Magic mushroom use rises despite concerns of rare paralysis syndrome
SOURCE:ABC Australia|BY:Peter de Kruijff
Wood-lover paralysis is a poorly understood syndrome related to consuming a native species of magic mushroom, with sufferers experiencing weakness and difficulty breathing in some instances.
What started with muscle weakness soon becomes an inability to walk.
Simon Beck watched as someone who had taken a magic mushroom cycled between being strong enough to move around, and feeling too weak to stand.
"It sort of progressively got better and they still had a little bit of weakness the next day after they'd slept, but it wasn't anywhere near as dramatic," he said.
"That was pretty interesting because that's a fairly unusual way for weakness to present clinically."
What Dr Beck, a psychedelic harm reduction researcher, was witnessing is known as "wood-lover paralysis" within the illicit psychedelic drug-using community, although it's not currently described in medical literature.
Psilocybe subaeruginosa mushrooms are illegally used both recreationally and to self-medicate because of their psychedelic properties. (iNaturalist: Jeremy Hegge, Psilocybe subaeruginosa, CC BY-NC 4.0)
Little is known about what exactly happens to users' bodies or causes the suspected drug-related syndrome, known as a toxidrome, which has often been associated with the consumption of the native Australian hallucinogenic fungi Psilocybe subaeruginosa.
Although presentations of the malady appear to be rare, Dr Beck suspected it could be deadly in some circumstances.
"It looked like something that could pose a range of risks ... but also the possibility of respiratory depression [low breathing rate] if it was severe enough."
Dr Beck and other researchers are hoping to raise awareness around drug harm reduction for the public and medical professionals.
Especially as the use of magic mushrooms and other illegal psychedelic drugs, like LSD, continues to rise in Australia for recreational use and potentially self-medication purposes.
What we know about wood-lover paralysis
Wood-lover paralysis is named after a native "magic" mushroom species (P. subaeruginosa) that grows from woody material in New South Wales, Victoria, South Australia and Tasmania, but also parts of South East Queensland and as an introduced species in Western Australia.
Correct identification of the species, commonly referred to as subs or gold tops, is difficult with several poisonous look-alike mushrooms often found growing in the same habitats.
Dr Beck, as part of research with mycologist Caine Barlow for Australian Psychedelic Society and Entheogenesis Australis, has been trying to understand the symptoms and potential causes of wood-lover paralysis.
Dr Beck and Mr Barlow co-led a study that surveyed 392 magic mushroom users and found that 42 per cent of them reported an experience of weakness at least once after consuming fungi.
One hundred and fifty-eight of the 165 people who experienced weakness reported it happening after eating wood-growing mushrooms.
Only one person said they experienced weakness after taking the most popular magic mushroom species, Psilocybe cubensis, which grows out of dung.
Dr Beck said respondents described symptoms appearing most commonly within four hours of ingestion.
Negative effects like muscle weakness lasted anywhere from a few hours to up to three days.
Dr Beck said the survey was targeted at users who had experienced paralysis, and therefore was not an indication of the general prevalence of the syndrome.
Australian mycologist Alistair McTaggart, from the private company Psymbiotika Lab and who was not involved with the research, said there was still more to learn about the cause of the paralysis.
He hypothesised that the cause was an additional tryptamine, a hallucinogen, produced by mushrooms with duplicated genes.
Dr McTaggart said this was because when a gene was duplicated, sometimes the copy would do something completely different to the original gene.
Could wood-lover paralysis kill?
Whether a case of wood-lover paralysis could lead to death is unclear.
Dixon had drunk a brew containing magic mushrooms at an unregulated "wellness retreat" that left several other participants with symptoms consistent with wood-lover paralysis.
Dr Beck shared details with the inquest about two suspected, but unpublished, instances of severe wood-lover paralysis.
The first was in New Zealand, where a mushroom user had weakness and difficulty breathing, and was later found unresponsive and died.
The second was a person in Australia who needed CPR and a breathing tube, but recovered the next day.
Mushroom use by Australians increasing
Psychedelic drug use appears to be increasing in Australia.
The latest National Drug Strategy Household Survey from 2022–23 saw the percentage of Australians who used a psychedelic drug rise from 1.6 per cent in 2019 to 2.4 per cent three years later taking the number of people who use these drugs annually up to about 500,000 people.
Mushrooms and psilocybin were the most common hallucinogens used in 2022–23 with 1.8 per cent of Australians using them.
A retrospective analysis of calls to the country's biggest poison information line, in NSW, also saw an increase in psychedelic inquiries from 45 in 2014, to 105 in 2022.
Almost half the calls were related to psilocybin, with the majority from hospitals.
Wood-lover paralysis was not recorded specifically, but there were other psychological illnesses and physical problems like vomiting and high heart rates.
Ethnopharmacologist and clinical psychologist Stephen Bright, from Edith Cowan University, said the high cost of available experimental psychedelic treatments**,** introduced to Australia in 2023, meant some people sourced drugs themselves.
"This increases risk of both wood-lover paralysis and other harms such as sexual assault, in addition to deterioration of the individual's mental state due to inadequate after-support," he said.
"Which is why it is important that these people access these experimental treatments through legitimate pathways."
Treatments in clinical settings are not undertaken without a screening process for histories of severe mental health problems, psychosis, heart problems or seizures.
Zena Burgess, Australian Psychology Society chief executive, said "psychedelic-assisted therapy should only be undertaken in an approved setting".
But what about the psychologists whose patients tell them they intend to use drugs like mushrooms illegally?
Psychological advice confronts 'grey areas'
Registered psychologist Carissa Dutton, a James Cook University PhD student, said psychologists were in a tricky situation if their clients were interested in taking illicit psilocybin.
"I was trying to look for some guidance around where do we [psychologists] stand ethically with providing harm reduction support for this cohort of people and there's not a lot of guidance or information out there," she said.
"Currently my understanding is that we can provide preparation and education prior to someone having an experience and we can provide integration support after.
"But we cannot be present when someone is taking the drug itself."
Carissa Dutton says more research is needed to understand which harm reduction strategies actually work. (Supplied: Carissa Dutton)
"What we found was that people that use psilocybin for self-exploration or for treatment of mental health were more likely to put in strategies to reduce their risks of harm," she said.
But, she said, more research was needed to understand what harm reduction strategies actually worked.
"We don't actually have a lot of research around [the question of] do these strategies equal less harm?"
If you or someone you know is in a life-threatening emergency you should call 000. For non-emergencies you can call a poison information centre on 13 11 26 anywhere and at any time in Australia.