The Strange Second Life of MDMA’s Revolution

2024 was meant to go down as the year the MDMA revolution finally arrived.

Around this time 12 months ago, prescription MDMA looked all but guaranteed to win formal U.S. approval. After decades of clinical research, political haggling, and relentless advocacy, the iconic underground club drug was on track to be normalized, medicalized, and stamped with official approval from the U.S. Food and Drug Administration. Then, that future fell apart overnight.

In a sharp reversal of expectations, an FDA advisory committee voted 10-1 to reject the MDMA-assisted therapy the agency had been reviewing. The decision derailed the entire future of psychedelic medicine for the foreseeable future. Except for one unexpected twist: an unlikely lifeline thrown out by the second Trump administration. In May, the FDA’s new commissioner, surgical oncologist Marty Makary, went on cable news to name MDMA and other Schedule I narcotics a “top priority for this FDA and this administration.” Not far behind, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. — the public face of the administration’s “Make America Healthy Again” (MAHA) agenda — has spoken publicly in positive terms about ayahuasca, the psychoactive plant-based tea. Matt Zorn, a recently appointed attorney in Kennedy’s department, previously spent years fighting the federal government to expand public access to cannabis and psychedelic mushrooms. Casey Means, Trump’s nominee for surgeon general, has openly touted the benefits of psilocybin-assisted therapy, recalling that psychedelic mushrooms helped her open up to love and left her feeling like “part of an infinite and unbroken series of cosmic nesting dolls.”

It turns out that psychedelic medicine fits surprisingly well into the anti-establishment “burn it all down” ethos that defines Kennedy’s political movement. But as MDMA’s backers regroup to capitalize on this new wave of support, they’re still grappling with why they lost FDA approval the first time around, and whether a second attempt can fare better. Could the psychedelic community’s new alliance with Trumpworld be the push that finally helps them reach their decades-old goal?

For nearly 50 years, one man has been the indispensable backbone of American psychedelic medicine, and the MDMA movement in particular: Rick Doblin. On a crisp December morning, I met Doblin at his vivid purple craftsman home in Boston’s suburbs. Clad in a well-worn chamois shirt and khakis, with a messy thatch of graying hair, he was warm, cheerful, and avuncular. His look was classic New England, a little unkempt, fitting for the heir to a wealthy industrialist family who became the elder statesman of the modern counterculture.

Doblin first tried LSD in 1971, as a psychology freshman at Florida’s experimental New College. By 1982, he was studying under psychedelic research and therapy pioneer Stanislav Grof at California’s Esalen Institute in Big Sur. At the time, many in the Esalen community were buzzing about a legal compound called MDMA, which was said to help people overcome fear and build deep, meaningful connections with others. Doblin tried the drug with his girlfriend, and was stunned by how easily it let them work through their relationship issues. But just as he was discovering its potential, the U.S. criminalized MDMA, much to his frustration. In 1986, he founded the Multidisciplinary Association for Psychedelic Studies, or MAPS, a nonprofit dedicated to advancing psychedelic research.

For years after its founding, MAPS was essentially a one-person operation. To push for MDMA legalization, Doblin compiled data from animal studies on the drug’s toxicity, lined up experts to debate DEA officials on the Phil Donahue Show. He snuck into Nicaragua during its civil war to get MDMA to local clinicians treating traumatized soldiers and civilians. He even volunteered for agonizing spinal taps to debunk the common myth that MDMA permanently depletes the brain’s natural serotonin stores.

Early on, Doblin believed that MAPS needed to distance itself from counterculture stereotypes to win mainstream credibility. (The organization’s first 2010 Psychedelic Science conference even implemented a “no tie-dye” rule for staff.) He set out to gather rigorous clinical data proving the therapeutic benefits of MDMA and other banned substances, then used that data to shift public opinion and end federal prohibition. Between 2005 and 2017, MAPS refined a clinical framework for therapists to administer MDMA to patients with post-traumatic stress disorder (PTSD), guide their trips, and provide emotional support after the experience. Their 74-page treatment manual emphasizes “inner healing intelligence,” a concept popularized by Doblin’s mentor Grof that holds the human psyche has an innate ability to heal itself.

For much of this period, MAPS operated as a public charity, pulling in more than $6.7 million in 2013 alone to fund its research and advocacy work. The organization prided itself on living its values of destigmatizing drug use, implementing a policy that let employees clear “smokable tasks” (work that could be completed productively while under the influence of drugs) with their managers. “I personally feel like strategizing and brainstorming goes better when I’m high,” Doblin explains.

But the cornerstone of Doblin’s plan — proving MDMA’s effectiveness through large-scale clinical trials — required far more resources than MAPS’ charity model could raise. The organization needed more than $100 million to cover research and operational costs, so in 2014 it launched a for-profit subsidiary that would later become known as Lykos Therapeutics.

To rebrand MDMA from a party drug to a life-saving treatment, Doblin chose to center his work on a sympathetic patient group: military veterans living with treatment-resistant PTSD. MAPS built partnerships with veterans’ organizations, and in 2018 secured a $1 million donation from the Mercer Family Foundation, run by conservative mega-donor Rebekah Mercer, sometimes called the “First Lady of the alt-right.” Mercer’s support marked a notable shift from MAPS’ traditional donor base, which included Silicon Valley venture capitalist and long-time backer George Sarlo, lifestyle podcaster and author Tim Ferriss, and David Bronner, the “cosmic engagement officer” at the family-owned Dr. Bronner’s soap company.

In 2017, the FDA granted MAPS’ MDMA therapy a Breakthrough Therapy designation, opening a fast track through the agency’s lengthy trial and review process. In December 2023, Lykos submitted its approval application to the FDA, including trial data from hundreds of patients that showed a remarkable 70% success rate for treating PTSD. A quick approval review was expected to follow.

On June 4, 2024, Jonathan Lubecky, a 48-year-old former Marine and U.S. Army sergeant, appeared via webcam before the FDA advisory committee to share how MDMA therapy saved his life. Lubecky deployed to Iraq in 2005 for a year-long tour. After returning home, he was tormented by nightmares, crippling anxiety, depression, and constant suicidal thoughts. Triggered by fireworks during a Fourth of July celebration, he once hid in a closet with his service dog. He had a public breakdown at Disney World after spotting a guest in Islamic clothing carrying a backpack.

After exhausting all treatment options offered by the Department of Veterans Affairs, Lubecky had lost all hope. He was taking 42 prescription pills a day and had attempted suicide five times. Then, in 2014, an intern at a South Carolina hospital slipped him a scrap of paper with one line scrawled on it: “Google mdma ptsd.” Searching the term led Lubecky to a MAPS-run clinical trial for MDMA therapy that was recruiting veterans. With nothing left to lose, he signed up.

Under the influence of MDMA and guided by his therapist, Lubecky found himself finally opening up about the horrors he’d witnessed in the war — and kept going. “I went in thinking I was going to talk about Iraq,” he says, “and I ended up talking about my whole fucking life.” The treatment, which included three MDMA-assisted sessions plus regular talk therapy, “healed me,” Lubecky told the committee. Since his recovery, he’s made multiple trips to the front lines of the Ukraine-Russia war as a volunteer, restocking Ukrainian medical supplies. He also became a dedicated advocate for clinical MDMA, serving as MAPS’ government liaison between 2018 and 2023. Like Doblin, Lubecky was optimistic the treatment would win approval.

But during the hearing, a damning statement was entered into the record from a woman named Meaghan Buisson. Buisson said she’d been recruited into a 2014 Phase 2 clinical trial run by MAPS. While under the influence of MDMA, she claimed, she was “blindfolded, gagged, pinned, cuddled, and caressed” by her two therapists, a married couple. She attempted suicide after the incident, she said, and a doctor later told her she had effectively been “drugged, raped, blamed, and held as a sex slave.”

Another witness, Neşe Devenot, a senior writing lecturer at Johns Hopkins University, shared another account: a therapist pinned a patient down as the patient’s distress escalated to the point they shouted, “Go away. Get your effing hands away from me.” In a 17-page document submitted to the FDA, Devenot alleged that MAPS’ therapy was not a legitimate scientific treatment at all: it was a “therapy cult,” comparable to NXIVM, the infamous sex-trafficking pyramid scheme.

After eight exhausting hours of testimony, the hearing adjourned. Lubecky stepped out onto the balcony of his Washington, D.C. apartment, took a deep breath, and yelled, “FUCK!” He was certain Buisson’s and Devenot’s accounts would sink the treatment’s approval chances. Here was a medical innovation that could save thousands of lives, he thought, and it had been torpedoed not by the movement’s traditional enemies — law enforcement, drug prohibition opponents — but by rival factions within the psychedelic community itself. Or, as he put it: “a bunch of fucking hippies who fucked it up.”

Until recently, the “psychedelic space” was a small, insular circle of academics, research chemists, and recreational users, loosely connected to the drug underground and the remnants of the 1960s counterculture. Then, in 2018, author Michael Pollan published How to Change Your Mind, his bestselling deep dive into the “psychedelic renaissance,” which helped bring LSD, MDMA, psilocybin, and mescaline into the mainstream.

Psychedelic community gatherings outgrew church basements and Holiday Inn ballrooms, moving to glass-and-steel convention centers packed with pharmaceutical salespeople and venture capitalists. To many left-wing, anti-capitalist psychedelic activists, Devenot told me, this corporate takeover felt like the evil Eye of Sauron from The Lord of the Rings had turned its gaze their way.

Devenot, who uses they/them pronouns, first took LSD as a freshman at Bard College. It was “the most profound experience of my life,” they said. Before that trip, Devenot had been cripplingly shy and plagued by intrusive thoughts about death. But while on LSD, Devenot says, “the finality and fearfulness I associated with death disappeared.” They soon joined the community of researchers and enthusiasts that revered Doblin as a pioneer. “Before this field became financialized,” Devenot told me, “it was a domain for a lot of weirdos and misfits … people looking for community and meaning and connection.”

In 2018, Devenot joined Psymposia, an advocacy group founded to push for drug policy reform. The group began working to research policy and speak out against the corporate co-optation of psychedelia. Psymposia co-founder Brian Normand told me he sees Silicon Valley and Big Pharma’s entrance into the psychedelic space as “incredibly cheesy.” Through open letters, articles, academic papers, podcasts, and hundreds of social media posts, Psymposia has highlighted abusive psychedelic therapists and the right-wing misuse of mind-altering compounds, among other issues. Early on, Psymposia and MAPS worked together. But a few years after MAPS launched its for-profit subsidiary, the alliance fell apart.

In 2021, Psymposia partnered with New York magazine to produce an investigative podcast called Cover Story: Power Trip. One of its most critical episodes focused heavily on MAPS, and featured Meaghan Buisson — the same woman whose assault story was presented at the FDA hearing.

The podcast, alongside accompanying video footage from Buisson’s therapy, covered most of the details she would later share with the FDA. Buisson was homeless when she joined the 2014 trial, which was run by two MAPS-trained clinicians, Richard Yensen and Donna Dryer. Buisson also alleged that Yensen, an unlicensed psychotherapist, pursued a sexual and romantic relationship with her after the trial ended. In 2018, Buisson filed a civil suit against Yensen, which was reportedly settled out of court, and filed an ethics complaint with MAPS. In a public statement, MAPS confirmed Yensen admitted to having sexual contact with Buisson. Dryer gave up her medical license. (Yensen did not respond to a request for comment. When asked for comment, Dryer cited a Canadian Medical Association rule that bans doctors from commenting on former patients.)

“We never tried to downplay it,” says Michael Mithoefer, a MAPS clinical researcher and psychiatrist who wrote the organization’s treatment manual. MAPS confirmed the ethical misconduct, notified the FDA, banned Yensen and Dryer from all future work with the organization, and gave Buisson roughly $11,000 to cover therapy costs. MAPS also notified all trial participants that anyone with similar complaints could confidentially reach out to its compliance team or the study’s Institutional Review Board. But MAPS researchers did include data from Buisson’s trial in three scientific papers published in the journal Psychopharmacology. “That was a mistake,” Mithoefer admits. Psychopharmacology has since retracted the papers. MAPS has emphasized that Buisson’s case is the only documented instance of sexual abuse among hundreds of patients treated in its trials.

It later emerged that at least six of the witnesses who gave negative testimony to the FDA had personal or professional ties to Psymposia. (Devenot notes that two of the six were not officially affiliated, just “fans” of the group.) This created a strange imbalance during the hearing. Positive testimony came from representatives of large groups like the Veterans of Foreign Wars, which represents more than 1 million members. The most shocking accounts came from people loosely connected to a small advocacy group that opposed MAPS’ methods.

In 2024, Psymposia received $185,000 from the Sarlo Charitable Fund, at the recommendation of Susie Sarlo, daughter of long-time MAPS donor George Sarlo. MAPS board members and the Sarlo estate had previously been locked in a dispute over alleged elder abuse of George. Susie Sarlo also submitted a public comment to the FDA advisory committee warning of “MDMA’s recognized use as a tool for exploitation.” When asked about Sarlo’s donation, Normand insisted Psymposia is “nobody’s attack dog.” Devenot added that Psymposia members had spent years developing their analysis and raising the same concerns long before they received the funding.

In the view of many MAPS-trained therapists, Psymposia used Buisson’s isolated case to discredit the entire treatment. Devenot’s FDA complaint argues that MAPS’ protocols “incentivize” exploitative power dynamics between vulnerable patients and potentially predatory therapists. Abusive practitioners like Yensen and Dryer, Devenot alleged on Substack last fall, are “an inevitable consequence of MAPS’s therapeutic ideology.” (Speaking for Psymposia, Devenot responded: "We are disappointed to see that MAPS has reverted to scapegoating critics rather than engaging with substantive safety improvements that would protect future patients.")

“The metaphor they use is that’s not just one rotten apple, it’s the whole orchard,” says Casey Paleos, a board-certified psychiatrist who worked as a therapist in MAPS’ Phase 3 trial. “I know the other apples in the orchard. None of us are like Richard Yensen.”

I interviewed several patients from MAPS’ Phase 3 trial to understand how the therapy typically works in a clinical setting. Laura Lynn MacDonald, a 55-year-old mother of two, is a survivor of childhood sexual abuse. She had cycled in and out of therapy for years, and was prescribed antidepressants and a range of anti-anxiety medications to treat panic attacks, ADHD, and insomnia. (The average trial participant had lived with PTSD for 14 years.)

MacDonald credits MDMA therapy with curing her symptoms. By her account, her therapists were methodical and responsible as they helped her process intense sensations and traumatic memories. She always felt safe and guided, even when she accessed a vivid, happy memory of being paddled in a canoe by two caring camp counselors. “No boundaries were crossed. Safety measures were diligently followed,” she said, adding, “as a sexual abuse survivor, the manipulation and weaponization of the only sexual abuse case that occurred during the MAPS clinical trials infuriates me.”

During the hearing, Devenot used the account of a therapist pinning down a patient to argue that abuse is a widespread pattern. The therapist in question, Veronika Gold, says the patient (who was taking ketamine, not MDMA) had consented to touch and role-play, and Gold was acting in character as the patient’s abusive father. The patient has never spoken publicly about the incident, and Gold wrote about this “reparative fantasy” case extensively in a published book chapter. “It has been very upsetting,” Gold says of Devenot’s characterization of her work. “They are misrepresenting what actually happened … and it seems like it made an impact on the advisory committee." Devenot, meanwhile, argues that Gold’s use of physical touch “exposes patients to an undisclosed risk of retraumatization.”

It’s unclear exactly how much Psymposia’s criticism influenced the FDA’s final decision. Members of the FDA advisory committee did not respond to repeated requests for interviews. I spoke to two former Lykos executives who have seen the agency’s Complete Response Letter, who said the FDA took Psymposia’s concerns very seriously, and cited problems with trial design — a longstanding criticism of psychedelic treatments. The FDA also reportedly flagged underreporting of “positive adverse events,” cases where the experience was not just therapeutic, but so pleasurable that it could prime patients for future drug abuse.

After the ruling, Psymposia appeared eager to claim credit for the outcome. The