Written by Spring 2026 M-VETS Student Advisor Cole Smith
Servicemembers can encounter traumatic events during their service, leading to Post-Traumatic Stress Disorder (PTSD) or Traumatic Brain Injury (TBI). PTSD and TBI can cause functional impairments and may lead to anxiety or depression. Many treatment pathways exist to help a veteran cope with these conditions, but none of the current treatment pathways can fully cure PTSD or TBI. However, some veterans have begun to use a psychedelic drug called ibogaine and have reported significant improvement in their symptoms, with some reporting an almost perfect cure. Ibogaine, derived from a root found in Africa, has traditional uses in religious and healing ceremonies.[1] Veterans have described the experience of using ibogaine as entering a dreamlike state that allows them to contemplate and understand events more deeply, and, when it wears off, leaving them with a feeling of fulfillment.[2] In some circumstances, the veterans may no longer want to use alcohol or other substances.[3] Although there are promising results for veterans, the federal government classified ibogaine as a Schedule I hallucinogenic substance.[4] Because of the classification, the Department of Veterans Affairs (VA) cannot offer ibogaine as a treatment option.[5]
States across the country have begun laying the groundwork to support ibogaine’s development as a potential treatment for PTSD, TBI, and related conditions by funding or proposing Food and Drug Administration (FDA) compliant research pathways. Texas recently authorized a clinical trial of ibogaine to provide veterans with access to the treatment option. The Texas statute S.B. 2308 creates a state-run clinical trial of ibogaine to accelerate federally recognized clinical development.[6] The Texas model creates a partnership between academics, drug manufacturers, and hospital administration to provide a research-based approach to approval.[7] Some other states have begun to propose legislation that replicates Texas’s approach, allowing their own clinical trials of ibogaine as a limited treatment option.[8]
The effectiveness of encouraging the federal government to adopt the treatment plan through state-level legislation is limited. Sam Adriance explains that state-level legislation can “persuade policy makers at other levels of government” to secure the right to try the medication or treatment, such as ibogaine, for veterans.[9] Adriance’s article evaluates the general right-to-try principles and their effects on the federal government through state-level legislation, but it is also relevant to the expansion and use of ibogaine for veterans.[10] The dual system of legislation in the medical world can prevent, or effectively slow access to, treatment. Although some states, like Texas, created paths for veterans to “bypass” the federal system, the federal system disincentivizes drug corporations from participating in expansive state-level programs because state law may conflict with federal law, and the companies lack federal liability protections.[11] Additionally, ibogaine is distinguishable from marijuana, which has a large non-medical market for recreational use. In contrast, ibogaine is not a recreational drug with a large following, which could further slow the use of ibogaine in the veteran population, absent FDA approval.[12]
The VA has a primary mission to provide “complete medical and hospital services” for veterans; however, the VA has a gap in its treatment options for PTSD or TBI, thus providing incomplete medical services for veterans.[13] The VA can address this gap in treatment through the further evaluation of ibogaine and, eventually, adding it as a treatment option for veterans with PTSD or TBI. Congress has addressed the perpetual gap in medical treatments that would exist absent the introduction of new treatment plans or options within the VA hospitals. Congress requires the Secretary of Veterans Affairs to “carry out a program of medical research in connection with the provision of medical care and treatment to veterans.”[14] The research shall address mental health and rehabilitative treatment options, and it must stress “injuries and illnesses particularly related to service.”[15] These research requirements perfectly align with the investigation and evaluation of the use of ibogaine for PTSD and TBI for veterans. The VA has the framework that could allow for a limited treatment plan to help veterans through VA hospitals.
The Right To Try provision under 21 U.S.C. § 360bbb-0a offers a narrower avenue to treatment. For a veteran to qualify under the statute, they must have a life-threatening disease or condition, have exhausted approved treatment options, and have written informed consent.[16] PTSD or TBI may not meet the definition of life-threatening in most cases; however, in rare cases that meet the exception, the eligible patient may be able to use the investigational drug, provided the sponsor makes it available.[17] Essentially, for a veteran to qualify under the Right To Try statute, they must provide informed consent, demonstrate that the PTSD or TBI is life-threatening, and exhaust most, if not all, available treatment options, which could take several years, with the uncertainty of ever being able to try ibogaine as a treatment option. However, if the VA complies with the Controlled Substances Act research guidelines under the FDA’s regulatory scheme, the VA may provide ibogaine as a treatment option for some veterans.
The Schedule I classification complicates VA’s ability to administer ibogaine.[18] VA will need to proceed through the Schedule I research pathway to offer ibogaine.[19] A qualified VA practitioner-researcher would need Schedule I research registration under 21 U.S.C. § 823(g)(2)(A). The Drug Enforcement Administration (DEA) would process the application and forward it, along with the protocol, to the Secretary of Health and Human Services for review of the applicant’s qualifications and the merits of the protocol.[20] For a clinical investigation, the VA must submit the required Investigational New Drug (IND) materials to the FDA.[21] VA may pursue access to ibogaine through a federally supervised research and investigational drug pathway, which would allow access to ibogaine for some veterans.
Once the VA clears the Schedule I barrier, expanded access appears to be a stronger route than the Right To Try because the FDA may authorize access for patients with a serious or immediately life-threatening disease or condition, not just a life-threatening one.[22] An expanded access IND can go into effect within 30 days of the FDA receiving the application, or earlier if the FDA allows treatment to begin sooner, such as in emergency cases.[23] The expanded access program through VA could work if the FDA concludes that veterans with PTSD or TBI have a serious or immediately life-threatening condition that has no comparable or satisfactory alternative therapy to treat it; the veterans’ benefits outweigh the potential risks; and providing ibogaine should not interfere with any clinical approvals.[24] The benefits of ibogaine could be as great as a complete cure or as low as some relief, and they may outweigh the potential cardiac risk of using it, which physicians could minimize through screening or by administering magnesium.[25] Whether expanded access within the VA interferes with ongoing clinical investigations into ibogaine, it could be limited through proper screening of VA personnel and participants, while also supporting further research into the drug’s efficacy. The VA will have to follow the safeguards required by the regulation, but because some VA facilities already have hospital-based infrastructure, many of the requirements may already be in place.[26] The largest gaps in VA’s framework are the investigator and sponsor roles, and they will have to ensure that physicians meet the required qualifications and receive the necessary information.[27]
Ibogaine is a promising treatment option that could help many veterans with PTSD or TBI. The current VA framework includes a pathway that would allow for a limited treatment plan to help veterans through VA hospitals. The VA can use the expanded access pathway through clinical investigations conducted under an IND application.[28] The VA will fulfill its primary mission of providing “complete medical and hospital service for the medical care and treatment of veterans” by adding the new treatment option for PTSD or TBI, which could help many more veterans.[29] If the VA begins to administer ibogaine, it will reach the veterans who need it and save those who otherwise might not have received the treatment. While this path may not be the quickest, it promises to make a profound and lasting impact on the veteran community.
[1] See Kirsten N. Cherian et al., Magnesium–Ibogaine Therapy in Veterans with Traumatic Brain Injuries, 30 Nature Med. 373, 374 (2024).
[2] See Cherian et al., supra note 1, at 374; Shawn Ryan Clips, Navy SEAL Shawn Ryan Shares Profound Experience With Ibogaine (Feb. 11, 2023), YouTube, https://www.youtube.com/watch?v=9-vEIopSPxo.
[3] See Navy SEAL Shawn Ryan Shares Profound Experience With Ibogaine, supra note 2.
[4] See 21 C.F.R. § 1308.11(d)(21).
[5] See 38 C.F.R. § 17.38(c)(3).
[6] See S.B. 2308, 89th Leg., R.S. § 491.051(a) (Tex. 2025).
[7] See S.B. 2308, 89th Leg., R.S. § 491.051(b)(1)–(3) (Tex. 2025).
[8] See, e.g., S.B. 2308, 89th Leg., R.S. §§ 491.051, .053, .056, .057 (Tex. 2025) (enacted) (building a state ibogaine clinical-trial infrastructure tied to Investigational New Drug submission and FDA approval); S.B. 2149, 114th Gen. Assemb. §§ 33-12-104(b), -105(b)(2)–(4), -108, -109, -116 to -118 (Tenn. 2026) (pending) (authorizing state-supported ibogaine drug-development clinical trials, requiring Investigational New Drug submission, and limiting trial sites to research institutions or hospitals); Assemb. B. 9583, 2025–2026 Leg., Reg. Sess. § 3399(1)–(4) (N.Y. 2026) (pending) (proposing a competitive grant program for FDA-compliant clinical trials of ibogaine for veterans with PTSD, limited to entities capable of Phase II or III trials seeking FDA approval); H.B. 1477, 2026 Leg., Reg. Sess., proposed Md. Code Ann., Health-Gen. § 13-5902(b)–(e) (Md. 2026) (pending) (proposing an ibogaine clinical research grant program for FDA-overseen clinical drug-development trials, administered in consultation with Maryland’s Department of Veterans and Military Families).
[9] See Sam Adriance, Fighting for the “Right To Try” Unapproved Drugs: Law as Persuasion, 124 Yale L.J. F. 148, 149 (2014).
[10] See Id.
[11] See Id. at 153.
[12] Id. at 154–55.
[13] See 38 U.S.C. § 7301(b).
[14] See 38 U.S.C. § 7303(a)(1).
[15] See 38 U.S.C. § 7303(a)(2)–(3).
[16] See 21 U.S.C. § 360bbb-0a(a)(1)(A)–(C); 21 C.F.R. § 312.81(a)(1)–(2) (defining life-threatening as “Diseases or conditions where the likelihood of death is high unless the course of the disease is interrupted; and [d]iseases or conditions with potentially fatal outcomes, where the end point of clinical trial analysis is survival”).
[17] See 21 U.S.C. § 360bbb-0a(b).
[18] See 21 C.F.R. § 1308.11(d)(21).
[19] See Advanced Integrative Med. Sci. Inst., PLLC v. U.S. Drug Enf’t Admin., 128 F.4th 1133, 1144–45 (9th Cir. 2025) (explaining that practitioner use of Schedule I substances is limited to bona fide research and the requesting party must show their proposal is consistent with public health and safety).
[20] See 21 U.S.C. § 823(g)(2)(A); 21 C.F.R. § 1301.32(a), (c).
[21] See 21 C.F.R. §§ 312.20(a)–(b), 312.23(a), 312.40.
[22] See 21 C.F.R. § 312.305(a)(1).
[23] See 21 C.F.R. § 312.305(d)(1)–(2).
[24] See 21 C.F.R. § 312.305(a)(1)–(3).
[25] See 21 C.F.R. § 312.305(a)(1)–(3); Cherian et al., supra note 1, at 373.
[26] See 21 C.F.R. § 312.305(c)(1)–(5).
[27] See 21 C.F.R. § 312.305(c)(4)–(5).
[28] See 38 C.F.R. § 17.38(c)(3).
[29] See 38 U.S.C. § 7301(b).