Psychedelic-Assisted Therapy in Military and Veterans Healthcare Systems: Clinical, Legal, and Implementation Considerations.
Aaron Wolfgang, Charles W Hoge
Current Psychiatry Reports October 1, 2023 DOI: 10.1007/s11920-023-01446-4 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Interventions | MDMA-assisted therapy psilocybin-assisted therapy |
| Topics | MDMA Psilocybin Psychedelic-assisted therapy |
| Keywords | Military Psychedelics Veterans Psychedelic medicine Innovative medicine Novel interventions |
| Citations | 15 |
| Key findings | MDMA- and psilocybin-assisted therapy show promising outcomes for PTSD and depression, but implementation in DoD and VA healthcare systems faces barriers including high resource demands and need for strong evidence. |
Abstract
This review discusses the current and projected landscape of psychedelic-assisted therapy (PAT), with a focus on clinical, legal, and implementation considerations in Department of Defense (DoD) and Department of Veterans Affairs (VA) healthcare systems. 3,4-Methylenedioxymethamphetamine (MDMA)- and psilocybin-assisted therapy have shown promising outcomes in efficacy, safety, tolerability, and durability for PTSD and depression, respectively. MDMA-assisted therapy is already approved by the Food and Drug Administration (FDA) on an Expanded Access ("compassionate use") basis for PTSD, with full approval projected for 2024. Psilocybin-assisted therapy is projected to be FDA-approved for depression soon thereafter. Other psychedelics are in earlier stages of development. The VA is currently conducting PAT clinical trials. Although there are clear legal pathways for the VA and DoD to conduct PAT trials, a number of implementation barriers exist, such as the very high number of clinical hours necessary to treat each patient, resource requirements to support treatment infrastructure, military-specific considerations, and the high level of evidence necessary for PAT to be recommended in clinical practice guidelines. Ongoing considerations are whether and how PAT will be made available to VA and DoD beneficiaries, feasibility and cost-effectiveness, and ethical safeguards that must be implemented to prioritize access to PAT given the likelihood of extremely limited initial availability. However, with imminent FDA approval of PATs and considerable national interest in these treatments, DoD and VA policymakers must be prepared with clearly delineated policies and plans for how these healthcare systems will approach PAT.
Comparable studies
Other narrative reviews on MDMA and psychedelic-assisted therapy, most cited first.
Citations in the library
Cited by 16
- MDMA and MDMA-Assisted Therapy. American Journal of Psychiatry 2025
- A Transformative Trip? Experiences of Psychedelic Use Neuroethics June 20, 2024
- Ethical issues with psychedelic-assisted treatments in psychiatry: A systematic scoping review Psychological Medicine 2025
- The Clinical Potential of Dimethyltryptamine: Breakthroughs into the Other Side of Mental Illness, Neurodegeneration, and Consciousness Psychoactives February 26, 2024
- Employment-Related Risks in a Clinical Trial of Psychedelic Treatment for Chronic Pain The American Journal of Bioethics September 18, 2026
and 11 more in the library
Cites 55
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
- Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study Journal of Psychopharmacology January 13, 2015
and 50 more in the library