HMN 2025: How Psychedelic decriminalization hasn’t increased ER visits

A study published in JAMA Network Open analyzed national hospital admission data from 2016 to 2023 to assess whether decriminalizing psychedelics—such as psilocybin (“magic mushrooms”)—has led to more people needing emergency or inpatient care.

“These findings add important context to other studies showing rises in hallucinogen use,” said Richard Grucza, Ph.D., professor of family and community medicine and health outcomes research at Saint Louis University School of Medicine.

“Those increases don’t seem to be contributing to rising ER visits, and if anything, alcohol and other drugs seem to be driving adverse consequences of psychedelic use.”

“In fact, after a small rise through early 2020, admissions declined through 2023, with no correlation to decriminalization policies,” added senior author Kevin Xu, M.D., assistant professor of psychiatry at Washington University School of Medicine in St. Louis.

The study was a collaborative effort between researchers at SLU and WashU Medicine. Grucza co-designed the study and co-led the analysis. Ruizhi (Regina) Huang, a biostatistician at AHEAD, collaborated with WashU Medicine’s Joanna Buss on time-series modeling.

Grucza emphasized that while psychedelics can pose risks for people with mental health issues, there is no evidence of widespread harm following policy changes.

As municipal and state-level policies evolve and psilocybin nears FDA consideration for depression, the data show that hallucinogen incidents remain rare. They account for just 0.6–1.2% of substance-related hospital encounters, far eclipsed by alcohol and opioid cases. Importantly, those admitted tend to have serious mental illness or co-occurring substance use disorders.

The researchers caution that while the findings do not indicate large-scale public health problems, psychedelics still carry risks, especially for vulnerable individuals.

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