VA Psychedelic Push Meets Federal Safety Gatekeeping

The Trump administration wants to expand research and potential access to psychedelic treatments for veterans, though no government regulator has found the drugs safe or effective for treating mental illness. Andrew Gradison, a senior adviser at President Donald Trump's Veterans Health Administration, said as many as 2.1 million veterans could benefit. Federal agencies are moving, but treatment remains experimental and access isn't guaranteed.

Juliana Mercer, a Marine Corps veteran, called for faster access at the Horizons: Perspectives on Psychedelics conference in New York City. “We were able to roll out a vaccine for Covid because of President Trump's Warp Speed initiative. Why aren't we warp-speeding this treatment to save our veteran lives? What's keeping us from doing that?” she said. Her question landed in a system where federal officials, regulators and drug companies shape the path from promising treatment to patient care.

Who Controls Access

Trump issued an executive order in April 2026 to accelerate research, clinical trials and patient access. A week later, the Food and Drug Administration allowed fast-track application reviews for three drugmakers developing psychedelic treatments. Compass Pathways expected to finish submitting an application in the fourth quarter of 2026 for its synthetic psilocybin treatment for treatment-resistant depression; the company anticipated approval in the first half of 2027.

That schedule meets a hard regulatory limit. In 2024, the FDA rejected a proposal to authorize MDMA, also known as ecstasy, combined with talk therapy to treat PTSD. The agency cited difficulty separating clinical improvement from MDMA and intensive talk therapy, missing safety data, accusations of trial manipulation and possible misconduct by therapy practitioners. Advocates may cite veterans’ experiences and clinical-trial data, but regulators haven't found the drugs meet government standards.

Gradison said practical challenges and safety concerns would constrain an early rollout. “In the first year to treat four digits worth of patients” would be a challenge for the VA, he said. “Our demand will exceed our ability to supply these therapies, no doubt.” The department says 6.4 million veterans regularly rely on it for care, and Gradison said nearly one in three veterans relying on government health care could benefit from medicines such as psilocybin or MDMA.

The Cost at the Bottom

For veterans waiting for care, the stakes aren't abstract. Research cited by the VA found that 23% of veterans receiving VA care had PTSD at some point in their lives, compared with 7% of veterans who did not seek VA care. The agency identifies war-zone deployments, training accidents and military sexual trauma as possible causes. U.S. veterans die by suicide at a rate roughly 57% higher than the general adult population, with an average of nearly 18 veterans dying by suicide each day.

Glenn H. Curtis, a retired Army major general, described taking ibogaine in Mexico last year as having a “miraculous” effect on his PTSD and traumatic brain injuries. Curtis, a volunteer for Americans for Ibogaine, said: “Those same people that had issues coming home from deployments, even like myself, 20 years later, still have issues today that they have not received any kind of treatment [for].” Ibogaine, derived from an African shrub and widely available in Mexico, has drawn interest from veterans for conditions including PTSD.

The VA runs 20 psychedelic clinical trials and became one of the first major health care systems to offer Spravato, an FDA-approved depression treatment using esketamine, a chemical component found in ketamine. Ketamine, an anesthetic with psychoactive effects, remains the only psychedelic-like drug approved for medical use.

Policy Can Shift; Need Remains

Members of Congress are also trying to shape the treatment pipeline. Sen. Tim Sheehy (R-Mont.) sponsored legislation to establish an office within the VA to prepare for psychedelic-drug approvals and integrate therapies into patient care. Reps. Lou Correa (D-Calif.) and Jack Bergman (R-Mich.) co-chair the Psychedelics Advancing Therapies Caucus, which released a suggested framework for integrating FDA-approved psychedelic therapies into the U.S. health care system.

Rep. Morgan Luttrell, who sought ibogaine treatment in Mexico for a training-related traumatic brain injury, will retire from Congress in January 2027 after deciding not to seek reelection. “Executive orders have a tendency to go away as the tides ebb and flow, and I would just hate for something like this to be removed,” he told POLITICO, saying he wanted Congress to codify Trump's executive order. Veterans were a reliable Republican voting bloc in 2024: 61% voted for Trump over Kamala Harris.

Supporters disagree over who should deliver treatment. Drugmakers and biotech investors back a drug-first model, while some clinicians, particularly psychotherapists, and lawmakers say treatment works more safely and effectively when paired with psychotherapy. Rep. Lou Correa said treatment involves preparation, counseling, the session itself and post-treatment care. Matt Zorn, deputy general counsel at the Health and Human Services Department, put the official condition plainly: “We want to see the drug approved if it's safe and effective, and the reason why is because there's a mental health crisis.”