The DOI matches its Crossref record; 180 of the 180 references it cites were found in a registry or an index.
The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act
Open accessAbstract
This review assesses the abuse potential of medically-administered psilocybin, following the structure of the 8 factors of the US Controlled Substances Act (CSA). Research suggests the potential safety and efficacy of psilocybin in treating cancer-related psychiatric distress and substance use disorders, setting the occasion for this review. A more extensive assessment of abuse potential according to an 8-factor analysis would eventually be required to guide appropriate schedule placement. Psilocybin, like other 5-HT2A agonist classic psychedelics, has limited reinforcing effects, supporting marginal, transient non-human self-administration. Nonetheless, mushrooms with variable psilocybin content are used illicitly, with a few lifetime use occasions being normative among users. Potential harms include dangerous behavior in unprepared, unsupervised users, and exacerbation of mental illness in those with or predisposed to psychotic disorders. However, scope of use and associated harms are low compared to prototypical abused drugs, and the medical model addresses these concerns with dose control, patient screening, preparation and follow-up, and session supervision in a medical facility. CONCLUSIONS: (1) psilocybin has an abuse potential appropriate for CSA scheduling if approved as medicine; (2) psilocybin can provide therapeutic benefits that may support the development of an approvable New Drug Application (NDA) but further studies are required which this review describes; (3) adverse effects of medical psilocybin are manageable when administered according to risk management approaches; and (4) although further study is required, this review suggests that placement in Schedule IV may be appropriate if a psilocybin-containing medicine is approved. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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“are not associated with addiction [9, 11, 12]”
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“Hence, despite psilocybin being classified as a drug of abuse, the US Drug Enforcement Administration (DEA) does not include it among the drugs that can cause dependence and/or addiction. 45”
From The revival of psilocybin between scientific excitement, evidence of efficacy, and real-world challenges (2024) · cites this paper as [45]
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“Psilocybin is a serotonin 5-HT2A receptor agonist with very low abuse potential (11)”
From Psilocybin-assisted psychotherapy for methamphetamine dependence: a case report involving daily methamphetamine use (2024) · cites this paper as [11]
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“Psilocybin-assisted psychotherapy (PAT) also appears to be safe and potentially efficacious for substance use disorders, based on early trials for nicotine and alcohol use disorders [14,15], with little evidence of harmful use in the community [16].”
From Psilocybin‐assisted psychotherapy for methamphetamine use disorder: A pilot open‐label safety and feasibility study. (2025) · cites this paper as [16]
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“the use of a single dose of either LSD or psilocybin in a controlled clinical setting can considerably improve the quality of life of patients in parallel with relatively few side effects and a low prevalence of abuse”
From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as Johnson, Griffiths, Hendricks, & Henningfield, 2018
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Metadata
- Authors
- Johnson, M. W., Griffiths, R. R., Hendricks, P. S., & Henningfield, J. E.
- Affiliations
- Johns Hopkins University (US)
- University of Alabama (US)
- Corresponding author
- Johnson, Matthew W.
- Venue
- Neuropharmacology
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 142
- Pages
- 143-166
- ISSN
- 0028-3908 (ISSN-L)
- PMC
- PMC6791528
- OpenAlex
- W2806419184
- Cited by
- 354
- References
- 180
- Citations by year
- 2026: 36 · 2025: 61 · 2024: 57 · 2023: 55 · 2022: 60 · 2021: 31 · 2020: 33 · 2019: 15 · 2018: 4
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Neuropharmacology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Heffter Research Institute
- NIH (RO1DA03889)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Alkaloids: synthesis and pharmacology
- Keywords
- psilocybin, abuse liability, Controlled Substances Act, drug scheduling, classic psychedelics, substance use disorders, adverse effects, psychosis, risk management, dose control
- MeSH terms
- Animals, Drug and Narcotic Control, Hallucinogens, Humans, Psilocybin, Substance-Related Disorders
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