Drug Checking as a harm reduction measure for people who self-medicate with psilocybin mushrooms v2.0
Background: Thousands of people use psilocybin (‘magic’) mushrooms annually in New Zealand, with around half of these people having used them to self-medicate mental health disorders. Use of psilocybin mushrooms risks drug-associated harm such as consumption of toxic or contaminated mushrooms, bad trips’, muscle paralysis, or hallucinogen persisting perception disorder.
Self-medication of mental health disorders comes with additional risks such as interactions with concomitant prescribed medicines, the triggering or exacerbation of mental health disorders, or ineffective treatment response due to incorrect treatment protocols, lack of engagement with therapists, or the consumption of an inadequate dose. Drug Checking has been legal in New Zealand for five years and has promise as a harm reduction intervention for people who self-medicate with psilocybin mushrooms. However, Current Drug Checking services are not tailored to testing natural substances nor to providing harm reduction advice specific to people who may be self-medicating.
Approach: In conjunction with in-person interviews and online surveys investigating psilocybin mushroom use in New Zealand, Drug Checking appointments are being provided to research participants to understand how such a harm reduction intervention could be implemented in New Zealand. Drug Checking appointments involve species determination and dose measurement alongside the provision of harm reduction information. Participants can ensure that their mushrooms are not a toxic species and that the dose they are taking is desired. Participants are provided with information on less harmful use practices, mushroom identification, potential drug interactions, and how to prepare for and integrate their psychedelic experiences, particularly for those using them to self-medicate.
Participants who wish for more intentional preparation and integration sessions or who need additional mental health support are signposted to appropriate services. Findings: Drug Checking tailored towards people who use naturally occurring drugs for therapeutic purposes provides a unique opportunity to reduce harm amongst people who are using psychedelics therapeutically. Whilst the current approach has practical and financial barriers to frontline use, new technologies and approaches could fill this gap.
Further research is required to identify medical conditions where use should be suggested against, and to determine the effectiveness of harm reduction information provided in reducing harm to this unique group of people who use drugs.
