Down the rabbit hole

Jonathan Lubecky lay in a hospital bed and stared at the ceiling as two attendants hooked him up to a medical monitor. One of them handed him a dish that held a single green capsule.

The pill contained MDMA, an illegal party drug known as “molly” or “ecstasy.” But Lubecky wasn’t looking for a good time. He was hoping for a cure. For eight years he had battled severe post-traumatic stress disorder (PTSD) and depression, ever since coming back from a deployment to Iraq. He’d tried to kill himself at least five times.

The attendants at Lubecky’s bedside, therapists with the pharmaceutical company Lykos Therapeutics, believed this so-called party drug could be just what he needed.

MDMA, which stands for 3,4-Methylenedioxymetham­phetamine, is a potent compound some scientists consider a member of the psychedelic family because of the mood swings and sensory distortions it causes. Others prefer the label “empathogen” because it heightens users’ feelings of empathy and sociability.

Either way, the Drug Enforcement Administration labels it a Schedule 1 substance, meaning a drug with “no currently accepted medical use” and a “high potential for abuse.” Last August, the Food and Drug Administration (FDA) refused to approve MDMA-assisted PTSD therapy, citing a lack of sufficient evidence it’s safe and effective.

But Lubecky felt he’d exhausted all his other treatment options. He took a deep breath and put the capsule in his mouth. Then, he lay back and waited for the drug to kick in.

A new wave of psychedelic enthusiasm is sweeping the United States. After decades of tight restrictions, researchers, veterans, and other advocates are touting the wonders of hallucinogens to “rewire” brains and alleviate suffering. Buoyed by success stories and preliminary data, the movement has gained bipartisan support. But critics worry this new fervor overlooks the drugs’ serious risks. They argue efforts to deregulate or decriminalize the powerful compounds are motivated by religion as much as science and could put vulnerable people at risk—opening a nightmarish Pandora’s box.

Roland Griffiths Travis P Ball/Getty Images for SXSW

THE WORD PSYCHEDELIC refers to a diverse category of psychoactive drugs ranging from naturally occurring substances like psilocybin and mescaline to synthetics like lysergic acid diethylamide (LSD). It comes from two Greek words meaning “to make visible the soul.” During the 1950s and ’60s, researchers hoped these drugs would do just that—provide a window into the human mind and act as a panacea for mental afflictions such as depression and addiction.

But the drugs sparked a public outcry after they fueled widespread experimentation among members of the hippie counterculture. In 1970, President Richard Nixon approved the Controlled Substances Act, tightening restrictions on drugs, including hallucinogens. Today, all major psychedelics other than ketamine are federally illegal, except for a few niche exemptions.

But in 2000, a cadre of Johns Hopkins researchers, spearheaded by scientist Roland Griffiths, secured government approval to pursue psychedelic research once again. Six years later, the group published a study on psilocybin, the psychoactive chemical in “magic mushrooms.” Interest in the field exploded, and research programs sprang up at institutions like NYU Langone, Yale, and Stanford. Research organizations such as Compass Pathways and Lykos Therapeutics also got involved.

Lying in the Lykos lab in 2014, Jonathan Lubecky had just decided he got the placebo when he noticed a subtle shift. He didn’t start hallucinating or hearing voices, but he felt more open and trusting. His attending therapists started asking him simple questions about his time in Iraq.

Lubecky started talking. Gradually, the questions became more personal. Lubecky had expected to spend most of his time talking about Iraq. Instead, he focused on all the other hard experiences in his life—childhood abuse and his wife’s abandonment.

Periodically, the therapists directed Lubecky to don eyeshades and quietly reflect on everything he’d said.

Time passed, but Lubecky had no idea how much. Everything felt “wonky.” Then, his brain fog started to clear. Suddenly, he felt a sharp craving for a cigarette. The MDMA was wearing off.

Lubecky and Staff Sgt. Ragsdale at Balad Air Base in Iraq, 2006. Photo courtesy of Jonathan Lubecky

That’s when Lubecky realized he’d been in the lab for eight hours.

For the rest of his time in the MDMA trial, Lubecky alternated between “active” drug sessions and normal 90-minute talk therapy sessions. At his two-month checkup, Lubecky’s PTSD scores had halved. His depression scores remained high, but Lubecky has an explanation for that. “I still thought I was going to have PTSD,” he said. “I thought it would come back.”

Over time, Lubecky’s new reality started to sink in. After a year in remission, he dared to hope his PTSD might really be gone for good. And he started to feel different—lighter. “I don’t remember the first day I didn’t think of killing myself,” he said. “But I remember the first day I realized it.” He stopped having PTSD nightmares, too.

Nine years later, Lubecky said his PTSD still hasn’t flared up again. Not when a man drowned in the lake behind his house and Lubecky performed CPR on him. Or when Lubecky rendered aid to a man wounded in a Charleston shooting. Not even when Lubecky’s son had a medical emergency and had to be life-flighted off a cruise ship. “I’m continually amazed at how healed I am,” he said.

Lubecky at the 2018 NYC Veterans Day Parade. Photo courtesy of Jonathan Lubecky

EXTRAORDINARY SUCCESS stories like Lubecky’s have escalated the psychedelic enthusiasm. But some whistle­blowers highlight troubling shortfalls in the existing scientific research and argue all the excitement blinds researchers to the dangers of these powerful substances. Others say the social agenda promoted by many industry leaders undermines their credibility and feeds a culture of dishonesty.

For starters, scientists don’t even know exactly how psychedelics work. Peter Hendricks, a researcher at the University of Alabama at Birmingham, said psilocybin seems to be a “pesticide” of sorts, “designed to prevent gastropods from eating this genus of mushrooms.” While these psychoactive substances might repel slugs and snails, it’s not clear what they do to the human brain.

Explanations range from the theory that psychedelics reset the brain’s network, boost neuroplasticity, or make people more psychologically adaptive, according to Dutch psychedelic researcher Michiel van Elk. But he said none of these current theories are proven, and each “suffers from methodological shortcomings.”

In 2023, van Elk published a paper highlighting a laundry list of problems riddling much current psychedelic research. These include jumping to conclusions, failing to disclose financial conflicts of interest, and “breaking blind” among study participants. Among the biggest problems van Elk identified: scientists allowing personal bias to infect their work.

Michiel van Elk Jiri Buller

“Almost any researcher I’ve spoken to in psychedelic science has become interested in psychedelics based on personal experience—including myself,” said van Elk. He became interested in these substances after an ayahuasca retreat he describes as “quite profound.” Ayahuasca is a hallucinogenic tea traditionally brewed in South America and used in shamanistic healing rituals. Although personal enthusiasm doesn’t automatically discount the validity of the research, van Elk said it “brings in bias” and can create a “blind spot for mistakes or errors.”

That’s something Joe Welker, a Presbyterian pastor and former psychedelics user, finds deeply problematic. Welker once interned with the Christian psychedelic society Ligare and welcomed the idea of integrating hallucinogens with religious practice. But over time, he became troubled by what he describes as the “utter sociopathic behavior” of the psychedelics industry.

For Welker, the primary danger of psychedelics boils down to one particular temptation: idolatry. He said there’s something insidious about the power hallucinogens can exert over users. Even though psychedelics are not addictive in the way drugs like opioids are, he said they can still “colonize” people’s minds and affections through experiences that feel “realer than real” and keep them chasing sensations they view as mystical revelation.

Since the ’60s, Welker said, something about these drugs has predictably left people with the conviction that, “If only everybody was tripping, then the world would be a better place.” That makes it difficult to draw a clear line between therapeutic and spiritual uses of these drugs, and Welker said most major players in the industry emphasize psychedelics’ medical uses primarily as a political move—­a Trojan horse to pave the way for spiritual and recreational uses.

For example, Rick Doblin, head of the Multidisciplinary Association for Psychedelic Studies (MAPS)—a major funder for psychedelic studies and the organization behind Lykos Therapeutics—has publicly outlined his view that “beyond the medicalization” of psychedelics “legal access is absolutely essential to achieve the kind of mass mental health and spiritualized humanity that we’re looking to have.” Doblin has also repeatedly emphasized global access to MDMA-assisted therapy as key to achieving “a world of net-zero trauma by 2070.”

“That motivation should make us all question the state and the neutrality of the science, because of the incredible biases behind it, which are not purely monetary, but religious in nature,” Welker said.

On top of that, the powerful nature of psychedelics makes it easy for researchers to “fall into the trap of playing guru or priest,” according to a 2020 article from psychedelic researcher Matthew Johnson. Johnson, a longtime co-worker of groundbreaking scientist Roland Griffiths, later lodged an ethics complaint against Johns Hopkins, alleging Griffiths ran his psychedelic studies “more like a ‘new age’ retreat center” than “a clinical research laboratory.”

People tend to be very suggestible under the influence of psychedelics, which opens the door for researchers to cross boundaries or inappropriately influence study participants—either consciously or subconsciously. Sexual abuse allegations have long hounded psychedelic subcultures, and surfaced again in 2018 after a former MDMA clinical trial participant sued her therapist for sexual assault.

Researchers had high hopes the FDA would approve MDMA-assisted therapy as a treatment for PTSD. When the agency refused, it dealt a serious blow to Lykos, and the following week, the company announced a decision to lay off 75 percent of its staff. MAPS founder Rick Doblin also resigned from the organization’s board.

Peter Hendricks The University of Alabama at Birmingham

IN THE WAKE OF the failed FDA application, researchers continue to look for evidence supporting the effectiveness of drugs like MDMA and psilocybin. But many veterans, first responders, and abuse victims suffering from acute mental health issues feel they can’t afford to wait and have joined the movement for decriminalization. So far, 20 cities and two states have deregulated psychedelics, despite the federal ban. Nine other states are considering such bills, according to the online tracker Psychedelic Alpha.

Researchers like Peter Hendricks find that trend concerning, since there are still so many unknowns surrounding these substances, especially concerning their long-term health risks. Calls to decriminalize psychedelics are typically grounded in the claim these drugs are safe and effective, but Hendricks said that isn’t true. “There are clearly safety concerns,” he said. “These are very powerful drugs. They should be used in very careful circumstances.”

Hendricks said there is “some pretty solid data” suggesting MDMA can be an effective PTSD treatment and psilocybin can alleviate depression, at least temporarily. But these drugs don’t work for everyone, and it’s not yet clear who might be most helped and who might be most hurt by this treatment modality.

Although van Elk does support a carefully regulated decriminalization effort, he believes allowing people to dabble in these drugs on their own is extremely dangerous. There’s a risk people might start experimenting with MDMA alone in their living rooms thinking it’s a “cure” and end up harming themselves, especially if they’re already in a fragile state of mind.

Reported risks of using psychedelic drugs range from mundane symptoms such as acne, nausea, and headaches to a wildly frightening array of effects such as false memories, recurring hallucinations, flashbacks to the trips, and feelings of dissociation, van Elk said. In rare cases, psychedelics such as LSD can even trigger short-term psychosis or schizophrenia for people with a genetic predisposition. And psychedelics can spark dangerous behavior in people under the influence, leading to death or injury.

Van Elk cited one researcher in the U.K. who discovered approximately one-third of participants who reported recurring thoughts, hallucinations, and increased anxiety experienced these symptoms for more than a year after their psychedelic experience. Another review of ketamine studies concluded over 40 percent of the “serious adverse events” that occurred were not reported in the published studies. Van Elk said that’s much-needed context for this discussion: “Psychedelics can do good when used in the right circumstances. But they can also do harm if you’re unprepared or if you have a certain vulnerability in your genes or in your personality.”

Those types of vulnerabilities are difficult to screen for with certainty, Welker pointed out, since people can never be sure they don’t have instances of undiagnosed mental illness in their family history.

On top of that, some negative effects of psychedelics are subtle, not necessarily something a doctor could diagnose. Welker’s seen people in his own circles with “wild, conspiratorial” thinking likely linked to their drug use. Others devolve into apophenia, a condition where they mistakenly see connections between unrelated occurrences or ideas.

In rare instances, people develop hallucinogen persisting perception disorder and experience recurring visual distortions and flashbacks. Welker has also seen people drop out of ministry in favor of a psychedelic crusade or break up with their partner because the drug “told them” they were “not aligned.”

Welker admits he feels torn about psychedelics because he does think some people genuinely experience “some measure of healing” from them. And he expects scientific research will bear that out in the long run. But some people just end up swapping one set of problems for an array of “new spiritual diseases.”

For that reason, Welker describes psychedelics as a sort of “spiritual casino.” Some people win the lottery and find healing. Others get hurt. “There’s a certain amount of spiritual gambling that is intrinsic to this process—even psychedelic industry people would agree with that,” he said. “It’s an intrinsically spiritually risky thing.”

Lubecky on a captured Russian vehicle in Donbas, Ukraine. Photo courtesy of Jonathan Lubecky

DESPITE—OR PERHAPS because of—his own experience with MDMA, Jonathan Lubecky staunchly opposes decriminalization. “You have a lot of people who think just taking drugs will fix your mental health, and that’s not true,” Lubecky said. MDMA can’t fix anyone, he added. “It puts your mind, body, and spirit in the place it needs to be so that the therapy can actually work.” MDMA generally makes people feel more open and trusting, which Lubecky said is especially critical to help veterans overcome an often deep-seated distrust of therapists.

Without access to talk therapy, or “integration,” Lubecky said people who take psychedelics hoping for healing are “just doing drugs.”

Instead of calling for blanket decriminalization, Lubecky spends his time working to connect veterans to clinical trials and lobbying for FDA approval and congressional support for new psychedelic research.

When he’s not in Washington, Lubecky makes regular trips to Ukraine, helping provide humanitarian assistance on the front lines. He said he’s visited the war zone nine times over the last three years—all without PTSD and without nightmares.

One of the reasons Lubecky volunteered for this dangerous work? Just to see what would happen. “You can’t ask somebody who’s a victim of domestic violence or childhood abuse to go do that again, see if you relapse,” Lubecky said. “I’m a soldier. I could volunteer to go back to war, and I had the skill set to do it.”

Once, during a night of heavy shelling, he noticed a team member shaking and covered with sweat. The next morning, the man said he hadn’t been able to sleep because of all the incoming missiles. Lubecky slept like a baby.

That experience gave Lubecky an answer for skeptics, who ask him for proof he’s really healed: “I’ve been shot at and bombed again, and I still don’t have PTSD.”