The Department of Veterans Affairs has selected ten hospitals to begin offering psychedelic-assisted therapy and is declining, for now, to say which ones. The program is aimed at the roughly 2.1 million veterans in VA care who carry a diagnosis of post-traumatic stress disorder, major depressive disorder or treatment-resistant depression — and it is being built before any of the drugs involved has been cleared for those uses.
Andrew Gradison, a senior adviser at the Veterans Health Administration, laid out the plan at a psychedelic policy forum in New York in mid-October, and the agency's ambitions were reported this past weekend by Politico. The sites chosen are likely to be those that already ran psychedelic clinical trials, Gradison said.
The arithmetic of the rollout
The scale is what makes the ten-site number worth reading twice. The VA covers about 9 million veterans, of whom 6.4 million get care regularly. Within that group sit the 2.1 million diagnoses the program targets.
Against that, Gradison's own estimate of first-year capacity was deliberately modest: treating "four digits' worth of patients" in year one would be a challenge, he said, and demand will outrun supply. Four digits against 2.1 million is a rollout reaching, at best, something under one in a thousand of the eligible population in its first year.
He also put a date on the earliest possible start. In the "rosiest scenario," he said, the medicines could become available in January or February, and the VA would begin treating patients immediately. The agency has stood up what it calls a community of practice to prepare clinicians in the meantime.
No approval yet
The regulatory gap is the part of this that has drawn criticism. No regulator has determined that these drugs are safe and effective treatments for mental illness. The Food and Drug Administration rejected MDMA for PTSD in 2024, and the substances under discussion across federal programs — MDMA, psilocybin, LSD, ibogaine and ketamine among them — sit at very different stages of evidence.
The policy push around them has moved faster than the approvals. An executive order signed in April 2026 directed the FDA to speed its review of several psychedelic treatments and committed at least $50 million to ibogaine research. In July, the VA and the Department of Health and Human Services signed a memorandum of understanding to expand trial participation, train clinicians to administer the drugs if they are federally approved, and collect data for patients, doctors and regulators. VA Secretary Doug Collins described it at the time as turning research into treatment.
VA researchers are already involved in more than 20 psychedelic trials, including a study in Providence, Rhode Island, comparing MDMA-assisted therapy with a placebo in 80 veterans. A Defense Department study at Walter Reed National Military Medical Center, looking at MDMA for mild to moderate PTSD, has a $4.9 million budget.
Why the department is pushing
The case the VA makes rests on how poorly existing treatment serves part of this population. Studies cited in the debate suggest roughly a third of PTSD cases resist conventional treatment, as many as half do not respond to psychological therapy, and about 40% are not treatable with the drugs commonly prescribed.
Veterans themselves are ahead of the institutions in one respect and behind them in another. A RAND study estimates 4.8 million U.S. veterans have used psychedelic drugs — lifetime use of 19.6% for LSD and 18.6% for psilocybin — while support for legalizing their use is narrower: 23% for psilocybin, 11% for LSD and 9% for MDMA.
Reporting from Politico, Psychedelic Alpha and Military Times.
