When President Trump signed his executive order on psychedelic medicines on April 18, the reaction split, predictably, along the usual lines. Skeptics called it a stunt. Advocates called it a breakthrough. What almost no one in the American debate seems to realize is that the experiment the order contemplates is no longer theoretical. It has been running, quietly and carefully, in another allied country for more than two years — and the results are already reshaping how that country cares for the men and women it sent to war.
I run a pharmaceutical company that has been the primary commercial supplier of clinical-grade MDMA into Australia since the country became the first in the world to authorize psychiatrists to prescribe it. I am not a neutral observer. But because of where we sit in the supply chain, I have watched, in close to real time, what happens when a serious Western democracy decides to stop treating MDMA as a cultural artifact of the 1990s rave scene and start treating it as what the clinical evidence says it is: one of the most promising tools we have ever had for treatment-resistant PTSD.
The Trump executive order is the right instinct. It directs the FDA to issue National Priority Review Vouchers to psychedelic medicines with Breakthrough Therapy designation, instructs the DEA to prepare for rescheduling upon approval, and — crucially — tells HHS, the FDA, and the VA to start sharing data and generating real-world evidence together. That last piece matters more than any of the headlines about Joe Rogan in the Oval Office. Real-world evidence is how a promising therapy moves from a heroic Phase 3 result to something a VA clinician can actually prescribe on a Tuesday morning in Tacoma.
Australia has spent two years building exactly that evidence base, and American policymakers should be paying close attention.
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In November 2025, the Australian Department of Veterans' Affairs (DVA) became the first government payer in the world to fund MDMA-assisted psychotherapy for veterans with PTSD. The DVA did not do this on a hunch. They did it after watching the Australian Authorised Prescriber Scheme run for more than two years without serious adverse events across the cohort of patients treated. They did it after looking at real-world outcomes data showing that more than half of patients treated for PTSD reported significant, durable relief — in a population that had, by definition, already failed multiple standard therapies.
Today, an eligible Australian veteran can have the DVA fund up to roughly $33,000 AUD of MDMA-assisted psychotherapy — covering the medication, the authorized psychiatrist, the co-therapist, the preparation sessions, the three dosing sessions, and the integration work that follows. For a veteran who has cycled through drugs, therapy, and suffering without getting their life back, that is not a line item. That is the difference between a marriage surviving and not. Between staying in the workforce and not. In too many cases, between being alive next year and not.
The Australian model is not perfect. It is expensive, the prescriber workforce is still small, and most civilians remain priced out. But it has done something the American debate has mostly failed to do: it has moved the argument from ideology to evidence. The DVA did not wait for a culture-war resolution on whether psychedelics are "good" or "bad." They looked at the clinical data, looked at the safety data, looked at the rates of veteran suicide, and made a decision to save lives rather than sit on their hands.
That is the template. The Trump executive order opens the door for the United States to do the same — to let the FDA's science-based approval pathway work, to let the VA get to work in actually treating patients, the same way that the Australian DVA has.
Nicholas Kadysh is the CEO of PharmAla Biotech, a pharmaceutical company manufacturing clinical MDMA and novel MDMA-like molecules for medical use.
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