Marie Phelan said she had never heard of MDMA before seeing a flyer looking for veterans suffering from post-traumatic stress disorder.
Now, he says the psychoactive drug more commonly known as ecstasy or molly has changed the trajectory of his life.
“My experience with MDMA was that it opened my heart wide open,” said Phelan, who enlisted in the U.S. Army Reserve in 1999 and deployed to Iraq in 2003.
“I was carrying a big, heavy backpack, and I left it on the beach and started unpacking it, one tiny thing at a time, and placing every little thing on the waves,” Phelan said of the treatment release.
Phelan is not alone in turning to alternative treatments for trauma. She is one of a small group of Americans who have undergone psychedelic-assisted therapy through clinical trials studying new approaches to mental health treatment.
Now, access to those therapies is closer than ever to expanding more widely, bringing new options for patients and opportunities for companies, but also new scrutiny over safety and effectiveness.
In April, President Donald Trump signed an executive order aimed at speeding up research into psychedelic drugs for mental illness. The move came as his administration issued priority review vouchers to three companies developing psychedelic or MDMA-like therapies: Compass PathsUsona Institute and Transcend Therapeutics, which aim to speed up parts of the FDA review process.
The order marks a notable change in tone from Trump's first term, when his administration took a tougher stance on cannabis and other controlled substances. This time, the White House said psychedelic compounds “show potential in clinical studies to address serious mental illness in patients whose conditions persist after completion of standard therapy.”
US President Donald Trump signs an executive order on research into the effects of psychedelic drugs on medical treatment for veterans, Saturday, April 18, 2026, in the Oval Office of the White House in Washington, DC
The Washington Post | The Washington Post | fake images
Investors quickly flocked to the sector. Shares of psychedelic drug developers such as Compass Pathways and other rivals linked to the space rallied following the announcement, and Wall Street analysts argued that the order could legitimize an industry long considered marginal.
However, the science remains deeply debated, raising questions about how much room the segment has to grow.
Inside the laboratory
Historically, research on psychedelics has focused more narrowly on certain conditions. Psilocybin, the active compound in psychedelic mushrooms, has been linked to the treatment of depression, MDMA-assisted therapy to post-traumatic stress disorder, and LSD to anxiety.
While drugs like psilocybin and ibogaine (a psychoactive compound derived from a West African bush that some advocates believe can help treat addiction and traumatic brain injury) are considered classic psychedelics, MDMA is technically classified as an empathogen.
Still, researchers and regulators often group MDMA-assisted therapy within the broader field of psychedelic medicine because the treatments involve supervised therapeutic sessions designed to address conditions such as post-traumatic stress disorder, depression and addiction.
“One of the things that's important to recognize is that these are all very different drugs,” said Brandon Weiss, a researcher at the Center for Psychedelic and Consciousness Research at Johns Hopkins University School of Medicine. “Ibogaine and other psychedelic compounds have different safety profiles and different risks.”
FILE PHOTO: Psilocybin or “magic mushrooms” are seen in an undated photo provided by the U.S. Drug Enforcement Administration in Washington, May 7, 2019.
DEA | Reuters
Clinical research on some of these compounds has shown promising results. In late-stage trials sponsored by the nonprofit psychedelic research advocacy group According to the Multidisciplinary Association for Psychedelic Studies, approximately 71% of participants with severe PTSD no longer met diagnostic criteria for the disorder after MDMA-assisted therapy sessions.
The FDA rejected an earlier application for an MDMA-assisted therapy in 2024, citing concerns about the design of that same late-stage study. and the need for additional data. Some psychedelic researchers saw that decision as evidence that the agency remains cautious despite growing public enthusiasm.
Countries outside the United States have already begun to relax restrictions. Australia in 2023 became the first country to allow licensed psychiatrists to prescribe MDMA and psilocybin for certain mental health conditions. Researchers in Canada, Switzerland, and the United Kingdom have also expanded clinical studies examining psychedelic-assisted therapies.
Still, Weiss cautions that not all psychedelic compounds carry the same risks or the same amount of evidence supporting their use.
“Psychedelic compounds have different safety profiles and different risks,” Weiss said. “Ibogaine has particularly high cardiovascular risks, so what needs to be done is a very measured and methodical weighing of safety and efficacy between ibogaine and other compounds.”
The White House executive order made specific reference to accelerating ibogaine research. But unlike psilocybin or MDMA-assisted therapy, ibogaine has not been the subject of large-scale clinical trials in the United States and has been linked to potentially serious cardiovascular side effects.
Weiss said the real concern among some researchers is not that psychedelic therapies are ineffective, but that the political push could overtake the scientific process.
“My biggest concern would be that FDA standards are relaxed for politically motivated reasons,” he said. “It's not clear that's the case, but what's required is a lot more scientific research and a very objective interpretation of the risks and benefits.”
Kabir Nath, CEO of Compass Pathways, said his company adheres to the same standards that the FDA maintains for all medications. He said the company would not have started the process of submitting its drug, COMP360 Psilocybin, for approval in the first place if it had deemed the data insufficient.
Even supporters of psychedelics used as treatment acknowledge that the therapies are much more complex than taking a prescription pill at home. Most psychedelic-assisted therapy trials involve hours of preparation with doctors, supervised treatment sessions, and subsequent follow-up integrative therapy.
The treatments also carry risks. Patients may experience panic attacks, paranoia, elevated heart rate, or psychological distress during sessions. In some clinical settings, doctors use so-called “rescue drugs,” such as benzodiazepines or antipsychotic medications, to calm patients who are experiencing severe adverse reactions or overwhelming hallucinations.
Phelan said his own experience with MDMA-assisted therapy felt less like poisoning and more like facing years of trauma in a controlled environment.
For veterans advocates like Juliana Mercer, executive director of the nonprofit Healing Breakthrough, the administration's order represents validation for patients who have spent years pushing for broader access to alternative mental health treatments. Mercer, a U.S. Marine Corps veteran, said psychedelic-assisted therapy “completely changed” her life after battling trauma.
“One of the things this experience was able to give me was that permission to heal,” Mercer said.
Why now?
As the Trump administration seeks to reduce VA staff and deepen military involvement in Iran, some veterans are increasingly questioning the prioritization of their care.
Therefore, some critics of the Trump administration have said the timing of the executive order is of particular importance as the president tries to win back veterans' support ahead of the midterm elections.
Phelan, however, rejected the idea that support for psychedelic therapies translates into political support for Trump.
“They had made a lot of cuts to veterans' health benefits and services,” Phelan said. “Great, you did something good. You did something right… I can't speak to how other people will react, but if that's the intention, I doubt it will be effective.”
Some industry executives also argue that the executive order may have a less immediate impact than the headlines suggest. Companies like Compass Pathways were already approaching the final stage of Phase 3 trials before the White House announcement, meaning FDA approval requests would likely come anyway.
Nath, executive director of Compass Pathways, said the order primarily indicates broader political acceptance of the field.
“It is certainly an important boost, encouragement and validation,” Nath said.
— CNBC's Ryan Baker contributed to this report.
