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Synthetic psychedelic found in candies linked to seizures, intubation

4-AcO-DMT, candies, CDC, chocolate, diamond shruumz, fda, kava, piper methysticum, psilocybin, psychedelic, Science / /

Toxic trip —

Cases grow to 39, including 23 hospitalizations, across 20 states.

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A Diamond Shruumz chocolate bar, which comes in a variety of flavors.

Enlarge / A Diamond Shruumz chocolate bar, which comes in a variety of flavors.

The US Food and Drug Administration has identified a synthetic psychedelic compound as well as compounds from a potentially toxic plant in the Diamond Shruumz-brand microdosing candies linked to a growing number of severe illnesses nationwide that have included seizures, intubation, and admissions to intensive care units.

As of June 25, the case total has grown to 39, including 23 hospitalizations, across 20 states, the FDA and the Centers for Disease Control and Prevention reported.

It remains unclear what is in the candies and what may be causing the severe illnesses. Diamond Shruumz does not provide a full list of ingredients. The term “microdosing” and other marketing used by Diamond Shruumz suggests the candies contain a psychedelic compound, but the company does not name any. To figure it out, the FDA has been analyzing multiple samples of Diamond Shruumz-brand candies, including chocolates, gummies, and candy cones. On Tuesday, the FDA reported finding the synthetic psychedelic compound 4-AcO-DMT in the company’s Dark Chocolate Bar and its Birthday Cake Chocolate Bar.

As Ars reported previously, 4-AcO-DMT (aka 4- acetoxy-N,N-dimethyltryptamine, O-acetylpsilocin, or psilacetin) is a common synthetic tryptamine used in psychedelics and was previously suspected to be in the Diamond Shruumz candies. The psychoactive drug has a chemical structure similar to the most notable mushroom-derived psychedelic, psilocybin, as well as LSD. Though safety data on the compound is scant, it is not known to be linked to some of the severe symptoms seen in the current string of illnesses. People who use 4-Aco-DMT describe it as producing effects similar to psilocybin, but without some of the unpleasant side effects noted with natural mushrooms, such as nausea. Still, according to the CDC, some people who use it could experience nausea, vomiting, fast heart rate, anxiety, agitation, lightheadedness, or tremor.

Additionally, the FDA found three compounds from the Kava plant (Piper methysticum) in the company’s dark chocolate bar, though not the birthday-cake flavored bar. The compounds are kavalactones—desmethoxyyangonin, dihydrokavain, and kavain.

Concerning kava

Kava is a plant found on some Pacific Islands and is used in traditional herbal remedies for the treatment of anxiety, insomnia, stress, and other ailments. But, over the years, it has also occasionally been linked to severe liver toxicity. In the early 2000s, this led to warnings, withdrawals, and even bans in several countries, including Germany, Switzerland, France, Canada, and the UK. In 2002, the FDA issued an advisory of its own over the associated liver injuries, which include hepatitis, cirrhosis, and liver failure. Later that same year, researchers published case reports of 11 people (two in the US and nine in Europe) who developed liver failure after using kava products and needed subsequent liver transplants.

In an update on the illnesses linked to Diamond Shruumz candies, the CDC noted that kava can cause numbness of the mouth and skin, loss of coordination, dizziness, sedation, and gastrointestinal effects, such as nausea and vomiting. Consuming kava products alongside alcohol or drugs like benzodiazepines (e.g. Valium and Xanax) can heighten the sedative effects. But, the CDC seemed to downplay the risk of liver toxicity here, noting that it has only occasionally been associated with chronic or heavy ingestion of kava.

In all, it’s still unclear if the compounds the FDA identified in the Diamond Shruumz chocolate bars so far can explain the illnesses seen in the linked cases. The CDC lists the severe and common symptoms from those cases as including seizures, decreased level of consciousness, respiratory failure, nausea, vomiting, abdominal pain, hallucinations, uncontrolled movements, abnormal heart rate (e.g., too fast or too slow), high or low blood pressure, excessive sweating or secretions, and flushed skin.

The FDA said testing of other Diamond Shruumz products is still in progress. The agency noted that there can be differences across products and batches. In the meantime, the agency advises consumers not to eat, sell, or serve any of the company’s products and, instead, discard them.

There is still no recall of the candies. Diamond Shruumz has not responded to multiple inquiries from Ars. The FDA said Tuesday that the agency has “been in contact with the firm about a possible voluntary recall,” but to date, Diamond Shruumz has not initiated one.

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Microdosing candy-linked illnesses double; possible recall in “discussions”

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No recall —

Of the 26 cases identified so far, 25 sought medical care and 16 were hospitalized.

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Microdosing candy-linked illnesses double; possible recall in “discussions”

Cases of illnesses linked to microdosing candies have more than doubled, with reports of seizures and the need for intubation, mechanical ventilation, and intensive care stays. But, there remains no recall of the products—microdosing chocolates, gummies, and candy cones by Diamond Shruumz—linked to the severe and life-threatening illnesses. In the latest update from the Food and Drug Administration late Tuesday, the agency said that it “has been in contact with the firm about a possible voluntary recall, but these discussions are still ongoing.”

In the update, the FDA reported 26 cases across 16 states, up from 12 cases in eight states last week. Of the 26 reported cases, 25 sought medical care and 16 were hospitalized. No deaths have been reported.

Last week, the Centers for Disease Control and Prevention released a health alert about the candies. The agency noted that as of June 11, the people sickened after eating Diamond Shruumz candies presented to health care providers with a host of severe symptoms. Those include: central nervous system depression with sedation, seizures, muscle rigidity, clonus (abnormal reflex responses), tremor, abnormal heart rate (bradycardia or tachycardia), abnormal blood pressure (hypotension or hypertension), gastrointestinal effects (nausea, vomiting, or abdominal pain), skin flushing, diaphoresis (excessive sweating), and metabolic acidosis with increased anion gap (an acid-based disorder linked to poisonings).

At the time of the CDC alert, 10 patients had been hospitalized, and “several required intubation, mechanical ventilation, and admission to an intensive care unit,” the agency reported.

It remains unclear what ingredient in the candies could be causing the poisonings. The FDA reports that it has worked with state partners to collect multiple samples of Diamond Shruumz products so they can be analyzed for potential toxic components. That analysis is still ongoing, the agency said.

Diamond Shruumz has not responded to multiple requests for comment from Ars.

Untold toxic ingredients

Diamond Shruumz does not list the ingredients of its products on its website. They are sold as “microdosing” candies, a term that typically suggests a small amount of a psychedelic compound is present. The company describes its chocolates, gummies, and cones as “trippy,” “psychedelic,” and “hallucinogenic,” and also claims they contain a “primo proprietary blend of nootropic and functional mushrooms.” But, it’s unclear what, if any, psychoactive compound is present in the candies.

The CDC notes that products like these “might contain undisclosed ingredients, including illicit substances, other adulterants, or potentially harmful contaminants that are not approved for use in food.”

Diamond Shruumz posted documents on its website from third-party laboratories claiming to indicate that the candies do not contain the most notable mushroom-derived psychedelic compound, psilocybin. The reports also indicate that some of the products do not contain cannabinoids or compounds from the hallucinogenic Amanita muscaria mushroom. Additionally, the company said in a blog post that its products contain a blend of Lion’s mane, Reishi, and Chaga mushrooms, but these are all non-hallucinogenic mushrooms used in herbal and traditional medicines and supplements.

In recent decades, hundreds of new synthetic psychoactive substances have hit the market in such products, including many new phenethylamines and tryptamines, which are chemically related to LSD and psilocybin. Some experts and members of the psychedelic community have speculated that Diamond Shruumz products could potentially contain one of the more popular tryptamines, 4-AcO-DMT, often pronounced  “4-akko-DMT,” and also known as 4- acetoxy-N,N-dimethyltryptamine, O-acetylpsilocin, or psilacetin. According to a qualitative 2020 study, users describe 4-AcO-DMT as producing effects similar to psilocybin, but without some of the unpleasant side effects noted with natural mushrooms, such as nausea. Animal experiments have confirmed that 4-AcO-DMT appears to produce psilocybin-like effects.

Still, it’s unclear if such ingredients could explain the symptoms seen in the current outbreak. Though clinical data on 4-AcO-DMT is scant, it has not been linked to such severe symptoms. On the other hand, some novel synthetic compounds, such as Dox and NBOMe, often misrepresented as LSD, are considered dangerous. For instance, NBOMe compounds (N-methoxybenzyl, also called N-bombs or 251), first discovered in 2003, have been linked to overdoses and deaths. In the scientific literature, they’ve been linked to “unpleasant hallucinations, panic, agitation, hypertension, seizures, acute psychosis, and/or excited delirium that can result in cardiac arrest,” according to the 2020 study.

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People are seizing, being intubated after eating microdose chocolates

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Yikes —

“Extreme caution” urged as at least 8 people in 4 states sickened, 6 hospitalized.

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A Diamond Shruumz chocolate bar, which come in a variety of flavors.

Enlarge / A Diamond Shruumz chocolate bar, which come in a variety of flavors.

Various federal and state health officials are sounding the alarm on Diamond Shruumz-brand Microdosing Chocolate Bars. The candy, said to be infused with mushrooms, has been linked to severe illnesses, including seizures, loss of consciousness, confusion, sleepiness, agitation, abnormal heart rates, hyper/hypotension, nausea, and vomiting, according to an outbreak alert released by the Food and Drug Administration on Friday.

So far, eight people across four states have been sickened—four in Arizona, two in Indiana, one in Nevada, and one in Pennsylvania, the FDA reported. Of the eight, six have been hospitalized.

“We are urging the public to use extreme caution due to the very serious effects of these products,” Maureen Roland, director of the Banner Poison and Drug Information Center in Phoenix, said in a press release earlier this week.

Steve Dudley, director of the Arizona Poison and Drug Information Center, added that there’s “clearly something toxic occurring” with the chocolates. “We’ve seen the same phenomenon of people eating the chocolate bar then seizing, losing consciousness, and having to be intubated.” Dudley noted that the state is aware of additional cases beyond the eight reported Friday by the FDA. Those cases were reported from Nebraska and Utah.

It’s not entirely clear what is in the chocolates or what could be causing the illnesses. The FDA said it was working with the Centers for Disease Control and Prevention as well as America’s Poison Centers to “determine the cause of these illnesses and is considering the appropriate next steps.”

On its website, Diamond Shruumz says that its chocolate bars contain a “primo proprietary blend of nootropic and functional mushrooms.” The website also contains reports of laboratory analyses on their products, some of which indicate the absence of select known fungal toxins and compounds such as the hallucinogen psilocybin and cannabinoids.

Diamond Shruumz did not immediately respond to Ars’ request for comment.

The chocolate bars are still available for sale online but the FDA said that consumers should not eat, sell, or serve them. Any bars already purchased should be discarded. Likewise, retailers should not sell or distribute them. The FDA noted that, in addition to being available online, the bars are also sold in various retail locations nationwide, including smoke/vape shops and retailers that sell hemp-derived products.

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