In the body, 4-AcO-DMT / psilacetin is thought to be deacetylated into psilocin during first pass metabolism and subsequent passes through the liver (evident as psilacetin is also active when injected). This has not been formally proven, however, and is based on reports that most users cannot tell the difference between these two compounds when ingested to the point that they are often considered as indistinguishable from each other in terms of their subjective effects.There are, however, claims of subjective differences in effect between the acetylated and non-acetylated forms of psilocin. Some users report that it lasts slightly longer than psilocin while others report that it lasts for a considerably shorter time. Many users report less body load and nausea compared to psilocin. Some users find that the visual distortions produced by 4-AcO-DMT more closely resemble those produced by DMT than those produced by psilocin. These differences could be possible if 4-AcO-DMT is active itself and not merely as a prodrug.

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