Johnson · Neuropharmacology 2018 · narrative review · n=?

The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act.

Cited 355 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and expert regulatory analysis

PubMed 29753748 · doi:10.1016/j.neuropharm.2018.05.012 · record verified 2026-08-26

What was done

The authors reviewed the abuse potential of medically administered psilocybin structured around the 8 factors required by the United States Controlled Substances Act (CSA).

What was found

The abstract reports no numerical data. Qualitatively, psilocybin produces limited reinforcing effects and only marginal, transient self-administration in non-human models. Harms in unsupervised settings include acute dangerous behavior and potential exacerbation of psychotic disorders in predisposed individuals, but overall abuse scope and harms are low compared to prototypical abused substances. The authors conclude that Schedule IV placement may be appropriate if approved as a prescription drug.

Why it matters

It provides a structured regulatory framework arguing that if clinical trials demonstrate efficacy, psilocybin's abuse profile warrants rescheduling to Schedule IV rather than remaining in Schedule I.

Limits

This is a narrative review without systematic search criteria or quantitative synthesis. The abstract provides no primary data, sample sizes, or numerical harm estimates. Proposed safety depends entirely on medical safeguards, including screening, preparation, and supervised administration.

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