In 2004, Mike Gemignani enlisted in the Army after graduating from high school. A forward observer, he directed artillery units and Apache attack helicopters to their targets during his two tours in Iraq with the 101st Airborne Division.
He eventually left the military, went to college and settled into a job. But a slow trickle of anxiety and depression soon followed.
He sought help through the Department of Veterans Affairs, where counselors prescribed him “fistfuls” of medication, including opioids and more drugs to counter their side effects. The drugs didn’t help his depression, and for days at a time he would do nothing, immobilized by the illness.
Gemignani’s story is not uncommon for those who served in the military. But now, after years of effort, momentum is building in Congress to explore a new path for servicemembers and veterans struggling with psychological illnesses: psychedelics.
Current legislative proposals include studies of the effectiveness of using psychedelics to treat PTSD among active-duty servicemembers and veterans, reflecting a small but significant shift among lawmakers’ attitudes toward therapeutic use of the drugs.
But psychedelic therapy was not an option when Gemignani turned to the VA, and his mental status continued to deteriorate.
“I got to the point where I was sitting in my basement office with a pistol in my hand,” Gemignani said.
Gemignani’s situation changed when his wife found a website for the organization Veterans of War, a nonprofit that facilitates six-month programs for veterans who, having exhausted their other options, travel overseas in an effort to treat their depression, anxiety and PTSD with psychedelics.
The program includes months of coaching, therapy and community-building, but is centered around a weeklong trip, typically to the jungles of Peru or Costa Rica, where participants take ayahuasca, a powerful psychoactive brew traditionally used by indigenous cultures that, among other psychedelics, is gaining popularity in the U.S. as a way to treat psychological issues without turning to opioids.
But psychedelic substances like ayahuasca and psilocybin — commonly referred to as magic mushrooms — are illegal in the U.S., forcing interested Americans to seek them out in more permissive nations overseas, or find them on the black market.
“That’s the irony. You have veterans who have done so much for our country yet, when we find a cure, they have to leave the country to get cured,” said Rep. Lou Correa, D-Calif., who co-chairs the Congressional Psychedelics Advancing Therapies (PATH) Caucus alongside Rep. Jack Bergman, R-Mich.
Therapeutic value
Attitudes toward the substances in the U.S., and on Capitol Hill, are slowly shifting.
Proponents say psychedelics offer a long-term alleviation of symptoms, if not cures, to some psychological illnesses, sometimes after a single use.
The Food and Drug Administration has previously granted “breakthrough therapy” designations to psilocybin and MDMA, another psychedelic, commonly referred to as ecstasy or Molly. The designation recognizes the therapeutic potential of the drugs, and can eventually lead to their approval.
Full approval for MDMA is widely expected in the coming months, and psilocybin may not be far behind.
Researchers have compared the effects of psychedelics on a person’s brain to fresh snowfall on a heavily used ski slope. Once the new snow has fallen, new paths — or thought patterns — can be created. Those new thought patterns may play an important role in overcoming illnesses like PTSD.
Jesse Gould, a former Army Ranger and founder of the Heroic Hearts Project, another nonprofit that facilitates access to psychedelic programs for veterans, says his organization has served over 850 veterans and 100 spouses.
When combined with all of the other groups in the space, that figure is likely over 3,000. And when that figure is combined with the number of veterans who go it alone, it’s likely over 5,000, Gould estimated.
Legislative efforts
With Congress back from Thanksgiving recess, House and Senate lawmakers are set to begin formal conference negotiations on the fiscal 2024 Pentagon policy bill.
Among the thousands of proposals that members will wade through is one by Reps. Alexandria Ocasio-Cortez, D-N.Y., and Daniel Crenshaw, R-Texas, that would direct the Defense Department to study the use of psychedelics in the treatment of PTSD and other related illnesses in active duty servicemembers.
If included in the final version of the bill and passed into law, the provision would be a first for the Defense Department. It’s something Ocasio-Cortez has advocated for since 2019, when she tried unsuccessfully (91 for, 331 against) to attach a similar amendment to an appropriations package.
“Every time we bring this issue up we gain ground. When I first introduced an amendment on this, people were laughing at it. Fast forward a couple of years and it’s now actually taken very, very seriously,” Ocasio-Cortez said in an interview.
According to Ocasio-Cortez, that unsuccessful vote four years ago sparked national interest in the issue.
“When people saw how out of step Congress was with the general public on this issue, that’s when we started seeing the outpouring of support from veterans and survivors of sexual trauma,” she said.
In the days following the vote, members not only approached Ocasio-Cortez to apologize, she said, but subsequently changed their positions. And the issue has attracted champions on both sides of the aisle.
At a news conference earlier this year, Crenshaw, a conservative, acknowledged his unlikely pairing with Ocasio-Cortez, one of the most progressive members of Congress. “This is a wild coalition, okay?” Crenshaw said.
“But everybody’s on the same page because there’s a realization that these therapies are working. There’s already some pretty solid studies, specifically on MDMA, that show just unbelievable outcomes — massive reductions in PTSD symptoms. We need to keep replicating those studies,” he said.
And other psychedelics-related pieces of legislation are also working their way through Congress.
In July, Bergman and Correa successfully offered an amendment to the fiscal 2024 Military Construction-VA appropriations bill that pushed the VA to carry out “large-scale studies” into drugs like psilocybin and MDMA.
This month, Carolyn Clancy, VA assistant undersecretary for health for discovery, education, and affiliate networks, told the House Veterans’ Affairs Subcommittee on Health that her agency is conducting several studies on the topic.
Changing attitudes
Correa and Bergman, a former Marine Corps lieutenant general and the highest-ranking combat veteran to serve in the House, have been working to bring awareness to the possibilities surrounding psychedelics.
As co-chairs of the PATH Caucus, the pair hold regular briefings with lawmakers, inviting those who they feel “will have an open mind” toward new applications for psychedelics.
In an interview, Bergman described one such briefing also attended by veterans who had found success in treating their illnesses with psychedelics.
“We brought in veterans who had gone to Mexico to get the treatment, and it was powerful. There’s no other word. And I had a few members who said they couldn’t thank us enough because it opened their eyes,” Bergman said.
Bergman and Correa both said they felt a shift in momentum among lawmakers as, little by little, more members come around to seeing psychedelics in a positive light.
House Armed Services ranking member Adam Smith, D-Wash., who has talked publicly about his own experiences in psychotherapy to overcome chronic anxiety, said he was supportive of the push in Congress to study the drugs, but that non-pharmaceutical options should also be considered by those seeking treatment.
“I think [the legislation] makes sense,” he said, “but you’re messing with some pretty complicated stuff and introducing drugs into that. It’s worth pursuing, but it’s also worth aggressively pursuing some non-pharmaceutical options.”
But Senate Armed Services Chairman Jack Reed, D-R.I., foreshadowed possible headwinds in his chamber.
“Generally speaking, a study of a serious subject like this is something we would include in the NDAA, but it’s a new topic and for some people it may be the first they’ve heard about it,” Reed said in an interview.
That hesitancy could mean that the provision from Ocasio-Cortez and Crenshaw is dropped from the final version of the bill. Even if that were to happen, however, it appears clear that momentum for the study and use of psychedelics in the U.S. is steadily building, and other avenues besides the NDAA exist.
Brett Waters, the founder of Reason for Hope, an organization that advocates for access to so-called psychedelic medicine and assisted therapies, said the last few years have shown a clear shift toward understanding and acceptance of psychedelics in the U.S.
“The way people describe psychedelics is unlike the way they talk about any other therapy,” Waters said. “They say it was life changing, or one of the most meaningful things to ever happen to them. And as more legislators are hearing those stories from veterans and others it’s having an incredibly compelling effect.”
