The Case Against Trump's Psychedelic Executive Order — And Why It Falls Short
A full written analysis of my debate with a former Obama/Bush drug policy advisor & renowned Johns Hopkins psychedelic researcher.
When President Trump signed an executive order accelerating federal action on psychedelic therapies, the response from many advocates was celebratory. For veterans, addiction patients, and people with treatment-resistant depression, the order looked like long-overdue recognition that America’s mental health crisis demands new tools.
But not everyone was convinced.
On my podcast, I debated the order with Dr. Kevin Sabet, a former drug policy advisor in the Obama, Bush, and Clinton administrations, and Dr. Matt Johnson, a psychiatry professor at Johns Hopkins and one of the world’s leading psychedelic researchers. Sabet is one of the most articulate critics of drug liberalization in America, and his critique deserves to be taken seriously. His core concern is not that psychedelic compounds have no medical potential. In fact, he repeatedly acknowledged that they may. His concern is that America may be “putting the cart before the horse”: allowing hype, politics, celebrity influence, Silicon Valley investment, and desperation to outrun the science.
The executive order, signed on April 18, directs the FDA to prioritize certain psychedelic drugs with Breakthrough Therapy designation, helps create a pathway for eligible patients to access investigational psychedelics under Right to Try, and calls for support for research, including ibogaine compounds. The FDA soon announced National Priority Vouchers for three psychedelic-related programs, a mechanism intended to speed review timelines while maintaining safety and efficacy standards.
Sabet’s argument is the best version of the skeptical case: psychedelics may help some people, but the culture around them is moving too quickly, too emotionally, and too commercially. But after pressing each of his objections one by one, I came away believing that the executive order is far more modest — and far more defensible — than its critics suggest.
1. “The psilocybin depression studies are weaker than advocates admit”
Sabet’s first major argument was that the evidence base for psychedelics, especially psilocybin for depression, has been oversold (he wrote about this in Unherd). He pointed to methodological weaknesses, potential conflicts of interest, small sample sizes, weak control groups, and a broader tendency in psychedelic culture to inflate early findings into grand claims.