On Saturday, President Donald Trump issued an executive order aimed at “accelerating medical treatments for serious mental illness” by facilitating regulatory approval of ibogaine and other psychedelics that have shown promise as psychotherapeutic catalysts. Although the case for doing that is compelling, the medical model embraced by the president excludes most psychedelic use, which will remain illegal even if the “historic reforms” that Trump announced work as planned.
Trump takes it for granted that Americans should be allowed to use psychedelics only for reasons that the government recognizes as legitimate. Otherwise, they are criminals rather than patients, subject to arrest, prosecution, and potentially severe penalties for daring to assert sovereignty over their own bodies and minds.
The injustice of that policy is readily apparent when people use psychedelics in ways that manifestly improve their lives. Many combat veterans, for example, have found that ibogaine, which is derived from the root of an African shrub, provides dramatic relief from the constellation of problems known as post-traumatic stress disorder (PTSD).
“It absolutely changed my life for the better,” former Navy SEAL Marcus Luttrell, whose Afghanistan memoir inspired the 2013 movie Lone Survivor, remarked as Trump signed his executive order. “I was reborn,” says Luttrell’s twin brother, Rep. Morgan Luttrell (R–Texas), also a former Navy SEAL. “It is one of the greatest things that ever happened to me.”
Because ibogaine is banned in the United States, the Luttrell brothers had those transformational experiences at a clinic in Mexico. So did the 30 subjects of a recent Nature Mental Health study, which found that ibogaine, combined with magnesium as a safeguard against the drug’s cardiac side effects, “safely and effectively reduces PTSD, anxiety and depression and improves functioning in veterans” with traumatic brain injuries.
Research on ibogaine, which also is reputed to be remarkably useful for people struggling with drug addiction, is relatively limited so far. But the evidence supporting the use of MDMA (for PTSD) and psilocybin (for depression), both of which the Food and Drug Administration (FDA) has designated as “breakthrough” therapies, is strong enough that they may soon be approved as prescription medications.
If that happens, some people who could benefit from these drugs will be able to use them legally, provided they can obtain a diagnosis and a prescription. But where does that leave all the psychedelic users who can’t meet those requirements?
In a 2023 survey of psilocybin users, the RAND Corporation found that the most common motivations included “fun” (59 percent), “improved mental health” (49 percent), “personal development” (45 percent), “curiosity” (43 percent), and “spiritual growth” (41 percent). Although very few of those people would qualify for the medical exception that Trump advocates, that does not mean their reasons for using psilocybin should be dismissed as frivolous, let alone that they should be treated as criminals.
Hellbound and Down 
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