Help for a bad reaction, a poisoning or a crisis

When should I call 911?

Call 911 right away, and don't wait to see if it settles, if someone:

• has chest pain, or a racing or pounding heart that won't slow down
• has a seizure
• has trouble breathing
• has collapsed or can't be woken
• is overheating: very hot, flushed or confused
• may hurt themselves or someone else

Poison Help, the service of the nation's poison centers, gives the same core list: "If an individual has collapsed, had a seizure, has trouble breathing, or can't be awakened, call 911 immediately."¹ Treat chest pain or a racing heart as an emergency: cardiac arrest and heart attacks have been reported after psilocybin,¹⁰ and shop "mushroom" products can contain other drugs, including a prescription drug.¹¹ Don't try home remedies or try to make the person throw up.¹ Stay with them until help arrives.

Which line should I call?

If a number here has changed, please tell us.

Poison Control: 1-800-222-1222

The line reaches "a live poison expert" through the nation's 53 poison centers, and the service is free and confidential. Its online tool asks what the product was, the person's age group, what happened and the symptoms.¹ Calls help others too: CDC found cases of the 2024 mushroom-chocolate outbreak through the poison centers' national data system.¹²

988 Suicide and Crisis Lifeline

The Lifeline is free, confidential and "available 24/7/365," and it lists alcohol or drug use concerns among reasons to reach out.² For Spanish, dial 988 and press 2 or text AYUDA to 988. Veterans can press 1 after dialing or text 838255, and 988 also takes videophone calls.³

Fireside Project: 62-FIRESIDE

Fireside Project's psychedelic peer support line is free and confidential, and it has a free app. It says plainly that it is not a suicide hotline: it sends people with suicidal thoughts to 988 and people in danger to 911.⁴ Use it to talk through a hard experience, during or after one.

SAMHSA National Helpline: 1-800-662-4357

SAMHSA's helpline is a free, confidential "treatment referral and information service" for people and families facing mental health or substance use disorders, in English and Spanish. SAMHSA's site also links to FindTreatment.gov, a treatment locator.⁵

What should I tell responders?

Give them facts, as exactly as you can:

• What was taken: the product's name and type, and the package or label if you have it
• When it was taken
• How much, if you know
• Anything else taken: alcohol, cannabis, other drugs
• Prescription medicines and supplements the person uses, especially lithium or antidepressants
• What you've seen: the symptoms and when they started

Shop "mushroom" products are often mislabeled, so say it was a "mushroom" product even if you aren't sure what was in it. When FDA tested mushroom chocolates and gummies tied to the 2024 outbreak, it found a prescription drug (pregabalin), kava compounds and a synthetic tryptamine, in mixes that varied even within the same flavor.¹¹ The product name and package help clinicians and poison specialists work out what they're treating. Our page on what lab tests found in mushroom gummies has the full results.

Who should avoid psilocybin?

Clinical trials screen people out for medical and psychiatric reasons, and their lists show who researchers consider most at risk. They come from supervised research with screening and monitoring; meeting none of them doesn't make unsupervised use safe.⁶⁷

• Psychosis, schizophrenia or bipolar disorder, in you or a close relative. Johns Hopkins safety guidelines exclude people with these conditions or with a first- or second-degree relative who has them; a 2023 JAMA trial excluded a personal or first-degree family history of psychosis or mania.⁶⁷
• Lithium. In 62 online reports of a classic psychedelic taken with lithium, 47% described seizures. These were self-reports, not a controlled study, but the authors concluded psychedelic use "may pose a significant seizure risk" for people on lithium.⁸ Oregon's licensed service centers turn away anyone who has taken lithium in the past 30 days.⁹ That's a rule about who can take part, not a reason to stop lithium: talk to the prescriber before changing any medicine.
• Antidepressants and other medicines. The Hopkins guidelines say tricyclic antidepressants, lithium, short-term SSRI use and the antipsychotic haloperidol have been shown to strengthen a psychedelic's effects, and they exclude people currently or recently taking St. John's Wort or 5-HTP. They flag long-term SSRI use and MAOIs too.⁶ None of the sources on this page says any antidepressant is safe to combine with psilocybin. Oregon's program has facilitators encourage clients to ask a pharmacist or other health care provider about the medicines and supplements they take.⁹
• Heart disease or high blood pressure. The Hopkins guidelines exclude people whose resting blood pressure is above 140/90 and screen with an ECG. A 2025 cardiology review found that safety data for people with heart disease "are lacking."⁶¹⁰
• Pregnancy or breastfeeding. The Hopkins guidelines exclude pregnant women, and Oregon's program tells clients the risks in pregnancy and breastfeeding "are unknown."⁶⁹
• Suicidal thoughts or a substance use disorder. The 2023 trial excluded people with active suicidal thoughts with intent or a plan, suicidal behavior in the past 12 months, or a moderate or severe alcohol or drug use disorder.⁷ If you're having thoughts of suicide, call or text 988.