The United States Department of Defense is funding two studies in which active-duty soldiers with post-traumatic stress disorder will receive MDMA-assisted therapy, marking a significant shift in military mental health treatment.
New Research Initiatives
Approximately 186 service personnel will participate in multiple sessions of MDMA-assisted therapy, with the studies expected to begin next year. The research is being closely monitored by Sean O'Keefe, deputy under secretary of war for personnel and readiness, as indicated in a January letter. A new cohort of therapists from the Department of Defense and the Department of Veterans Affairs will start training in psychedelic-assisted therapy next week.
Potential Benefits
Advocates believe that guided sessions with the euphoria-inducing drug could help soldiers process trauma, enabling them to serve longer and avoid being crippled by stress after leaving the military. Rick Doblin, founding president of the Multidisciplinary Association for Psychedelic Studies, stated, "Helping people process trauma, whoever they are, is probably better than not." He added, "There's something noble about being willing to sacrifice yourself for other people. I don't feel morally conflicted by working with active-duty soldiers."
Political Support and Context
The funding was signed into law by former President Joe Biden as part of the National Defence Authorization Act in December 2023, which included provisions from Republican congressman Morgan Luttrell, a veteran Navy Seal who has personally undergone psychedelic therapy. "Our men and women in uniform deserve every tool available to heal and stay in the fight," Luttrell said. On April 18, Luttrell stood alongside Donald Trump as he signed an executive order to accelerate research into psychedelics and expand access, primarily for veterans. Trump noted, "The suicide epidemic among veterans is a national tragedy. Since 9/11, we've lost over 21 times more veteran lives to suicide than on the battlefield."
Historical Context
During World War II, the US Army treated soldiers with PTSD using barbiturate-induced deep sleep for up to 48 hours, allowing many to return to battle quickly, but this did not provide lasting relief. MDMA and other psychedelics like psilocybin appear far more effective in addressing mental health issues, but concerns are growing about their potential use to enhance combat readiness.
Ethical Concerns
Dennis McKenna, an ethnobotanist and author, warned of the consequences of restoring traumatized soldiers to health only to send them back to the frontline. "It would be completely cynical and cruel of the government to throw them back into combat. It's an abuse of psychedelics to use them to reconstruct people so that they can become more efficient killing machines." Doblin acknowledged the risks, noting that people are somewhat more likely to relapse into a PTSD response after treatment if they return to stressful situations.
International Developments
In Ukraine, Maps has trained 55 therapists to facilitate MDMA-assisted therapy for soldiers amid troop shortages and widespread untreated PTSD. Doblin supports "helping Ukrainians who choose to potentially sacrifice their life to fight the Russians." Although MDMA-assisted therapy is not yet permitted in Ukraine, hundreds of troops have undergone legal therapy with ketamine to address PTSD symptoms and return to the front.
Study Details
In the US, two randomized placebo-controlled MDMA studies for soldiers could begin recruiting volunteers later this year, with dosing likely in 2024. Department of Defense grants of $4.9 million each were awarded to Walter Reed National Military Medical Center and Emory University, working with the University of Texas Health Science Center. At Walter Reed, 91 military, guard, and reserve personnel with PTSD will receive three separate MDMA doses over 10 months and will not be deployed during the study. It is unclear how long they will be afforded after the research before potentially returning to duty. If the treatment proves effective, it could become standard therapy within the military.
Broader Implications
Doblin suggested that psychedelic therapy should begin before trauma occurs, as part of boot camp. "As part of boot camp, which is physical training, we should do emotional training, and give them MDMA sessions to work through whatever issues they might have had to make them less likely, if they're traumatized in the future, to develop PTSD." Psychologist Rachel Yehuda, director of the Parsons Research Center for Psychedelic Healing at Icahn School of Medicine, noted that soldiers might have transformative experiences that lead them to question their service, but it could also reaffirm their sense of mission. In an active-duty setting, treating someone when trauma is ongoing differs from treating its aftermath.
Historical Precedents
These studies are the first to officially investigate psychedelics on soldiers. From the late 1950s, the US Army dosed soldiers with LSD at a classified facility to assess its incapacitating effects. A soldier given LSD in 1958 told the New Yorker, "In the military, if you don't do something you will be ostracized. I believe they did give us the option to leave, at first, but you didn't really have a choice once you were in."
Global Research
In Israel, an MDMA-assisted group therapy study for victims of the October 7 Hamas attack could begin dosing patients later this year. With 168 participants, it will be the largest clinical trial involving psychedelics in the country, including Israeli military veterans and potentially serving soldiers. Psychologist Keren Tzarfaty, co-founder of Maps Israel, said, "We would like it to be a model to work with collective trauma that we can duplicate, not only in Israel, for Israelis, but around the world."
Addressing Moral Injuries
There are concerns that psychedelics could help soldiers effectively erase moral injuries from committing war crimes. But Doblin argued that such concerns stem from a misunderstanding of MDMA therapy. "A lot of times, people become more sensitive to the emotional consequences of what they did. If they're not treated at all … I think they're more dangerous of a soldier that way."
