Magic mushroom use in the Netherlands declined from 6.3% last-year prevalence in 2000 to 2.9% in 2005, and further after possession and use became illegal in December 2008. A review by the Coordination point Assessment and Monitoring new drugs concluded that the physical and psychological dependence potential of magic mushrooms is low, acute toxicity moderate, chronic toxicity low, and public health and criminal aspects negligible. Combined use with alcohol and the quality of the setting deserve attention. Overall, magic mushroom use is relatively safe with few and mild adverse effects, though the low but unpredictable provocation of panic attacks and flash-backs remain a concern.
Psilocybin, when combined with psychotherapy or psychotherapeutic support, shows promise as a treatment for various mental disorders, including treatment-resistant conditions. However, larger double-blind randomized controlled trials with objective long-term outcomes are needed to confirm these findings before standard clinical use can be considered.
Ecstasy (MDMA) is a popular recreational drug with low abuse and dependence liability compared to several other illicit drugs and alcohol, and there is little evidence of long-term harm. A potential health risk is acute hyperthermia, which occurs at an unknown incidence rate and is more prevalent when ecstasy is consumed with heavy exercise at high ambient temperatures or with other substances including alcohol. However, illegal production and trade in the Netherlands have developed into a serious public order and ecological problem, with organized crime related to production and trafficking growing. This review provides a science-based summary to assist debate on future Dutch ecstasy policy to reduce organized crime while maintaining harm reduction.