• Mark W Simon, Heather A Olsen, Christopher O Hoyte, Joshua C Black, Kate M Reynolds, Richard C Dart, and Andrew A Monte.
• Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO. Electronic address: mark.simon@denverem.org.
• Ann Emerg Med. 2024 Dec 1; 84 (6): 605618605-618.

Study ObjectivePsychedelic substances use is increasing in the United States (US). The approval of new psychedelic drugs and legalization of natural psychedelic substances will likely further increase exposures and subsequent adverse events. The study objective is to describe the clinical effects, therapies, and medical outcomes of patients with psychedelic exposures reported to US poison centers.MethodsWe performed a retrospective, cross-sectional study on psychedelic exposures reported to the National Poison Data System from January 1, 2012, to December 31, 2022. We categorized exposures into groups: hallucinogenic amphetamines, lysergic acid diethylamide, tryptamines (such as N, N-dimethyltryptamine), phencyclidine, hallucinogenic mushrooms, hallucinogenic plants, and ketamine and ketamine analogs. We summarized effects, treatments, and outcomes and evaluated associations with logistic regression and odds ratios.ResultsOur sample included 54,605 cases. There were concomitant exposures in 41.1% (n=22,460) of cases. Hallucinogenic mushroom exposures increased most over the study period from 593 in 2012 to 1,440 in 2022. Overall, 27,444 (50.3%) psychedelic exposures had symptoms that required treatment, severe residual or prolonged symptoms, or death. Cardiovascular effects were common, especially with hallucinogenic amphetamine exposures (31.1%). Patients managed in or referred to a health care facility received medical therapies in 62.4% of cases, including sedation (32.9%) and respiratory interventions (10.3%).ConclusionOver half of psychedelic exposures reported to US poison centers had symptoms that required treatment, severe residual or prolonged symptoms, or death. Increases in psychedelic use may lead to increased frequency of adverse events and health care utilization.Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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