Marie Phelan said she had never heard of MDMA until she came across a flyer recruiting veterans suffering from post-traumatic stress disorder.
Now, she says the psychoactive drug commonly known as ecstasy or molly changed the trajectory of her life.
“My experience with MDMA was one that really tore me apart,” said Phelan, who joined the U.S. Army Reserve in 1999 and was deployed to Iraq in 2003.
“I was carrying this big, heavy backpack and I put it down on the beach and started unpacking one little thing at a time and throwing each little thing out onto the waves,” Phelan said of being released from treatment.
Phelan is not alone in turning to alternative treatments for trauma. She is among a small group of Americans who have received psychedelic-assisted therapy through clinical trials investigating new approaches to mental health treatment.
Access to these treatments is now more widely expanded than ever before, creating new options for patients and opportunities for companies, while also subjecting new scrutiny to safety and efficacy.
President Donald Trump signed an executive order in April aimed at accelerating research into psychedelics for mental illness. The move came as his administration issued priority review vouchers to three companies developing treatments similar to psychedelics or MDMA. compass routeUsona Institute and Transcend Therapeutics — aimed at speeding up parts of the FDA review process.
The order marks a marked change in tone from President Trump’s first term, when the administration took a tougher stance on marijuana and other controlled substances. The White House said in a statement that psychedelic compounds “have shown potential in clinical studies to address severe mental illness in patients whose symptoms persist even after standard treatment has ended.”
U.S. President Donald Trump signs an executive order on research into the effects of psychedelics in veteran treatment on Saturday, April 18, 2026, in the Oval Office of the White House in Washington, DC.
Washington Post | Washington Post | Getty Images
Investors quickly flocked to the sector. The announcement sent shares of psychedelic drug developers such as Compass Pathways and other rivals in the field soaring, with Wall Street analysts arguing that the order could legitimize an industry long considered fringe.
However, the science remains deeply debated, raising questions about how much room there is for this segment to grow.
Inside the laboratory
Historically, psychedelic research has focused more narrowly on specific symptoms. Psilocybin, the active compound in psychedelic mushrooms, has been linked to the treatment of 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 proponents believe may help treat addiction and traumatic brain injury) are considered classic hallucinogens, MDMA is technically classified as an enzymatic agent.
Still, researchers and regulators often classify MDMA-assisted therapy within the broader field of psychedelic medicine. This is because treatment involves supervised therapy sessions designed to address symptoms such as PTSD, depression, and addiction.
“One of the important things to realize is that these are all completely different drugs,” said Brandon Weiss, a researcher at the Center for Psychedelic and Consciousness Research at the 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 shown in an undated photo provided by the U.S. Drug Enforcement Administration in Washington, May 7, 2019.
Drug Enforcement Administration | Reuters
Clinical studies on some of these compounds have shown promising results. In a late-stage trial sponsored by the nonprofit Multidisciplinary Association for Psychedelic Studies, about 71% of participants with severe PTSD no longer met diagnostic criteria for the disorder after an MDMA-assisted therapy session.
The FDA rejected a previous application for MDMA-assisted therapy in 2024, citing concerns about the same late-stage study design and the need for additional data. Some psychedelic researchers saw the decision as evidence that authorities remain cautious despite growing public enthusiasm.
Countries other than the United States have already begun to ease restrictions. Australia became the first country to allow certified 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 therapy.
Still, Weiss cautions that not all psychedelic compounds carry the same risks or have the same amount of evidence supporting their use.
“Psychedelic compounds have different safety profiles and different risks,” Weiss said. “Ibogaine poses particularly high cardiovascular risks, so what needs to be done is a careful and careful evaluation of the safety and efficacy between ibogaine and other compounds.”
The White House executive order specifically mentioned accelerating ibogaine research. However, unlike psilocybin and 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 concern among some researchers is not that psychedelic treatments are ineffective, but that political momentum may outweigh the scientific process.
“My biggest concern is that FDA standards will be relaxed for political reasons,” he said. “It’s not clear whether that’s the case, but what is needed is 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 set by the FDA for all pharmaceutical products. He said the company would not have started the regulatory filing process for its COMP360 psilocybin drug in the first place if it had felt there was insufficient data.
Even proponents of using psychedelics as treatment admit that the treatment is much more complicated than taking prescription drugs at home. Most psychedelic-assisted therapy trials involve hours of preparation with a clinician, supervised treatment sessions, and then follow-up integrative therapy.
Treatment also comes with risks. Patients may experience panic attacks, paranoia, increased heart rate, and psychological distress during sessions. In some clinical settings, doctors use so-called “rescue drugs” such as benzodiazepines and antipsychotics to calm patients who are experiencing severe side effects or overwhelming hallucinations.
Phelan said his experience with MDMA-assisted therapy was less like intoxication and more like dealing with years of trauma in a controlled environment.
For veterans advocates like Juliana Mercer, executive director of the nonprofit Healing Breakthrough, the government’s order means vindication for patients who have spent years seeking broader access to alternative mental health treatments. Mercer, a U.S. Marine Corps veteran, said psychedelic-assisted therapy “completely changed” his life after suffering trauma.
“One of the things this experience has given me is that it has given me permission to heal,” Mercer said.
Why now?
As the Trump administration cuts VA personnel and deepens military involvement in Iran, some veterans are increasingly questioning the prioritization of their care.
That’s why some critics of the Trump administration say the timing of the executive order is especially important as the president seeks to win back support from veterans ahead of the midterm elections.
But Phelan rejected the idea that support for psychedelic therapy translated into political support for Trump.
“They were making significant cuts to veterans’ benefits and health care services,” Phelan said. “Great, you did a good thing. You did the right thing…I can’t say how other people will react, but if that’s the intention, I doubt it will be effective.”
Some industry executives argue that the executive order’s immediate impact may not be as strong as headlines suggest. Companies like Compass Pathways were already nearing the end of their Phase 3 trials before the White House’s announcement, meaning they will likely file for FDA approval regardless.
Nath, CEO of Compass Pathways, said the order primarily signals broader political acceptance of the sector.
“It certainly gives us a big tailwind, encouragement and legitimacy,” Nass said.
—CNBC’s Ryan Baker contributed to this report
