambulatory Medical Care Survey (NHAMCS). These resources covered a range of age groups and offered insights from both self-reported survey data and clinical encounters. Through these datasets, the authors intended to map the extent of psilocybin use over time, paying close attention to shifts after the legal reforms initiated in 2019.
Methods
The researchers employed a multisource observational approach using data from 2014 to 2023. The NSDUH and NMURx surveys were key tools for estimating the prevalence of lifetime and past-year psilocybin use among adults and adolescents. NSDUH gathered responses from the general civilian population, while NMURx focused more specifically on adults and included information about mental and physical health symptoms such as anxiety, depression, and chronic pain.
Find this paper
The Rise of Psilocybin Use in the United States: A Multisource Observational Study
https://doi.org/10.7326/ANNALS-24-03145
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Cite this paper (APA)
Rockhill, K. M., Black, J. C., Ladka, M. S., Sumbundu, K. B., Olsen, H. A., Jewell, J. S., ... & Monte, A. A. (2025). The Rise of Psilocybin Use in the United States: A Multisource Observational Study. Annals of Internal Medicine.
Study details
Compounds studied
Psilocybin
Topics studied
Depression
Anxiety
Pain
Study characteristics
Survey