By: Katie Lea, Research & Development Project Coordinator, USDTL

Magic mushrooms, or shrooms, are well known for containing psilocybin.¹ Humans have ingested these mushrooms for centuries to experience mind-altering effects. In 1957, psilocybin was identified as the active component of a hallucinogenic mushroom extract. Since then, metabolic studies have revealed that psilocybin is rapidly converted to psilocin in the body.² Low levels of psilocin may also be present in the mushroom itself.¹ Psilocin is structurally very similar to serotonin and binds to the same receptors in the brain, causing changes in perception and mood. It is now understood that psilocin, not psilocybin, is primarily responsible for the psychedelic “trip” following magic mushroom consumption.  

The effects of magic mushrooms can vary widely depending on an individual’s mindset, body type, and level of tolerance.¹ Psychedelic effects typically begin 30-60 minutes after ingestion and last between 3-6 hours.¹ There is evidence that some effects may last up to 12 hours.³ Magic mushrooms are generally perceived as safe due to the rarity of overdose and low potential for addiction.¹ Some common negative effects include nausea, vomiting, dizziness, muscle weakness, and lack of coordination.^3,4 At high doses, panic and psychosis may occur.⁴ Additionally, psychedelic effects can lead to harmful and potentially fatal behaviors.³ There is also a risk of exacerbating existing psychological disorders such as schizophrenia.¹ 

Magic mushrooms are usually not included in routine drug testing.³ As mentioned, psilocybin is rapidly converted to psilocin in the body; therefore, detection of psilocin in a biological specimen could indicate magic mushroom use.^2,5,6 Psilocin is a particularly unstable chemical, but a majority of psilocin excreted in urine is present as the glucuronide metabolite, offering better stability and chance for detection.² Still, urine specimens should be wrapped in foil and shipped in an insulated box with cold packs to prevent degradation from light, heat, and air.² The detection of psilocin in hair or nail specimens may also indicate past magic mushroom use. Literature regarding psilocin in keratinized specimens is scarce, but there are two published reports of psilocin detected in the hair of hallucinogenic mushroom consumers.^5,6 With either specimen type, psilocin’s instability creates challenges in identifying past magic mushroom use. Care must be taken during specimen collection and analysis to minimize degradation of the drug in order to obtain the most accurate results.   

 References 

1. Lowe H, Toyang N, Steele B, Valentine H, Grant J, Ali A, Ngwa W, Gordon L. The Therapeutic Potential of Psilocybin. Molecules. 2021; 26(10):2948. https://doi.org/10.3390/molecules26102948 
2. Dinis-Oliveira, R. J. (2017). Metabolism of psilocybin and psilocin: clinical and forensic toxicological relevance. Drug Metabolism Reviews, 49(1), 84–91. https://doi.org/10.1080/03602532.2016.1278228 
3. Malaca S, Lo Faro AF, Tamborra A, Pichini S, Busardò FP, Huestis MA. Toxicology and Analysis of Psychoactive Tryptamines. Int J Mol Sci. 2020 Dec 4;21(23):9279. doi: 10.3390/ijms21239279. PMID: 33291798; PMCID: PMC7730282. 
4. DEA Drug Fact Sheet: Psilocybin https://www.dea.gov/factsheets/psilocybin 
5. Zhou, L., Xiang, P., Wen, D. et al. Sensitive quantitative analysis of psilocin and psilocybin in hair samples from suspected users and their distribution in seized hallucinogenic mushrooms. Forensic Toxicol 39, 464–473 (2021). https://doi.org/10.1007/s11419-020-00566-3
6. Kintz, Pascal & Raul, Jean-Sébastien & Ameline, Alice. (2021). Testing human hair after magic mushrooms abuse by LC-MS/MS: Pitfalls and limitations. Forensic Chemistry. 26. 100364. 10.1016/j.forc.2021.100364. https://doi.org/10.1016/j.forc.2021.100364

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 Additional Resources

• Psychedelics: Then and Now
• DMT: An Overview
• Read About Psilocin Launch

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A new disorder — Fetal Fentanyl Syndrome — has emerged, marked by microcephaly, distinctive facial features, cleft palate, and congenital anomalies in newborns exposed to fentanyl during pregnancy.¹ 

 Researchers and clinicians are at the forefront of understanding and addressing this urgent public health challenge. Detecting fentanyl exposure in newborns is now essential for: 

• Establishing Causality: Only with accurate testing can we confirm prenatal fentanyl exposure as the cause of this newly–recognized syndrome, differentiating it from genetic or other drug-related conditions.¹ 

• Uncovering Mechanisms: Early biochemical testing has revealed transient cholesterol metabolism abnormalities in affected infants, suggesting fentanyl may act as a teratogen by disrupting fetal cholesterol synthesis — a novel and critical area for research.¹ 

• Guiding Future Interventions: Systematic detection enables longitudinal studies to assess long-term neurodevelopmental and cognitive outcomes, informing clinical care and public health policy.¹ 

• Responding to an Epidemic: With fentanyl use rising, the potential impact of Fetal Fentanyl Syndrome is significant. Proactive detection is vital for quantifying prevalence, identifying at-risk populations, and shaping effective prevention strategies.¹ 

 Your detection can drive the discovery of mechanisms, outcomes, and solutions for Fetal Fentanyl Syndrome — but only if newborn fentanyl exposure is reliably detected and documented. 

USDTL is here to support you and your organization. We offer state-of-the-art, evidence-based toxicology testing for fentanyl and its metabolites in multiple mother and newborn specimens, including POCT and central laboratory testing options for maximum accuracy and detection. 

References 

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC11613603/ 

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What is DMT?

DMT, or N, N-Dimethyltryptamine, is a potent hallucinogen that is both synthesized in labs and found naturally in various plants and animals. DMT is renowned for its intense psychoactive properties. It is the primary psychedelic compound in the South American plant brew known as ayahuasca, which has been used for centuries in religious and spiritual practices. DMT is classified as a Schedule I substance in the United States. However, certain protections exist for its use in religious ceremonies and research.¹

Effects of DMT

When consumed, DMT induces a range of desired and undesired effects. Among the most common desired effects are vivid hallucinations, dissociation from the body, alterations in mood, and significant changes in perception. Users often report experiencing a profound shift in consciousness, a sense of connection to the universe, altered visual and auditory experiences, and intense emotional states. However, there are also unwanted effects, such as nausea, vomiting, elevated blood pressure, and increased heart rate.¹

In extreme cases, DMT use has been linked to severe reactions, including seizures, respiratory arrest, and even cardiac arrest.⁶ These more dangerous outcomes are rare but have been reported to poison control centers, highlighting the risks associated with the substance.^1,6

History of DMT

The use of DMT dates back centuries, with indigenous South American tribes using brews like ayahuasca in religious ceremonies.¹ The brew contains two primary ingredients: Psychotria viridis, a shrub rich in DMT, and Banisteriopsis caapi, a vine that contains monoamine oxidase inhibitors (MAOIs).^2,4 These MAOIs prevent the rapid breakdown of DMT in the body, allowing for the prolonged and intense effects of the brew.²

In the 1930s, ayahuasca began to make its way into urban Brazil, where it was used in religious environments.⁴ The first synthesis of DMT occurred in the 1950s, and by the 1960s, its hallucinogenic properties were widely recognized.¹ DMT’s popularity increased in the United States in the 1960s as a recreational drug. However, in 1971, the passage of the Controlled Substances Act led to DMT being classified as a Schedule I substance, making it illegal for most uses.¹

DMT Today – The Resurgence of Psychedelics

In recent years, there has been a resurgence of interest in psychedelics, including DMT. This revival includes both recreational use and the exploration of DMT’s therapeutic potential.^2,3 With a relatively short duration of action, DMT is considered a more appealing alternative to other psychedelics that have longer-lasting effects.³ It is also becoming increasingly available, both for recreational use and through religious practices, such as ayahuasca ceremonies.⁶

Despite its rise in interest, the use of DMT remains relatively low compared to other substances. However, recent statistics show a gradual increase in its use, especially among individuals who use other substances. From 2007-2014, tryptamine use (which includes DMT) increased from 0.2% to 0.7%, according to the National Survey on Drug Use and Health.⁵ Furthermore, there has been a notable increase in ayahuasca-related calls to poison control centers, particularly between 2005 and 2015, further demonstrating the growing prevalence of DMT-related incidents.⁶

 References

1. https://www.deadiversion.usdoj.gov/drug_chem_info/dmt.pdf​
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC6088236/pdf/fnins-12-00536.pdf​
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC10850177/​
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC11114307/pdf/PCN5-2-e146.pdf​
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC6182767/#:~:text=Prevalence%20of%20DMT%20and%20other,to%2015.5%25%20(p%20%3D%20.​
6. https://pubmed.ncbi.nlm.nih.gov/27896660/

 Learn more about Psychedelics.

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By: Amy Racines, MS, Research & Development Senior Project Coordinator

The opioid crisis has affected the United States for more than a decade. In 2017, the United States declared the opioid crisis a public health emergency, and, since then, new drugs have emerged on the illicit market with fentanyl, xylazine, and, most recently, medetomidine¹. Medetomidine entered the illicit market in July 2022 and has been on the rise ever since, with public health alerts issued from late 2023 through 2024². It is almost always used in combination with opioids, and the user may not be aware of its presence.  

Medetomidine is a potent and short-acting sedative and analgesic medication. Medetomidine can exist as two isomers: dexmedetomidine or levomedetomidine. Dexmedetomidine was approved for use by the FDA in 1999, and it is currently being used for critically ill patients, during surgery, or for those on ventilators³. It is only available by prescription. Medetomidine can also exist as a racemic mixture of both isomers, levomedetomidine and dexmedetomidine. This form is only approved for use in veterinary medicine and is not approved for human consumption, yet it has entered the illicit market¹. 

Medetomidine is about 200 times more potent and 10 times more selective than xylazine, and its effects are longer-lasting^4,5. It binds to the alpha2-adrenoergic receptor just like xylazine. Medetomidine’s desired effects include sedation, muscle relaxation, analgesia, and anxiolysis⁶. However, the adverse effects of medetomidine are mainly respiratory and cardiovascular effects such as bradycardia and associated arrhythmias, hypertension or hypotension, and reduced cardiac output. NARCAN has no effect on a medetomidine overdose, though it should still be used due to medetomidine use often being concurrent with opioid use. The medication atipamezole reverses the sedative and cardiovascular effects of medetomidine in some animals, though it has never been studied in humans⁷. 

References:

1. Medetomidine Infiltrates the US Illicit Opioid Market 
2. Medetomidine_Public_Health_Alert__Final.pdf 
3. Use of dexmedetomidine in critical-ill patients: is it time to look to the actual evidence? | Critical Care | Full Text 
4. Scheinin, H., Virtanen, R., MacDonald, E., et al. Medetomidine—a novel alpha 2-adrenoceptor agonist: a review of its pharmacodynamic effects. Prog. Neuropsychopharmacol. Biol. Psychiatry. 13:635–651, 1989. [DOI] [PubMed] [Google Scholar] 
5. 9. Tyner, C.L., Woody, B.J., Reid, J.S., et al. Multicenter clinical comparison of sedative and analgesic effects of medetomidine and xylazine in dogs. J. Am. Vet. Med. Assoc. 211:1413–1417, 1997. [PubMed] [Google Scholar] 
6. A review of the physiological effects of α2-agonists related to the clinical use of medetomidine in small animal practice – PMC 
7. Sedative and cardiopulmonary effects of medetomidine hydrochloride and xylazine hydrochloride and their reversal with atipamezole hydrochloride in calves in: American Journal of Veterinary Research Volume 69 Issue 3 

 Learn more about Medetomidine Testing at USDTL.

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By: Amy Racines, MS, Research & Development Senior Project Coordinator

Phenibut was first developed in Russia in the 1960s to relieve anxiety, insomnia, and alcohol withdrawal and as a potential treatment for Parkinson’s disease¹. It is structurally similar to a naturally occurring neurotransmitter, GABA, and therefore mimics GABA in the body. Phenibut is still widely used in Russia but is banned in some European countries. In the United States, it is not scheduled, banned, nor approved by the FDA. Phenibut is readily available to be purchased online and is frequently advertised as a supplement for anxiety, sleep, and post-traumatic stress disorder². 

The desired effects of phenibut include sedation and decreased consciousness, but other reported symptoms include agitation, delirium, seizures, hallucinations, and decreased respiration³. Tolerance is observed with phenibut use, with some cases happening in less than a week, and therefore dependence can occur. Since there is no FDA regulation or guidance of this compound, it has been reported that users take far greater doses than the recommended dose of 500-1500 mg/day, further increasing their risk of dependence⁴. Withdrawal symptoms can include hallucinations, psychosis, agitation, tachycardia, hyperthermia, seizures, and myoclonus. 

The statistics on phenibut use in the United States are unknown, but the number of calls to poison control centers involving phenibut has been on the rise since 2015⁵. It is thought that the key demographic of phenibut users is males between the ages of 20-35⁶. Many users may not be aware of their addiction, especially since phenibut is advertised as a supplement, so further public awareness and education around this compound is needed.  

 References:

1. https://www.cdc.gov/mmwr/volumes/69/wr/mm6935a5.htm) 
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC5952553/ 
3. July21-Phenibut.pdf 
4. A Systematic Review of Phenibut Withdrawals 
5. Notes from the Field: Phenibut Exposures Reported to Poison Centers — United States, 2009–2019 | MMWR 
6.  A Systematic Review of Phenibut Withdrawals 

 Learn more about Phenibut Testing at USDTL.

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We are excited to announce the addition phenibut, medetomidine, and tianeptine to our umbilical cord tissue, hair, and nail testing menus. These substances can be ordered as an individual test or an add-on to any umbilical cord tissue, hair, or nail drug panel beginning March 10, 2025.

Click here to learn more about our new phenibut, medetomidine, and tianeptine testing.

For more information on hair testing click here, for more information on nail testing click here, and for more information on umbilical cord tissue testing click here. 

Jones, J. , Coy, D. and Jones, M. (2024) A Comparison of Turnaround-Times for Two Popular Specimen Types Used for Newborn Toxicology: Meconium and Umbilical Cord Tissue. Open Journal of Obstetrics and Gynecology, 14, 1541-1547. DOI: 10.4236/ojog.2024.1410123.

Screened Negative Results = ~24 Hours* Confirmed Results (positive/negative) = additional ~48-72 Hours*
*Estimates are calculated based on the time the specimen is received at our laboratory.

Abstract

Background: Prenatal exposure to illicit substances is responsible for several long-term negative health consequences. It is critical for healthcare professionals to know the extent and scope of prenatal substance exposure in their cases. Several studies exist with mixed results comparing the effectiveness of umbilical cord tissue (UCT) and meconium (MEC) as toxicology specimen types. The specific aim of this study is to compare the use of UCT and MEC regarding the time interval between the birth of the neonate, receipt of the specimen at the laboratory, and the hospital’s receipt of the final toxicology report.

Method: The study queried de-identified results of 5358 consecutive UCT and 706 MEC from our laboratory.

Results: The mean time from birth to receipt of the specimen at the laboratory for MEC and UCT was 4.5 days ± 2.9 days and 2.8 days ± 1.9 days, respectively. The mean time from birth to final report for MEC was 6.9 days ± 3.8 days, 5.7 days ± 3.3 days, and 8.4 days ± 3.8 days for all MEC specimens, negative MEC, and positive MEC, respectively. The mean time from birth to final report for UCT was 4.3 days ± 2.4 days, 3.5 days ± 2.2 days, and 5.4 days ± 2.2 days for all UCT, negative UCT and positive UCT, respectively.

Discussion/Conclusion: Receipt of drug test results of the neonate prior to release from the hospital is critical. This study shows that UCT offers an advantage when results are needed quickly to make informed decisions about the health and well-being of newborns.

Click here to read the full abstract. Click here to learn more about our Newborn Testing. 

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