About 160 people in the United States have become ill after consuming sweets containing traces of chemicals from magic mushrooms.
The New York Times reported that more than a third of those required hospital treatment and that US health officials are investigating two deaths that may be related to the confectionery.
The case highlights the growing trade in legal “microdosing” sweets and the lack of regulation on their sale.
Symptoms suffered by sick people include vomiting, loss of consciousness, seizures and hallucinations.
The US Food and Drug Administration (FDA) said in July that at least 48 people in 24 states said they “got sick” after eating Diamond Schrumz-brand products, including chocolate bars, cones and gummies.
Prophet Premium Blends, the company that makes Diamond Schrumz products, issued a recall in June, saying it had received reports of consumers getting sick after consuming “whole chocolate bars and certain products containing higher than normal levels of muscimol.”
It urged consumers not to consume the product and retailers to stop selling it while the FDA investigates.
But the sweets remain on sale in more than 2,000 stores, according to the FDA.
Muscimol is a psychoactive compound found in some mushrooms. It is not illegal.
But the FDA also said that psilocin, a banned form of delusion, was found in four of the 22 Diamond Schrumz chocolate bars it tested.
It found pregabalin, a prescription drug used by the NHS to treat epilepsy and anxiety, in three of them.
Microdosing sweets, chocolates and other products are often sold legally in vape shops around the world or on the Internet, and are often subject to little or no regulation.
They typically contain substances such as delta-8-THC, which occurs naturally in cannabis in only trace amounts but is often purified to higher concentrations, or extracts of kratom, a tropical evergreen native to Southeast Asia with opioid-like effects.
Although commonly marketed as “natural” ingredients, health experts have expressed concern that the refining process may cause harmful effects.
In June, Food Standards Australia New Zealand recalled two flavors of Uncle Frog’s Mushroom Gummies, an American-made confection, after several people were hospitalized with numerous symptoms including seizures, hallucinations, dizziness and involuntary shocks.
The Queensland-based company that distributed the gummies said it was “truly sorry”.
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