Martin Makary, commissioner of the Food and Drug Administration, from left, President Donald Trump, Robert F. Kennedy Jr., Secretary of Health and Human Services and media personality, Joe Rogan, during an executive order signing in the Oval Office of the White House on Saturday, April 18, 2026. The order directs federal agencies to expedite research and access to psychedelics to treat certain mental health disorders. Photographer: Allison Robbert/The Washington Post/Bloomberg
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Psychedelics and marijuana are in the news as President Trump issued two executive orders last week with the potential to elevate the medical status of these drugs nationwide.
Though legally prohibited at the national level, American researchers have for many decades been investigating the therapeutic potential of psychedelics and marijuana. This has culminated in recent years in a modern day “renaissance” in terms of medical research regarding their potential benefits.
President Trump issued an executive order this month to accelerate research and access to psychedelic medication for people with “serious mental illnesses.” The document stipulates that there will be inter-agency collaboration between the Food and Drug Administration and the Department of Veterans Affairs to share data and increase clinical trial participation. The order states that on a case-by-case basis, psychedelics will be rescheduled from illegal to legal provided they receive marketing authorization from the FDA.
The unconventional way in which the order seems to have been hastened the president’s decision-making caught the media’s attention. Podcaster Joe Rogan revealed that a text message he sent to Trump suggesting ibogaine has an 80–90% success rate in breaking opiate addiction triggered a positive response by the president: “Sounds great. Do you want FDA approval? Let’s do it.”
Trump has now initiated a federal effort to expedite research and approval for ibogaine and other psychedelics. The executive order directed federal agencies to fast-track research into psychedelics as well as approval pathways.
In the past ten years, psychedelics like psilocybin, methylenedioxymethamphetamine or MDMA, ketamine and ibogaine have moved from the fringes of medicine to the mainstream, drawing attention from the media, investors, and the general public.
Psychedelic-assisted treatment involves the use of psychedelic substances alongside traditional talk therapy for a wide range of mental health issues, including post-traumatic syndrome disorder, treatment-resistant depression, severe anxiety and substance abuse. Most psychedelics are Schedule I substances with no currently accepted use in medicine. There appears to be a broad consensus, however, that psychedelics are worthy of research in disease areas with a significant amount of unmet need, in particular, PTSD and treatment-resistant depression.
Advocates have long argued that psychedelics can be a lifeline for those with severe mental illness, with an emphasis on war veterans suffering from PTSD. But at the same time, medical experts have cautioned about risks known to be associated with psychedelic use. This includes the psychedelic, ibogaine, mentioned in Rogan’s text to the president. Rogan’s claims greatly exaggerate the efficacy of ibogaine as a facilitator of opioid cessation with just one or two doses. He stated 80-90% effectiveness. But the rate of efficacy of the product taken for one year is 23-55%, according to observational studies. Moreover, Rogan doesn’t broach the important topic of the drug’s downsides. Besides hallucinations that can last more than 24 hours from a single dose, its risks include irregular heart rhythms, with over 30 documented deaths from its use.
Trump’s executive action will allocate $50 million to states advancing psychedelic programs. The FDA will soon issue new research guidance. The agency will also offer priority vouchers to companies with psychedelic development programs to cut approval times. Specifically, STAT News writes that the FDA will speed up its review of drugs from Compass’s psilocybin product for treatment-resistant depression, Usona’s similar medicine for major depressive disorder, and an MDMA-like treatment for post-traumatic stress disorder from Transcend.
While substances such as psilocybin and MDMA had previously been granted breakthrough therapy status with corresponding expedited reviews, the executive order also paves the way for the first United States human clinical trials of ibogaine. Simultaneously, it leverages the Right to Try legislation with respect to psychedelics for terminally ill patients. Trump signed this law during his first term in office.
Could we be on the cusp of seeing FDA approvals of psychedelics? Well, past experience suggests caution may be merited, given that the regulatory road has been rocky, as shown by an FDA rejection in 2024 of MDMA-assisted therapy for the treatment of post-traumatic stress disorder. Nonetheless, with more regulatory guidance imminent and an administration that appears enthused about prospects for psychedelics, it’s possible we’ve entered a new era.
Continuing on the path set out by the Biden administration, Trump has directed via executive order that cannabis be reclassified from a schedule I to a schedule III substance, which would remove restrictions on research specifically aimed at examining possible benefits from the compound, tetrahydrocannabinol or THC.
For decades, marijuana was grouped in the same Schedule I classification of drugs as heroin and LSD and kept under the tightest federal controls. Drugs in this category aren’t viewed as having any accepted medical use and seen as highly prone to abuse.
Schedule III drugs, on the other hand, are considered to have medical uses and a low to moderate potential for physical and psychological dependence. Examples include acetaminophen with codeine, ketamine, anabolic steroids and testosterone.
While the jury is still out on definitive estimates of clinical effectiveness and safety of marijuana and cannabis-derived therapeutics, they’ve been used to help treat a variety of conditions, from chronic pain and neurological disorders to nausea, depression, anxiety and sleep disturbances.
Forty states have legalized medical marijuana and two dozen the sale of cannabis for recreational use.
Rescheduling does not immediately affect recreational marijuana. The new policy only applies to marijuana products that are FDA-approved or regulated under a state medical marijuana license.
And so, those found to be in possession of marijuana in states where the drug is illegal could still face legal action.
Also, rescheduling marijuana won’t reduce regulatory confusion on the drug’s use. Together with an inconsistent patchwork of rules across states, there is still no federal oversight. For recreational use, for example, states have varying laws on permissible quantities that dispensaries can sell and customers can possess. In addition, sellers of medical marijuana market their products for numerous diseases and conditions with virtually no regulatory oversight.
Trump’s executive actions move the country several steps closer towards more widespread research on and use of two sets of controversial yet promising medications, psychedelic and cannabis products. Yet some uncertainty remains regarding the extent to which this will result in actual changes on the ground.
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