Unexpected Detection of Psilocybin in a 100 mg Tramadol Tablet: A Forensic Case Report

A tablet labeled as tramadol 100 mg was found to contain a high concentration of psilocybin, a hallucinogenic compound from certain mushrooms, along with only 60 mg of tramadol. Analysis by gas chromatography–mass spectrometry confirmed the adulteration. Psilocybin is a prodrug of psilocin, which activates serotonin receptors and can cause visual hallucinations, euphoria, and altered cognition. Combining such an adulterant with an opioid like tramadol, especially without known dosages, may intensify dangerous effects. The case highlights the need for drug monitoring and advanced toxicological analysis to address the public health risk of drug adulteration.

Study at a glance

Abstract

Background: Tramadol is a synthetic opioid analgesic prescribed for moderate pain. Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) is a naturally occurring psychoactive compound found in certain mushrooms, often referred to as "magic mushrooms" and is classified as a Schedule I substance. This case report aimed to present the unexpected detection of psilocybin in a 100 mg tramadol tablet.Case Presentation: This case report presents the forensic identification of psilocybin in a tablet labeled as tramadol 100 mg. Analysis was conducted using Gas Chromatography–Mass Spectrometry (GC-MS). A high concentration of psilocybin was confirmed, and additionally, 60 mg of tramadol was detected in the analyzed tablet.Discussion: Active compounds of some mushrooms, such as Psilocybe cubensis and Paneolus, have psychotropic agents with hallucinogenic effects. Psilocybin is a prodrug of psilocin, meaning it's converted into psilocin in the body, and Psilocin then acts as a serotonin receptor agonist, particularly on the 5-HT2A receptor, leading to visual hallucinations, euphoria, and altered cognition. These effects can be particularly dangerous when combined with other opioids and psychoactive substances that do not have a determined dosage and intensify each other's effects.Conclusion: This case underscores the importance of drug monitoring and advanced toxicological analysis in combating the public health threat posed by drug adulteration.