Perceived Risks of Psilocybin Mushrooms, and Acceptability of Psilocybin-Assisted Therapy in Black/African-American Patients Diagnosed with Opioid Use Disorder

Background and Purpose: To characterize the knowledge, perceptions, and attitudes towards psilocybin mushrooms and psilocybin therapy in fifty Black/African-American patients undergoing medication treatment (i.e., methadone) for Opioid Use Disorder in Baltimore City. Methods: Seven participants (mean age 63 years; 43% female) have completed a phone-based survey about their knowledge and perceived risks of psilocybin mushrooms, acceptability of psilocybin therapy, and health care system distrust. All respondents were recruited via telephone from the University of Maryland Drug Treatment Center in Baltimore City. Recruitment is ongoing and the plan is to collect data from up to 50 participants by the end of 2021. Results: Most (71.4%) respondents had heard of psychedelics before taking the survey, but only one of seven reported a lifetime use of a psychedelic substance. None of the participants reported lifetime psilocybin mushroom use. More than half of respondents endorsed a perceived risk for almost every item on the perceived risk questionnaires (i.e., indicated the perceived psilocybin risks to include depression (57.1%), flashbacks (57.1%), and brain damage (71.4%)). Less than one-half (42.9%) of respondents reported believing that psilocybin mushrooms were more harmful than alcohol, more than one-half (57.1%) endorsed psilocybin mushrooms as more harmful than tobacco, with very few (14.3%) endorsed psilocybin mushrooms as more harmful than ecstasy, and very few (14.3%) endorsed psilocybin mushrooms as more harmful than heroin. Only 14.3% of respondents had previous knowledge of psilocybin being used as an experimental medical treatment, and although 42.9% reported they were “willing to try psilocybin treatment”, only 14.3% thought that psilocybin treatment “could help patients with opioid use disorder get better”. About one-quarter (28.6%) of respondents endorsed that they would be more likely to try psilocybin treatment if it were a legal, FDA approved, treatment. Conclusions and Implications: Preliminary data shows that perceived risk of psilocybin mushrooms is generally high, and treatment acceptability is generally low amongst a sample of Black individuals undergoing medication treatment for Opioid Use Disorder in Baltimore City. However, some of these beliefs/attitudes are inconsistent with the scientific evidence about the safety of consuming psilocybin mushrooms and the medical potential of psilocybin therapy. Continued qualitative and quantitative research exploring these important dimensions of health behavior will help identify educational gaps and barriers to access that will improve the inclusivity of future clinical research design for psychedelic therapy.