18-year-old kills himself after consuming hallucinogenic mushrooms.?

Hallucinogenic mushrooms Psilocybe semilanceata (specimen collected in Sweden) © Wikimedia Commons

Forensic pathologists and toxicologists from Lyon reported in the Journal of Forensic Sciences on December 12, 2018 a tragic case: that of an 18-year-old young man who threw himself from a balcony after consuming hallucinogenic mushrooms.

On the evening of the incident, the victim and two of his friends consumed hallucinogenic mushrooms, a fourth comrade merely smoking cannabis. According to the testimonies collected, the three comrades only ingested “magic mushrooms”.

During the evening, the young man isolates himself in the bathroom and comes out completely naked. Having become abnormally aggressive and exhibiting an abnormal state of excitement, he heads for the balcony, located on the 2nd floor, and throws himself into the void. He dies instantly. A friend of his told the police that she was unable to hold him.

The victim had no particular medical or psychiatric history. According to his friends, the young man had already consumed magic mushrooms, a way for him to overcome his shyness.

Psilocybes

The most consumed psychoactive mushrooms, psilocybes, have psilocybin as their main active ingredient. Their consumption most often takes place in festive evenings with friends or during a rave party . Psilocybin and psilocin concentrations vary between species and within the same species.

In the young man’s room, the police discovered, in addition to cannabis, several plants of hallucinogenic mushrooms, also called magic mushrooms: red and white amanitas (probably fly agaric or Amanita muscaria ) and psilocybin mushrooms.

The autopsy was performed the same day of death. External examination found multiple facial fractures, bruises and contusions to the chest, abdomen, arms and legs. Above all, the autopsy revealed a cranio-encephalic trauma with fractures of the left orbit, the right temporal bone and an occipital hemorrhage (at the back of the skull). Finally, the examination of the contents of the stomach found only mushrooms, partially digested, whose cap was characteristic of psilocybes.

Pholiotina cyanopus , psilocybin mushroom. © Wikipedia

Psilocybin and psilocin

Psilocybin is the main psychoactive substance in hallucinogenic mushrooms. After ingestion, it is transformed into a pharmacologically active form, psilocine. This reaches a maximum blood concentration within 50 to 100 minutes after ingestion. Psilocin is able to cross the blood-brain barrier. At the cerebral level, it acts mainly on the 5-HT1A, 5-HT2A and 5-HT2C receptors for serotonin, a neurotransmitter.

Toxicological analyzes showed that the victim had consumed approximately five grams of dried mushrooms before death, a dose corresponding to the upper limit of the usual dose for recreational use. The blood alcohol level was negative. In addition, the blood THC (tetrahydrocannabinol) assays indicated that a considerable time had elapsed between taking cannabis and the young man’s death. In fact, no other psychoactive substance was detected in the biological samples taken during the autopsy. It therefore appears that “the inexplicable behavior that led to the fatal fall is toxicologically linked to the sole influence of the hallucinogenic mushrooms”, according to Emma Honyiglo, Laurent Fanton and their colleagues from the Forensic Institute of the Hospices Civils de Lyon.

Magic mushrooms enjoy a good reputation among narcotics due to their low direct toxicity and lack of dependence. In 2017, 6.8% of 17-year-olds said they had used hallucinogenic mushrooms at least once.

The effects of psilocybin and psilocin are manifested in altered perceptions, mood and thinking. These desired effects are not most often immediate but occur about 30 minutes after ingestion, which sometimes encourages consumers to take it again and experience greater psychedelic effects. These are also amplified by the concomitant consumption of alcohol or other psychoactive substances. The effects of magic mushrooms dissipate after about 4 to 6 hours, which can seem rather long in the event of a bad trip (frightening delirium).

Unpredictable dangerous behavior

Tragic incidents associated with the consumption of hallucinogenic mushrooms have been published in the medical literature. In 2000, Luxembourg toxicologists described the case of a 23-year-old young woman who had jumped out of the window from the second floor of a house after consuming about 5 grams of dried magic mushrooms. She had also smoked a cannabis joint. The 9 meter fall had been fatal. This was the first time that psilocybin use was indirectly associated with death.

Three other fatal cases were reported in 2013 and 2014: the death by hypothermia of a Japanese man found in a canal, the death in Germany of a man who had stabbed himself, a suicide in the Czech Republic.

Other non-fatal cases have also been published. A study , published in 1982, relating to 44 cases of poisoning with hallucinogenic mushrooms admitted to the emergency room, showed that the patients presented, depending on the case, aggressive behavior, suicidal thoughts, dangerous driving (walking naked along railroad tracks, banging your head violently several times).

These publications show that ”  the psychological effects of psilocybin mushrooms can indirectly lead to death or severe trauma and that their use is not as safe as their reputation might suggest” , state the authors. In rare cases, their consumption can lead to unpredictable side effects, as evidenced by the case of defenestration under the influence of hallucinogenic mushrooms reported by forensic doctors and toxicologists from Lyon.

And the authors conclude that “this case illustrates the possible dangers of the consumption of psilocybin mushrooms insofar as the fact of being a regular user, of consuming in a known environment and in the presence of a sober companion, does not not immune to potentially fatal consequences.