Poison Control
Elizabeth Briand
In June 2024, FDA issued a nationwide warning regarding a ‘shroom-based product that has been associated with at least 40 hospitalizations and potentially two deaths. Diamond Shruumz chocolate bars, gummies, and infused cones were recalled by the manufacturer after nearly 80 people reported abnormal heart rates, hypertension, seizures, nausea, vomiting, and more after ingesting the products.
In recent years, with changes in laws surrounding the sale and use of cannabis and psychedelics, a growing number of people have begun consuming these products, many of them in search of relief from anxiety, depression, and other health concerns. It can be difficult to track the growth in the consumption of mushrooms and other psychedelics, but tangential evidence suggests that interest is skyrocketing, with internet searches for the term “microdosing,” for example, increasing by more than a thousandfold since 2015.
Manufacturers are responding to that interest with the introduction of seemingly hundreds of new products, many of them drug-infused chocolates, candies, and baked goods offered in colorful, fun packaging.
Significant risks
The safety risk for users lies in the fact that, unlike food and medications, these products are not regulated by FDA, meaning that manufacturers are not following any guidelines in the creation of these products, which are sold online or by small, local smoke or vape shops, where it is difficult for regulators to track their sales.
“All of these unknowns are dangerous,” said Cyrus Rangan, MD, assistant director and medical toxicologist for the California Poison Control System. “Because of the darkness surrounding the manufacturing process, it’s difficult to know what’s in them. They’re made without oversight. Anyone can make and sell them the way they want and where they want.”
That means that different substances can be added beyond what is advertised on the bag or box. In addition to the hallucinogenic properties of mushrooms, for example, other substances that act like valium or phenobarbital can be brought into the mix, resulting in CNS depression and other dangerous outcomes—all potentially unknown to the consumer.
Once a problem is discovered, the work of tracing and getting the substances off the shelves can be its own challenge. When medications or foods that are FDA-approved are recalled, there is a system in place. The manufacturers of these products are known to the agency as are the products’ ingredients and the locations where they are sold. And there are already tried-and-true systems of contact with sellers, making it easy for FDA to contact a nationally known pharmacy chain, for example, and tell them to remove the product from their shelves.
That is not possible with the type of small shops and online stores where products like Diamond Shruumz are sold. “They are very difficult to track,” said Rangan.
With the Diamond Shruumz incident, the manufacturer itself issued the recall, followed by the warning from FDA. It took an FDA analysis to determine that the products were causing injury to consumers because the products contained muscimol, a chemical found in mushrooms of the genus Amanita and known to cause the same types of symptoms experienced by the people who fell sick.
In other instances, where the manufacturer may not have recalled their product, FDA can find itself playing catch-up, relying on hospitals, clinicians, consumers, and poison control centers to track the location of products and help get the word out on treatments.
With the support of pharmacists
When it comes to mitigating the impact of recalls such as these, pharmacists often play a key role, providing education and warnings to consumers. “They can spread the word,” said Rangan.
Rangan notes it is also important to get the word out to schools regarding the danger of these unregulated products. As tempting and innocuous as many of them may look, “it’s not much different from getting drugs on the street, the unknowns are so similar. Education is the most important tool in helping prevent these cases in the future.” ■