A ‘milestone’ for psychedelics: Pentagon directed to study alternative treatments for veterans

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An idea once widely mocked on Capitol Hill now has broad bipartisan support as part of the recently passed defense spending bill, and proponents say the change in attitude will save lives in the real world.

Tucked inside the massive $886 billion fiscal year 2024 National Defense Authorization Act signed by President Biden last month is a provision directing the Pentagon to study the effects of psychedelic-assisted therapy on veterans suffering from post-traumatic stress disorder, traumatic brain injuries, depression, insomnia and other invisible wounds of war.

The legislation directs the Defense Department to partner with federal and state government agencies or academic institutions. It says the Pentagon may “authorize any member of the armed forces serving on active duty who is diagnosed with a covered condition to participate in a clinical trial” using psychedelic-aided treatment.

The NDAA passed the House and Senate with strong bipartisan support, underscoring the rapid shift on the issue in Congress and the broader American public over the past several years. Proponents of such therapies say the inclusion of the provision in the NDAA is a watershed moment.

“Through embracing innovative approaches like clinical trials on psychedelic therapy to address PTSD, supporting [traumatic brain injury] research and incorporating other vital provisions, this legislative milestone marks a significant stride in our ongoing battle,” said Amber Capone, co-founder of Veterans Exploring Treatment Solutions, or VETS, an organization that aims to attack the epidemic of veteran suicides by offering alternative treatments, including psychedelic-assisted therapy.

“Far too long, our veterans have silently borne the weight of trauma, but through the thorough study of psychedelic-assisted therapy, we now harbor a renewed sense of optimism to reverse this trend,” she said in a statement after the NDAA passed both chambers of Congress.

The therapies use natural psychedelic compounds such as Ibogaine, 5-MeO-DMT and Psilocybin. Proponents also point to positive results from therapies using MDMA, the potent stimulant popularly known as ecstasy or, in crystal form, as molly.

Such substances have been outlawed for recreational use for decades and have long been stereotyped as the marker of drug addicts and burnouts. They have gained a second life as legitimate medical treatments. Numerous studies seem to show positive results, and more and more people share anecdotal accounts of how the therapies have helped them.

The central idea is that mind-altering drugs can open new pathways in the brain and help repair psychological and emotional damage.

Psychedelic-assisted therapies have been more accessible in other countries, though that’s slowly changing. Oregon launched a state-run Psilocybin program, the first of its kind in the U.S., last year. Academic institutions nationwide have other programs and clinical trials.

The Veterans Affairs Department also has been studying the effects of psychedelic drugs on veterans suffering from PTSD and other mental illnesses. Before the latest NDAA was approved, government researchers had to obtain waivers to conduct large-scale studies using banned or restricted substances and fund their research through private donations rather than federal money.

The new law says such research can be conducted legally regardless of a substance’s classification under the Controlled Substances Act or Uniform Code of Military Justice. The secretary of defense must report to Congress for the next five years on institutions provided funding for the studies, the number of troops participating and the clinical trial results.

Growing support — and a warning

The idea of psychedelic therapy was mostly dismissed for years in Washington. Previous efforts to pass such legislation in the House failed, often by significant margins.

Lawmakers in both parties now sense a shifting cultural mood. Rep. Lou Correa, California Democrat, and Rep. Jack Bergman, Michigan Republican, launched the Congressional Psychedelics Advancing Therapies Caucus last year. The caucus, whose members span the ideological spectrum in what is a sharply divided body in most cases, advocates for research into the benefits and potential drawbacks of psychedelic therapies.

At a press conference in July, Mr. Correa said it’s “shameful” that the U.S. lags behind other countries in providing the most effective, cutting-edge therapies for veterans.

“These veterans that fought for our country saw things no human being should see,” he said. “They come back to America and say, ‘Help us,’ and we say no. It’s against the law. Are you kidding me?”

Joining Mr. Correa at the press conference were Rep. Dan Crenshaw, Texas Republican, and Rep. Alexandria Ocasio-Cortez, New York Democrat. All signed onto the psychedelic provisions in the NDAA.

“It is our moral responsibility as legislators to help members of our armed forces suffering from PTSD, as well as helping thousands of survivors of sexual assault, trauma, violence and beyond,” Ms. Ocasio-Cortez said.

Mr. Crenshaw acknowledged that a “really wild coalition” had come together.

“There’s a lot of people in our country that could use effective treatments that are feeling hopeless right now,” he said. “That’s why you’re seeing this kind of bipartisanship.”

Some researchers warn that the rapid growth of psychedelic-assisted therapy and the unbridled enthusiasm of its supporters could create something of a speculative medical “bubble” that ultimately bursts with more research and patients who don’t see the promised results.

“Until recently, this community has comprised researchers who were willing to accept the professional ramifications of working in a stigmatized area,” British scholars Tehseen Noorani and Jonny Martell wrote in a 2021 piece for the Frontiers in Psychiatry medical journal.

“While the early advocates of any new treatment can be expected to be enthusiastic, the interaction effects of any researcher bias with psychedelics’ sensitivity to the context of their use would contribute especially large outcome confounders, leading to limited replication of the early findings,” they said.

The National Institute on Drug Abuse continues to warn that abuse of drugs such as ecstasy and molly has been linked to high blood pressure, seizures and kidney failure. Users have also experienced negative long-term effects, including irritability, depression, anxiety and memory issues.

Mr. Noorani and Mr. Martell warned about potential “growth in adverse outcomes as the hype grows, the participant/patient pool is widened, and psychedelic therapies are provided in more streamlined ways. Increasingly diverse patient populations hopeful of being cured will experience rocky ‘landings’ post-treatment, the cost of which will be borne downstream of trial analysis endpoints, thereby falsely inflating favorable health economic calculations.”