Psilocybin mushroom stewardship: A qualitative inquiry into practices and priorities of “underground” psilocybin mushroom practitioners

Abstract Background and Aims Networks of so-called underground, or illegal, psilocybin mushroom practitioners are popularly known to exist, though few systematic investigations of their practices have been conducted. We sought to uncover the experiences of a hidden community of psilocybin practitioners in order to inform scientific and policy dialogues about safe and effective practices in this area. Methods An academic-community partnered research team used snowball sampling to recruit 17 underground psilocybin practitioners in a western U.S. state for in-depth individual interviews focused on training, protocols, practices, and policy priorities. Combined deductive and inductive analysis with three independent coders was completed using NVivo v12. Results Practitioners were white (76.5%), female-identified (64.7%), aged 31 to 50 (64.7%), non-therapists by training (58.8%), and moderately to highly experienced facilitators. All described multiple years of often difficult personal inner-directed work with psilocybin before guiding others. Benefits ranged from reduction in symptoms of depression, obsessive-compulsive disorder, and addictions to greater self-knowledge, reduced death anxiety, and a greater ability to experience joy. Client screening protocols revealed precautions for persons with severe trauma backgrounds, personality disorders, or lacking social support. Moving too quickly into a high dose mushroom session without adequate preparation or internal resourcing was perceived as a significant risk for harm. Practitioners' direct personal relationship with mushrooms was highlighted as critical to safe practice. Policy priorities centered on respectful reciprocity, defined as an ethos of giving back rather than extraction, and equitable access. Conclusions While some psychedelic research actively examines the role of the mystical-type experience in clients' positive outcomes, findings from underground practitioners suggest an even greater role of mysticism, relationality, and expanded concepts of holistic healing that can inform the development of best practice paradigms of an emerging profession.