Marie Phelan said she had never heard of MDMA before spotting a flyer seeking veterans suffering from post traumatic stress disorder.
Now, she says the psychoactive drug more commonly known as ecstasy or molly has changed the trajectory of her life.
“My experience of MDMA was that it just cracked my heart wide open,” said Phelan who enlisted in the U.S. Army Reserve in 1999 and was deployed to Iraq in 2003.
“I was carrying this big heavy rucksack and I just put it down on the beach and I started unpacking it one little teeny tiny thing at a time and setting each little thing out on the waves,” Phelan said of the release from the treatment.
Phelan isn’t alone turning to alternative treatments for trauma. She is among 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 being expanded more broadly, bringing new options for patients and opportunities for companies — but also new scrutiny about safety and effectiveness.
In April, President Donald Trump signed an executive order aimed at accelerating 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 Pathways, Usona Institute and Transcend Therapeutics — aimed at speeding up parts of the FDA review process.
The order marks a notable shift in tone from Trump’s first term, when his administration took a harder stance on cannabis and other controlled substances. This time, the White House said psychedelic compounds “show potential in clinical studies to address serious mental illnesses for patients whose conditions persist after after completing standard therapy.”
U.S. President Donald Trump signs an executive order on researching the effects of psychedelic drugs in medical treatment for veterans, on Saturday, April 18, 2026 in the Oval Office at the White House in Washington, D.C.
The Washington Post | The Washington Post | Getty Images
Investors quickly piled into the sector. Shares of psychedelic drug developers such as Compass Pathways and other rivals tied to the space rallied following the announcement, with Wall Street analysts arguing the order could legitimize an industry long viewed as fringe.
The science, however, remains deeply debated, raising questions about how much room the segment has to grow.
Inside the lab
Historically, research into psychedelics has focused more narrowly on certain conditions. Psilocybin — the active compound in psychedelic mushrooms — was tied to treating depression, MDMA-assisted therapy to PTSD and LSD to anxiety.
While drugs like psilocybin and ibogaine — a psychoactive compound derived from a West African shrub that some advocates believe may help treat addiction and traumatic brain injuries — are considered classic psychedelics, MDMA is technically classified as an empathogen.
Still, researchers and regulators often group MDMA-assisted therapy within the broader psychedelic medicine field because the treatments involve supervised therapeutic sessions designed to address conditions like PTSD, depression and addiction.
“One of the things that’s important to recognize is 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 Agency in Washington, May 7, 2019.
DEA | Reuters
Clinical research around some of these compounds has shown promising results. In late-stage trials sponsored by the nonprofit psychedelic research advocacy group Multidisciplinary Association for Psychedelic Studies, roughly 71% of participants with severe PTSD no longer met diagnostic criteria for the disorder after MDMA-assisted therapy sessions.
The FDA rejected a previous application for MDMA-assisted therapy in 2024, citing concerns around the design of that same late-stage study and the need for additional data. Some psychedelic researchers viewed that decision as evidence the agency remains cautious despite mounting public enthusiasm.
Countries outside the United States have already begun loosening restrictions. Australia became the first country to allow authorized psychiatrists to prescribe MDMA and psilocybin for certain mental health conditions in 2023. Researchers in Canada, Switzerland and the United Kingdom have also expanded clinical studies examining psychedelic-assisted therapies.
Even so, Weiss cautions that not all psychedelic compounds carry the same risks — or the same amount of evidence supporting their use.
“Psychedelic compounds, they have different safety profiles, different risks,” said Weiss. “Ibogaine has particularly high cardiovascular risks, and so what needs to be done is a very measured, methodical weighting of the safety and the efficacy between ibogaine and other compounds.”
The White House executive order specifically referenced accelerating research of ibogaine. But unlike psilocybin or MDMA-assisted therapy, ibogaine has not undergone large-scale clinical trials in the United States and has been linked to potentially serious cardiovascular side effects.
Weiss said the real worry among some researchers is not that psychedelic therapies are ineffective, but that political momentum could outpace the scientific process.
“My biggest concern would be that FDA standards are relaxed for politically motivated reasons,” he said. “It’s not clear that that is the case, but what’s required is a lot more scientific research and a very objective interpretation of the risks and benefits.”
Kabir Nath, Compass Pathways CEO, said his company is adhering to the same standards the FDA holds for all drugs. He said the company would not have started the process of submitting its drug, COMP360 Psilocybin, for approval in the first place if it felt the data was insufficient.
Even supporters of psychedelics used as treatment acknowledge the therapies are far more complex than taking a prescription pill at home. Most psychedelic-assisted therapy trials involve hours of preparation with clinicians, supervised treatment sessions and follow-up integration therapy afterward.
The treatments also come with risks. Patients can experience panic attacks, paranoia, elevated heart rates or psychological distress during sessions. In some clinical environments, doctors use so called “rescue drugs” like benzodiazepines or antipsychotic medications to calm patients experiencing severe adverse reactions or overwhelming hallucinations.
Phelan said her own experience with MDMA-assisted therapy felt less like intoxication and more like confronting years of trauma in a controlled setting.
For veterans’ advocates like Juliana Mercer, executive director of 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 she struggled with trauma.
“One of the things that this experience was able to give me was that permission to heal,” said Mercer.
Why now?
As the Trump administration pursues VA staffing cuts and deeper military involvement with Iran, some veterans are increasingly questioning the prioritization of their care.
Thus, some critics of the Trump administration have said that the executive order’s timing is of particular importance as the president attempts to gain back veteran support ahead of the midterm elections.
Phelan, however, rejected the idea that backing for psychedelic therapies will translate into into political support for Trump.
“They’d made so many cuts to veteran benefits and medical services,” Phelan said. “Great, you did a good thing. You did a right thing … I can’t speak for how other people will react, but if that’s the intention, I doubt it’s effective.”
Some industry executives also argue the executive order may have less immediate impact than headlines suggest. Companies like Compass Pathways were already nearing the final stage of Phase 3 trials before the White House announcement, meaning FDA approval submissions were likely coming regardless.
Nath, CEO or Compass Pathways, said the order primarily signals broader political acceptance of the field.
“It certainly gives a significant tailwind, encouragement and validation,” Nath said.
— CNBC’s Ryan Baker contributed to this report
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