When President Trump signed an executive order this spring to speed up FDA approval of psychedelic treatments, he echoed a push for healing long championed in California. I know these benefits myself — but also devastation.
In 2023, my husband and I enrolled in a clinical trial using MDMA (commonly known as ecstasy). I found this exploration transformative, but my husband, Kurt, suffered a nervous breakdown from which he is only now emerging. His prolonged collapse was exacerbated by mental health professionals untrained in psychedelic-related disturbances. Fast-tracking these substances without proper education is a prescription for harm.
The study Kurt and I joined in early 2023 was a dyad program for cancer patients and their caregivers. Four years before, he had been diagnosed with pancreatic cancer, which has a five-year survival rate of 13%. He sought psychedelic-assisted therapy to deal with debilitating fear of recurrence, along with trauma from treatment. We were told we could work on other issues too. He chose to try to address cyclical anxiety-based depression he’d carried since high school. I selected PTSD related to childhood sexual abuse.
Abiding by protocols established by the Multidisciplinary Assn. for Psychedelic Studies, which developed MDMA-assisted therapy, we had two dosing days several weeks apart — with therapy before, during and between sessions and a few days after. We were encouraged to find an “integration therapist,” a clinician trained in processing what surfaces after intense, mood-altering states, and we both did.
During the dosing window, and for two months afterward, the “medicine” seemed to work. We both had more resilience regarding Kurt’s cancer — past, present and future. Concurrently though, my partner had depressive dips, giving rise to suicidal thoughts — something he’d never had before. We were told MDMA floods the brain with mood-enhancing neurotransmitters, and afterward there could be a temporary crash.
Then things shifted.
I didn’t notice it at first, given eight weeks of expansive joy, but my husband’s brain worked differently after taking MDMA, and he began spiraling. At 68, he suddenly had obsessive-compulsive disorder, manifesting as rumination he couldn’t turn off. He stopped sleeping, gripped by suicidality and explosive emotions he had no container for. It was as if his psyche had been cracked open. Potentially making matters worse, Kurt’s integration provider stopped working with him in the middle of this crisis, switching to only ketamine patients. (Ketamine has limited FDA approval and can be very lucrative.)
Over the next six months, my spouse was institutionalized five times for suicidal ideation and a nervous system he couldn’t control. With his symptoms deteriorating, doctors recommended electroconvulsive therapy: 16 rounds that erased significant portions of his memory.
After he was released from the hospital, my husband took to bed and was unresponsive to five antidepressants and six therapeutic modalities. Once vibrant and the most intellectually curious person I’d ever met, my partner of 17 years could no longer read, watch television or even hold a conversation.
Throughout this ordeal, practitioners turned to me for insight. Such consultation is standard in mental health care — clinicians seeking context. But I quickly realized that, lacking psychedelics knowledge, they made me their de facto educator.
When the FDA declined MDMA therapy approval in 2024, it cited concerns about inadequate tracking of adverse effects — a gap already exposed by Psymposia, a psychedelic harm reduction nonprofit. Neşe Devenot, a psychedelic researcher and Psymposia board member, told me the true frequency of negative outcomes remains unknown because “the therapy model was designed to reframe harm as healing.” Along these lines, one of our researchers suggested Kurt’s unraveling was evidence of progress. Accelerated FDA approval, attracting many suffering individuals, will invite recklessness. The field is not ready.
Three changes could help. First, because distressed people often show up in hospitals, medical schools and psychiatric residencies should teach about psychedelic effects, just as they do for other substance use disorders. A 2024 study found a 54% increase in psychedelic-related emergency room visits in California between 2016 and 2022.
Therapists, of all kinds, also need better training. Complications related to mind-altering drugs are not consistently covered in clinical training — leaving providers ill-equipped to handle cases like my husband’s. Graduate programs could incorporate psychedelics into existing psychopharmacology education.
Finally, we need to use the expertise we have. Of the five times my partner was institutionalized, two were at a hospital within the Johns Hopkins system — home to perhaps the world’s authority on psychedelics: the Center for Psychedelic and Consciousness Research. But at least in Kurt’s case, there was zero communication between the center and those providing diagnosis and treatment. Institutions such as Johns Hopkins and the UC San Francisco Translational Psychedelic Research Program could provide specialist consults for complex cases — a model already proven by poison control centers.
With no licensed specialist to help, I tried assembling the pieces myself. Eventually, I surmised the real culprit for Kurt was an overloaded nervous system: What MDMA unburied had never been properly processed — a trauma response left entirely unaddressed. I found my husband a trauma expert, and three years after the breakdown, he is finally recovering.
I am not opposed to psychedelic medicine. I agree with Betty Aldworth, co-executive director of the Multidisciplinary Assn. for Psychedelic Studies, when she says: “Psychedelics are powerful healing tools for many, but any powerful tool requires safety guidelines.” The psychedelic trial helped my PTSD, a reminder of the promise this field holds. But I have also witnessed what happens when promise outpaces support systems. My spouse’s collapse is not an anomaly. It’s a warning.
Laura Zam is a writer and speaker working on a memoir about mental health, psychedelics and tea houses across America.
The post Mental health care isn’t ready for psychedelic side effects appeared first on Los Angeles Times.
