Us veterans and psychedelics

2- Research Report

Prevalence of Use and Policy Preferences

MICHELLE PRIEST, TERRY L. SCHELL, BEN SENATOR, BEAU KILMER

KEY FINDINGS

• Nearly one in four veterans supported the legal use of psilocybin mushrooms. The rates for LSD and MDMA were 11 percent and 9 percent, respectively.
• Veterans’ support for the legal use of psilocybin mushrooms, LSD, and MDMA was generally similar to nonveterans’ support. However, veterans were slightly more likely to support the legal use of psilocybin mushrooms and LSD than nonveterans of a similar age, gender, race, and ethnicity.
• Approximately 4.8 million veterans had used psilocybin, LSD, or MDMA in their lifetime.
• Veterans were slightly more likely to have used LSD in their lifetime than nonveterans.
• Less than 1 percent of veterans had used ibogaine or iboga in their lifetime. About 5 percent of veterans who had never used ibogaine or iboga were willing to try it.
• Nearly half of veterans were unsure whether a veteran would risk losing U.S. Department of Veterans Affairs (VA) benefits if they spoke to their VA doctors about use of psilocybin mushrooms (48 percent) or MDMA (46 percent).
• About half of veterans supported VA providing or paying for psilocybin-assisted therapy (54 percent) or MDMA-assisted therapy (45 percent) if approved by the U.S. Food and Drug Administration.

Introduction

The use of psychedelics is increasing in the United States. Data from the National Survey on Drug Use and Health (NSDUH) suggest that the share of Americans who used a psychedelic substance in the past year increased 33 percent from 2021 to 2024 (U.S. Substance Abuse and Mental Health Services Administration [SAMHSA], 2021; SAMHSA, 2024). This was likely driven by increased use of psilocybin mushrooms (“magic mushrooms”) and ketamine (Chen, Berg, and Yang, 2026; Priest et al., 2026).

The study of psychedelics is also increasing in clinical settings. Dozens of clinical trials are currently assessing the effects of psilocybin, 3,4-methylenedioxymethamphetamine (MDMA, also known as ecstasy), lysergic acid diethylamide (LSD), and other psychedelics to treat such mental health conditions as posttraumatic stress disorder (PTSD) and treatment-resistant depression (Chen, Berg, and Yang, 2026; Haichin, 2026; Kilmer et al., 2024; Priest et al., 2026). Numerous studies on psychedelics have been published from completed randomized controlled trials (Dominiak et al., 2025; Norring and Spigarelli, 2024), some of which have generated a large amount of interest and media attention (e.g., Jacobs, 2021; Pollan, 2018; White House, 2026).

This research and media attention likely motivated recent changes to some state laws on psychedelics. Although the U.S. federal government prohibits the supply and possession of most psychedelics outside approved medical research and some religious exemptions, this is not stopping some states from implementing or considering changes to their approaches to psychedelics. Oregon and Colorado legalized supervised psilocybin use for all adults, and New Mexico passed a law to allow supervised psilocybin use for adults with certain medical conditions (Oregon Revised Statutes 475A, 2025; Colorado Proposition 122, 2022; New Mexico Senate Bill 219, 2025). Colorado also goes further and allows adults to grow, possess, and share psilocybin and some other natural psychedelic substances (Colorado Proposition 122, 2022). Additionally, at least eight states have created working groups or task forces focused on making recommendations for potential changes to state psychedelics policies (UC Berkeley Center for the Science of Psychedelics, 2026).

Multiple bills related to psychedelics have also been recently introduced at the federal and state levels. For example, at the federal level there are bills to increase access to investigational drugs (including some psychedelic substances) to those with life-threatening medical conditions (e.g., S. 3346, 2025) and bills that would create a new office in the Veterans Health Administration to advance novel treatments for mental health, including some psychedelics if they are approved by the U.S. Food and Drug Administration (FDA; e.g., S. 4220, 2026). At the state level, dozens of bills related to various psychedelics have been introduced in 2026 (Psychedelic Alpha, undated). Some of these bills would provide state funding for clinical trials or trigger changes in state rescheduling following a federal change, but some go further. For example, some bills would allow access for adults with certain medical conditions regardless of federal status (e.g., Illinois H.B. 1143, 2025; Minnesota H.F. 2906, 2025)—somewhat similar to New Mexico’s approach to psilocybin. And in both New York and Massachusetts, bills were introduced that would allow for regulated psilocybin mushroom production and sales to adults 18 years and older (Massachusetts H. 4050, 2025; New York A2142A, 2025).

On April 18, 2026, President Donald Trump signed an Executive Order (EO) intended to expedite and fund more clinical research on psychedelics to treat mental health conditions (White House, 2026). The EO goes beyond research. For example, it orders the FDA and the Drug Enforcement Administration to “facilitate and establish a pathway for eligible patients to access psychedelic drugs, including ibogaine compounds, under the Right to Try Act” (White House, 2026). If implemented, this would increase access for “patients diagnosed with life-threatening diseases or conditions who have exhausted all approved treatment options and are unable to participate in a clinical trial to access certain drugs that have not been approved by the Food and Drug Administration” (FDA, undated). Furthermore, the EO called on the Attorney General and the Department of Health and Human Services to “initiate and complete review of any product containing a Schedule I substance that has successfully completed Phase 3 clinical trials for a serious mental health disorder” (White House, 2026). This could accelerate rescheduling some psychedelic substances under the Controlled Substances Act. If the FDA also approves the use of these substances for specific indications, that approval could facilitate them being prescribed and possibly covered by federal health insurers.

Veteran issues are prominently featured in many of these policy conversations and the media coverage surrounding psychedelics (e.g., Cooper, 2025; Jacobs, 2023). This is largely driven by the need to improve access to and efficacy of treatments for various mental health conditions, some of which, like PTSD, are much more common among veterans than non-veterans (Schell and Marshall, 2008; U.S. Department of Veterans Affairs [VA], 2025a). Multiple lawmakers (e.g., Representative Morgan Luttrell and Representative Jack Bergman) and nonprofit groups (e.g., Heroic Hearts Project, Veterans Exploring Treatment Solutions) are pushing to increase research and access to some psychedelics for veterans, and VA is now funding clinical research into the use of some psychedelics to treat PTSD and depression (Hultz, 2025; VA, 2024; VA, 2026b).

The EO specifically mentioned that veterans “often suffer in greater measure” from certain mental health conditions and suicide risk, and multiple veteran advocates were present at the EO signing ceremony. While veterans play a prominent role in psychedelics policy and research discussions, little is known about their use of specific psychedelic drugs, willingness to try these substances, and attitudes toward various policy options. This report fills these gaps by providing detailed information from the probability-based and nationally representative 2025 RAND Psychedelics Survey (RPS).

We have organized the report as follows. First, we provide additional background about the epidemiology of psychedelic use and policy preferences among U.S. veterans, noting the major gaps. We then provide additional information about the 2025 RPS and the analytic methods used throughout the report. Next, we present findings comparing the prevalence of specific psychedelics among veterans and nonveterans and the willingness to try various psychedelics among veterans. We then present findings on veterans’ opinions about various public policies related to psychedelics and VA. In the final section, we discuss the results and limitations of this analysis and offer ideas for future research.

Abbreviations

Background

Despite the increasing interest in the role of psychedelics in the treatment of veterans’ health, representative data on the prevalence of use of psychedelics and policy preferences among the U.S. veteran population are limited. Prior studies using convenience samples of veterans provide insights into the use of and beliefs about psychedelics (e.g., Davis et al., 2022); however, it is unclear how representative these views are of the larger veteran population.

One nationally representative study using multiple waves of the NSDUH (1985, 1988, 1990–2010) found that “prevalence of past-year hallucinogen use for all survey years combined is low: 0.89 percent for veterans and 1.5 percent for nonveterans” (Miech et al., 2013). A more recently nationally representative study of low-income veterans in the United States (n = 1,031) found that 5.6 percent reported lifetime use of any psychedelic substance for therapeutic purposes (Tsai, Witte, and Fate, 2025). We are not aware of any nationally representative studies of the full veteran population that have examined the prevalence of use of specific psychedelic substances.

Veterans might be expected to view psychedelic substances differently than nonveterans. For example, several factors may shape veterans’ attitudes toward MDMA: PTSD is more common in veterans than their civilian counterparts (VA, 2025a), MDMA received Breakthrough Therapy designation for the treatment of PTSD in 2017 (Wolfgang and Hoge, 2023), and the FDA approved Expanded Access for MDMA for PTSD in January 2020 (Wolfgang and Hoge, 2023). Similarly, veterans’ views may differ from nonveterans’ views on psilocybin for the treatment of depressive disorders. Psilocybin received the FDA’s Breakthrough Therapy designation in 2018 for treatment-resistant depression and in 2019 for major depressive disorder (Hejl et al., 2023; Wolfgang et al., 2025). However, we are not aware of any research comparing policy preferences for veterans and nonveterans.

Prior studies have found that veterans who have used psychedelics in the past have more positive views toward access for therapeutic purposes. For example, an analysis of a convenience sample of U.S. veterans (n = 426) found a statistically significant association between lifetime use of psychedelics and being more likely to be in favor of VA offering psychedelics-based treatment (Davis et al., 2022). Furthermore, lifetime use of psychedelics was associated with veterans reporting higher levels of knowledge on the topic of psychedelic use for therapeutic purposes than veterans who reported that they had never used psychedelics (Davis et al., 2022). Findings in Tsai, Witte, and Fate’s (2025) study of low-income veterans found that veterans who reported more frequent mental health issues and substance disorders were more likely to have used and support the legalization of psychedelics for therapeutic purposes. In that low-income veteran sample, support for legalization of psychedelics for therapeutic purposes was estimated to be 23.2 percent (Tsai, Witte, and Fate, 2025).

However, asking policy preference questions about the general class of drugs referred to as psychedelics without differentiating by substance can lead to incorrect inferences. Not only may survey respondents have different definitions of what a psychedelic substance is, but they may also feel differently about different substances. For example, if someone is supportive of using psilocybin for treating mental health disorders but not LSD, how will they answer a question that only asks about psychedelics?

Finally, there are also questions specific to VA policies that have not been addressed in nationally representative surveys of veterans. In contrast to what VA did for cannabis—nearly two decades after the first state legalized cannabis for medical purposes—VA has neither published a directive encouraging patients to discuss their use of psychedelics with VA providers nor made it clear that veterans would not be denied VA benefits for using any of these substances outside of clinical trials or as part of compassionate use programs, such as Expanded Access (Pardo et al., 2022; VA, 2023). We do not know what share of veterans believe that they would be at risk of losing VA benefits if they spoke to their VA doctors about their use of different psychedelic substances. Having a better sense of this could help inform discussions within VA about producing a cannabis-like directive for some psychedelics.

This report provides evidence on the use of psychedelics and policy preferences among a nationally representative sample of veterans.

Accounts of veterans using psychedelics—often for mental health purposes and frequently featured in media coverage—have influenced public and policy narratives around this issue. Evidence on use of psychedelics and policy preferences, including views on VA-related policies, among a nationally representative sample of veterans can provide valuable insights to inform policy decisions affecting veterans. This report provides such evidence with an intended audience of federal and state policymakers who are considering changes to psychedelics policies, VA administrators, members of veteran service organizations, and others interested in veterans’ perspectives on psychedelics.

Data and Methods

The RAND Psychedelics Survey

The RPS is a probability-based and nationally representative survey fielded to AmeriSpeak panelists. Operated by NORC at the University of Chicago, the AmeriSpeak panel is designed to be representative of the U.S. household population. Randomly selected U.S. households are sampled using area probability and address-based sampling, with a known, nonzero probability of selection from the NORC National Sample Frame. The panel provides sample coverage of approximately 97 percent of the U.S. household population. The AmeriSpeak panel has been used as a data source for nationally representative estimates in research related to health policy (Kennedy-Hendricks et al., 2024; McGinty et al., 2020; Miller et al., 2025; Taylor et al., 2021).

In the 2025 wave of the RPS, conducted from September 9, 2025, through October 1, 2025, panelists age 18 or older were interviewed primarily online (97.3 percent), and the remainder completed the survey over the phone (2.7 percent). In total, 10,122 panelists completed the survey with validated responses. The weighted response rate using the American Association of Public Opinion Research Response Rate 3 (AAPOR RR3) at the household level for AmeriSpeak panel recruitment is 26 percent. A recruited household is a household in which at least one adult successfully completed the recruitment survey and joined the panel. The weighted cumulative response rate, accounting for the panel recruitment, panel retention, and RPS survey completion, is 5 percent (NORC at the University of Chicago, 2025). This response rate is inclusive of all types of all potential nonresponse and is higher than other probability-based panels in the United States, which often report inclusive response rates close to 1 percent (NORC at the University of Chicago, 2024).

The RPS included an oversample of veterans to achieve a sufficient number of respondents for analyses conducted within that group. The oversample was identified by NORC based on existing demographic information maintained for the panel from the following question: Have you ever served on active duty in the U.S. Armed Forces, Reserves, or National Guard? Answer options were Yes, No, or I don’t know.

The survey questionnaire included questions about experiences and economics of the use of various psychedelic substances, as well as policy attitudes toward specific substances. We use the term use of psychedelics in this report to describe self-reported responses to these survey questions. In this report, we focus on an analysis of a subset of the questions related to psychedelic use and experiences of U.S. veterans, as well as some comparisons to responses of nonveteran U.S. adults. The exact wording of each survey question and answer options are described in the context of the relevant figures and tables in the “Findings” section and are listed in Appendix B. Additional information about the data collection methods, including the design of the survey weights, is available in the 2025 RPS Project Methods and Transparency Report (NORC at the University of Chicago, 2025).

Definition of Veteran Status

There are several reasonable ways to define veteran status, with different studies or organizations using slightly different definitions. In this study, we have data from a question that uses a broad definition of veteran status for all respondents, as well as a second question using a narrower definition for almost all respondents. We combined information across both of these questions to define veteran status in our analyses. Specifically, when both questions were available in the data, we counted someone as a veteran only if they qualified as a veteran on both questions. However, when only the broader question was available, we relied on that single question to determine veteran status. This procedure resulted in N = 1,339 veterans.

At the time the 2025 RPS was conducted in September 2025, NORC had existing demographic data for most panelists, including responses to this broad question about veteran status: Have you ever served on active duty in the U.S. Armed Forces, Reserves, or National Guard? Answer options were Yes, No, or I don’t know. These existing demographic data were collected at the time that panelists joined the panel and were periodically updated; however, some panelists may have skipped this question in previous demographic collection efforts. For respondents for which this data was missing, we asked the question in the 2025 RPS survey questionnaire. 1,528 respondents with a “Yes” response on this question were classified as possible veterans. Respondents with a “No” or “I don’t know” response were placed in the nonveteran group.

One potential limitation of using this single question to identify veterans is that it may label a small number of individuals as veterans who either (1) are currently on active duty or (2) were reservists who only served on active duty for training purposes. These two groups of individuals are not typically considered veterans by VA, and the survey question from the American Community Survey or Current Population Survey used to generate population targets for weighting is designed to align more closely with that narrower VA definition. Specifically, these surveys ask respondents to select one of the following responses to the question listed above, with only the final option counting as a veteran:

• Never served in the military
• Only on active duty for training in the Reserves or National Guard
• Now on active duty
• On active duty in the past, but not now.

AmeriSpeak panelists were asked this narrower question about veteran status with more detailed answer options from September to December 2025, shortly after the 2025 RPS was fielded. Eighty-six percent of the 1,528 respondents identified as possible veterans by the broad question about veteran status later responded to this second question with more detailed answer options. For N = 217 possible veterans, a response to this narrower question was not available, and their classification as veterans is based on the broader question. For N = 189 possible veterans, data from the narrower question indicated that they had only served on active duty for training or that they were still on active duty. Those respondents are not treated as veterans within this report. This procedure yielded a veteran analytic subsample of N = 1,339.

Analytic Weights

NORC created survey weights to account for the sample design and adjust for nonresponse. All estimates presented in the report are weighted. The analytic weights were derived by NORC to make the sample of 1,339 veterans representative of the U.S. veteran population on age, sex, race, region, education, and income using benchmarks from the March 2024 Current Population Survey (U.S. Census Bureau, 2025).

For analyses comparing veterans and nonveterans, we use two different sets of weights for nonveterans: either (1) weights derived by NORC that make the nonveteran sample representative of the U.S. nonveteran adult population using the same methods used with the veteran weights or (2) in adjusted models, a version of this population that was weight adjusted by our team to modify the nonveteran sample to match the age and sex distribution of the veteran population—specifically, the veteran distribution of age in five-year bands within each sex. Age and sex were used to adjust the nonveteran weights because the veteran population is substantially more male and older than the nonveteran population in the United States.

Additional information about the design of the survey weights is available in the 2025 RPS Project Methods and Transparency Report (NORC at the University of Chicago, 2025).

Analytic Methods

All analyses were conducted by RAND researchers in Stata version 17.0. Percentages of veterans endorsing each survey response were estimated using weights, as described in the “Analytic Weights” section. All estimates and 95-percent confidence intervals (CIs) from these analyses accounted for the survey weights and the survey design. The statistical estimates presented in this report are intended to be descriptive rather than to test a particular hypothesis across multiple statistics. Thus, we do not perform any correction for multiple hypothesis testing in this report. Item missingness rates for the survey questions included in this report were extremely low, generally less than 4 percent, and so results are based on complete-case analysis. See Table B.1 in Appendix B for a full listing of missingness by survey question.

We compare veterans and nonveterans on several outcomes. These comparisons were conducted using survey-weighted logistic regressions both with and without adjustment for the demographic differences between these two populations. The unadjusted comparisons assess the extent to which a representative sample of veterans differs from a representative sample of nonveterans on a given survey question. The adjusted comparisons assess the extent to which a representative sample of veterans differs from a demographically matched sample of nonveterans on a given survey question. The unadjusted comparisons use the survey weights designed to make the veteran and nonveteran subsamples representative of their respective U.S. populations. In contrast, the adjusted comparisons use doubly robust methods to control for age, sex, racial, and ethnic differences between the veteran and nonveteran populations. Specifically, these comparisons use the adjusted weights for non-veterans and include age, sex, race, and ethnicity as covariates in the logistic regression model in which the adjusted comparisons are made.

All comparisons are expressed as odds ratios (ORs) with 95-percent CIs. ORs less than 1 indicate responses that are more common among nonveterans than veterans, while ORs greater than 1 indicate responses that are more common among veterans than nonveterans. The unadjusted ORs compare the U.S. population of veterans and the U.S. population of adult nonveterans, while the adjusted odds ratios (AORs) compare the U.S. population of veterans and an analytic sample of nonveterans who are demographically similar to veterans.

Although p-values are included in the appendix tables for comparisons of veterans and nonveterans, readers should avoid focusing exclusively on statistically significant results. Strong claims about statistical significance may benefit from replication in another sample.

Use of AI Tools

Code for data analyses, formatting of tables, and summaries of tables were supported by ChatGPT 5.3. Data visualizations for figures were developed with assistance from Claude Sonnet 4.6. All AI outputs were generated with specific prompts in small chunks (for example, one figure or table was generated at a time), checked for accuracy, and refined in detail by the research team.

Findings

Prevalence of Use

All survey respondents were asked whether they had ever used the following psychedelic substances in their lifetime:

• Psilocybin mushrooms (“magic mushrooms”) or synthetic psilocybin—not including Amanita muscaria “fly agaric” mushrooms
• Amanita muscaria mushrooms (also known as “fly agaric” mushrooms)
• MDMA (also known as ecstasy or Molly) or MDA
• LSD (also known as acid)
• DMT (also includes ayahuasca, huasca, or yagé)
• 5-MeO-DMT (also known as 5 or toad)
• Mescaline (also known as peyote or San Pedro)
• Ibogaine or iboga
• Ketamine (also known as K or special K)
• Salvia divinorum (also known as diviner’s sage)
• 2C-B or other synthetic phenethylamines.

In the survey question, lifetime use was defined as any use, even a single occasion or use that occurred many years ago. The full text of the survey question is provided in Appendix B.

Figure 1 presents estimated differences in lifetime use of psychedelics between veterans and nonveterans. Among veterans, lifetime use was most common for LSD (19.6 percent) and psilocybin (18.6 percent), followed by MDMA (7.7 percent) and mescaline (7.7 percent), with lower prevalence for other substances (≤ 2.9 percent). See Figure 1 for the full list of percentages and 95-percent CIs.

Considering three of the most commonly discussed psychedelics, we estimated that 27.4 percent (95-percent CI: 24.0–31.0) of veterans had used one or more of psilocybin mushrooms, LSD, or MDMA in their lifetime, which translates to approximately 4.8 million veterans.

Veterans had higher odds of lifetime use of LSD (OR = 1.50) and mescaline (OR = 1.79) and lower odds of use for MDMA (OR = 0.68) relative to nonveterans. Veterans also had significantly lower odds of lifetime use of DMT (substances including N,N-dimethyltryptamine, such as ayahuasca) and 5-MeO-DMT (substances including 5-methoxy-N,N-dimethyltryptamine, also known as 5 or toad) than nonveterans did, although these estimates should be interpreted with caution because of substantial uncertainty indicated by the very wide CIs.

After adjustment for age, sex, race, and ethnicity, most differences were not statistically significant. The exception was LSD, for which veterans continued to have higher odds of lifetime use than demographically similar nonveterans did (AOR = 1.26).

Respondents who reported lifetime use of any of these substances were asked follow-up questions about how recently they had last used each substance. See Appendix B for details of the question wording. Figure 2 shows that past-year use among all veterans is rare across substances, with prevalence below 3 percent for all substances.

Because of the generally low prevalence of past-year use among veterans, the comparisons to nonveteran past-year use are relatively imprecise. Even for the most commonly used substances, CIs are wide. This imprecision limits the ability to draw firm conclusions about differences between veterans and nonveterans in recent use, particularly for less commonly used substances, for which estimates are especially unstable. Similarly, readers should avoid interpreting the lack of significant differences as suggestive of similar rates of use; in many cases, this study has extremely limited power to detect meaningfully large differences in prevalence of use between veterans and nonveterans.

With these caveats in mind, there is some evidence suggesting lower odds of past-year use among veterans than nonveterans for psilocybin (OR = 0.56) and Amanita muscaria (OR = 0.43), while other substances showed no statistically significant differences. However, after adjusting for demographic differences between veterans and nonveterans, none of the differences were statistically significant.

Figure 1. Lifetime Use Among Veterans, Compared with Nonveterans’ Use

NOTE: Exact values for estimates, 95-percent CIs, and p-values for comparisons are presented in Table A.1 in Appendix A. ORs less than 1 indicate responses that were more common among nonveterans than veterans, while ORs greater than 1 indicate responses that were more common among veterans than nonveterans.

Figure 2. Past-Year Use Among Veterans, Compared with Nonveterans’ Use

NOTE: Exact values for estimates, 95-percent CIs, and p-values for comparisons are presented in Table A.2 in Appendix A.

Willingness to Try

Respondents who reported no lifetime use of a given substance or who skipped the lifetime use question were asked this question: Would you consider trying the following substances? Response options were as follows:

• Would never try
• Unlikely to try
• Might be willing to try
• Very willing to try
• I’m not sure.

Table 1 presents responses to the lifetime use and willingness to try questions among all veterans. We focused this analysis on the veteran group and made comparisons between substances rather than between veterans and nonveterans. Responses are organized into four categories:

1. lifetime use (from the previously described question)
2. willing to try (Very willing to try and Might be willing to try response options)
3. not willing to try (Unlikely to try and Would never try response options)
4. unsure.

About 5 percent of veterans who had never used ibogaine or iboga were willing to try it.

Despite similar rates of lifetime use for psilocybin and LSD, willingness to try was higher among veterans for psilocybin (11.1 percent [95-percent CI: 9.3–13.3]) than for LSD (5.1 percent [95-percent CI: 3.6–7.0]), suggesting that psilocybin may be viewed more favorably. For substances with lower lifetime use, willingness to try often exceeded lifetime use, indicating curiosity despite limited exposure. For example, lifetime use of ibogaine or iboga was estimated at 0.3 percent (95-percent CI: 0.1–0.7), and willingness to try was 5.0 percent (95-percent CI: 3.8–6.4). This difference was similar for DMT, with lifetime use estimated at 1.2 percent (95-percent CI: 0.7–2.1) and willingness to try at 8.3 percent (95-percent CI: 6.6–10.3). Overall, however, the majority of veterans were not interested in trying any of these substances, especially those that were less commonly used.

Table 1. Willingness to Try Psychedelics, Among All Veterans

NOTE: Lifetime use estimates in this table may vary slightly from the estimates shown in Table A.1 because some veterans who skipped the lifetime use question went on to answer the willingness to try question.

Attitudes Toward Legal Use

To assess attitudes toward the legalization of psychedelic substances, all survey respondents were asked whether the use of psilocybin mushrooms, LSD, and MDMA should be legal, with response options of Yes, No, or I don’t know. A question with the same wording was also included for marijuana for comparison. Marijuana is not considered a psychedelic substance in this report; rather, it is included as another federally prohibited substance that has seen substantial policy changes in recent years, especially by U.S. states, which gives some context to the level of support for the legal use of psychedelics.

Veterans were slightly more likely than demographically similar nonveterans to support the legal use of psilocybin mushrooms and LSD.

Figure 3 presents the likelihood of endorsing legal use (Yes question response) among all veterans and compares that to nonveterans’ likelihood of endorsing legal use. Among all veterans, support for legal use was 23.0 percent for psilocybin mushrooms, 11.4 percent for LSD, and 8.5 percent for MDMA. For comparison, this same figure was considerably higher for marijuana, at 60.7 percent.

When comparing veterans and nonveterans, there were no statistically significant differences in their average attitudes about legal use of psilocybin mushrooms, LSD, or MDMA; however, veterans were less likely to support the legal use of marijuana (OR = 0.83). After adjusting for age, sex, race, and ethnicity, veterans had higher odds of supporting the legal use of psilocybin mushrooms (AOR = 1.34) and LSD (AOR = 1.41) than demographically similar nonveterans did. There were no statistically significant differences for MDMA or marijuana after adjustment for demographic differences between veterans and nonveterans.

Figure 3. Veterans’ Perspectives on Legal Use of Psychedelics, Compared with Nonveterans’ Perspectives

NOTE: Marijuana is shown for comparison but is not considered a psychedelic substance in this report. These results are presented in Table A.4 in Appendix A, along with p-values. “No” and “I don’t know” responses are combined for these analyses.

Attitudes on VA Policies

All veteran respondents were then asked specific survey questions about their perspectives on VA policies related to psychedelics. In two separate questions, one for psilocybin mushrooms and one for MDMA, veteran respondents were asked whether they thought a veteran would be at risk of losing VA benefits if they spoke to their VA doctors about their use of each substance. Response options were as follows: Yes, I think they could lose VA benefits; No, I don’t think they could lose VA benefits; or I’m not sure.

Figure 4 shows that across both substances, nearly half of veterans were unsure of the impact on VA benefits—48.1 percent for psilocybin mushrooms and 46.3 percent for MDMA were unsure. Fewer veterans believed that a veteran would not lose VA benefits (35.6 percent for psilocybin mushrooms and 32.9 percent for MDMA), while a smaller share believed that a veteran could lose VA benefits (16.3 percent for psilocybin mushrooms and 20.8 percent for MDMA). For both substances, about two-thirds of veterans did not feel confident (“yes” or “unsure” responses) that a veteran disclosing their use of psychedelics to VA providers would not jeopardize a veteran’s VA benefits.

Figure 4. Perceived Impacts of Use on VA Benefits, Among All Veterans

Veteran respondents were then asked, in two separate questions, how VA should provide psilocybin-assisted therapy and MDMA-assisted therapy if each were approved by the FDA. Each question included a description of the therapy; the following description is for psilocybin mushrooms (the MDMA-assisted therapy description is in Appendix B): Psilocybin-assisted therapy is the use of the active ingredients in psilocybin mushrooms (“magic mushrooms”) to treat mental or physical health conditions, often combined with psychotherapy. For each substance, respondents selected one of the following options:

• VA should not provide it at all
• Only VA healthcare professionals should provide it
• VA should pay for it, but only community health care professionals should provide it
• VA should pay for it, and either VA or community healthcare professionals should provide it
• I’m not sure.

Figure 5 shows that among the three options where VA does provide these services, veterans most frequently endorsed VA paying for care and allowing provision by either VA or community providers (28.8 percent for psilocybin and 23.3 percent for MDMA). Smaller proportions of veterans preferred VA-only provision (22.0 percent for psilocybin and 18.8 percent for MDMA). Relatively few respondents supported limiting provision exclusively to community providers (3.1 percent for psilocybin and 2.8 percent for MDMA). Opposition to any VA involvement in paying for or providing these provisions was higher for MDMA than for psilocybin (21.9 percent versus 15.1 percent). One-third of veterans were unsure how VA should provide these types of services (31.1 percent for psilocybin and 33.2 percent for MDMA). Combining responses of support (i.e., only VA provides, VA pays but only community providers provide services, and VA pays and either VA or community providers provide services), 53.9 percent of veterans supported VA provision for psilocybin-assisted therapy, and 44.9 percent supported VA provision for MDMA-assisted therapy.

Figure 5. How VA Should Provide Psychedelic-Assisted Therapy If Approved by the FDA, Among All Veterans

Discussion

Accounts of veterans using psychedelics to treat mental health conditions—often after they have tried multiple treatments but are still suffering—have influenced public and policy narratives around this issue. Data on use of psychedelics and policy attitudes among a representative sample of veterans are a useful addition to these discussions.

Findings from the 2025 RPS suggest that veterans hold nuanced and, in some respects, distinctly favorable views toward some psychedelic substances compared with members of the general public after controlling for age, sex, race, and ethnicity. After accounting for demographic differences, veterans were slightly more likely than nonveterans to support the legal use of psilocybin and LSD, even though rates of support remained modest in absolute terms. This pattern is notable given that we were unable to identify statistically significant differences in the unadjusted comparisons. This means that veterans, who are generally older than nonveterans and mostly male, were more likely to hold favorable attitudes toward the legal use of some psychedelics than nonveterans with similar demographic characteristics were.

In terms of use, veterans were more likely to have used LSD in their lifetime, even after demographic adjustment. Past-year use of psychedelics was rare across all substances, and differences in past-year use were not statistically significant between veterans and nonveterans. Note, however, that these estimates are imprecise and CIs are often wide. Readers should avoid interpreting the lack of significant differences as suggestive of similar rates of use; in many cases, this study has extremely limited power to detect meaningfully large differences in prevalence of use between veterans and nonveterans. The share of veterans who have used or are willing to try psychedelics varies by substance. For substances with lower lifetime use, willingness to try often exceeded prior use among veterans.

Among the survey question options in which VA hypothetically pays for or provides psychedelic-assisted therapy, veterans most commonly endorsed a flexible arrangement in which VA covers costs and allows treatment by either VA or community providers. This combination of choice and access rather than institutional exclusivity is similar to how VA currently works with respect to medically necessary treatment, suggesting that veterans feel that psychedelic-assisted therapy should be treated like other treatments.

Among all veterans, there was substantial uncertainty about whether a veteran who spoke to VA doctors about their use of psilocybin mushrooms or MDMA would put their VA benefits at risk; this is not entirely surprising. On one hand, these drugs are federally prohibited outside of clinical trials and Expanded Access for MDMA. And, on October 1, 2025, the military added psilocin (the active metabolite from consuming psilocybin) to its standard drug testing program (Fuller, 2025). On the other hand, three states have legalized supervised psilocybin use, and Colorado allows adults to grow and give it away. Given the media attention related to veterans and these substances, messages to veterans around psychedelics are mixed.

Clear guidance about psychedelics for VA patients and clinicians could help bridge the gap between emerging science and veterans’ everyday health care decisions.

Psychedelics policy continues to evolve at the state level, and VA is advancing its investment in clinical trials for psychedelic-assisted therapy. In this shifting context, clear guidance for VA patients and clinicians could help bridge the gap between emerging science and veterans’ everyday health care decisions. As noted in the “Background” section, it took VA nearly 20 years after the first state legalized medical cannabis to issue guidance indicating that VA clients would not lose VA benefits if they discussed their cannabis use with their VA providers. If VA is not having conversations about issuing a similar directive with respect to certain psychedelic substances, now is the time to start.

Limitations

Multiple limitations should be considered when interpreting these findings. Although the 2025 RPS included an oversample of veterans, for such relatively rare events as past-year use of psychedelics or lifetime use of less commonly used psychedelics, the subsamples for analysis remain small. This is reflected in the wide CIs observed throughout the lifetime use and past-year use figures.

The sample may also not fully capture veterans who are most marginalized or difficult to reach through standard survey methods. For example, the AmeriSpeak survey panel covers 97 percent of households, which does not include those experiencing homelessness or severe mental illness. These populations may have distinct patterns of substance use and attitudes toward psychedelic-assisted therapy. More broadly, veteran status is a heterogeneous category encompassing considerable variation in service era, branch of service, combat exposure, and VA enrollment status. The analyses presented here treat veterans as a single group and cannot speak to which subpopulations are driving the observed patterns. Findings should therefore be interpreted as descriptive of veterans broadly and may not generalize to all veteran subpopulations, including recently separated service members or those with little or no engagement with VA services.

About one-fourth of panelists invited to take the 2025 RPS completed it. We have mitigated systematic differences between the respondents and the broader population of interest by weighting on a wide range of characteristics. However, it is possible that nonrespondents still have systematically different responses to these survey questions even if they are the same as respondents on the full set of weighting variables. This can result in biased estimates. For example, our estimates of psychedelic use may be too high if those who have never used psychedelics were less likely to take the survey than demographically similar individuals who have used them. Similarly, these estimates could be too low if those who have used psychedelics were less likely to take the survey than those who have not used them.

Finally, survey items asking about the risk of losing VA benefits and preferred models for VA-provided therapy were hypothetical in nature. Responses reflect respondents’ perceptions and attitudes at the time of the survey rather than documented behavior or verified policy knowledge, and attitudes in these areas may shift as the policy and regulatory landscape continues to evolve.

Future Research

Future research would benefit substantially from a larger, nationally representative sample of veterans. Even the federally funded NSDUH, one of the largest ongoing surveys of substance use in the world, yields an annual veteran subsample of only approximately 2,000 respondents. This small sample size limits the precision of estimates for less commonly used psychedelic substances and precludes detailed subgroup analyses. Larger samples of veterans that are nationally representative would enable researchers to investigate rarer events, such as use of psychedelics, in more detail.

Larger, nationally representative samples of veterans can enable subgroup analyses to examine the broader context around veterans’ use of psychedelics.

A larger veteran sample would enable subgroup analyses, such as comparisons between those who served in the post-September 11, 2001, period and earlier cohorts. It would also support moving beyond prevalence estimates to examine the broader context surrounding substance use. These data may shed light on supervision or accompaniment during use, whether veterans traveled to access substances in jurisdictions where they are legal or there is less legal risk, their intentions and motivations for use, support structures involved, and many more policy-relevant questions. For substances with low prevalence, targeted convenience sampling among veterans who have used psychedelics may be a practical and informative complement to population-based approaches, allowing for more detailed characterization of use patterns that representative samples cannot reliably capture.

Finally, our question about willingness to try various psychedelic substances was very general. The question was not specific to a particular context of use, intention for use, or price point. More could be learned by asking about willingness to try under various scenarios (e.g., for therapeutic use only, if the FDA approves the drug, or if VA issued guidance that patients would not lose VA benefits by disclosing use). This is an area ripe for discrete choice experiments that could also incorporate questions about variation in costs to consumers to access psychedelic substances, along with questions about different types of supervision.

Appendix A: Supplementary Tables

Tables A.1 through A.6 present the underlying weighted estimates, ORs, CIs, and p-values used to produce the figures in this report.

TABLE A.1 Lifetime Use Among Veterans, Compared with Nonveterans’ Use

* p < 0.05.

TABLE A.2 Past-Year Use Among Veterans, Compared with Nonveterans’ Use

* p < 0.05.

TABLE A.3 Willingness to Try Psychedelics, Among All Veterans

NOTE: Lifetime use estimates in this table may vary slightly from the estimates shown in Table A.1 because some veterans who skipped the lifetime use question went on to answer the willingness to try question.

TABLE A.4 Veterans’ Perspectives on Legal Use of Psychedelics Compared with Nonveterans’ Perspectives

NOTE: For ORs related to “Yes” responses, “No” and “I don’t know” responses are combined. Similarly, for ORs on “I don’t know” (unsure) responses, “Yes” and “No” responses are combined. * p < 0.05.

TABLE A.5 Perceived Impacts of Use on VA Benefits, Among All Veterans

TABLE A.6 How VA Should Provide Psychedelic-Assisted Therapy If It Became FDA Approved, Among All Veterans

Appendix B: Survey Questions and Missingness

This appendix presents the full text of survey questions used in this report. Note that this is not the full list of survey questions asked in the 2025 RPS, and survey questions did not necessarily appear in this order on the questionnaire.

After the survey text, Table B.1 provides data on missingness among veterans compared with nonveterans.

Veteran Status Questions

Have you ever served on active duty in the U.S. Armed Forces, Reserves, or National Guard?

• Yes
• No
• I don’t know

Have you ever served on active duty in the U.S. Armed Forces, Reserves, or National Guard?

• Never served in the military
• Only on active duty for training in the Reserves or National Guard
• Now on active duty
• On active duty in the past, but not now

Prevalence and Use Questions

Have you ever used any of these substances in your lifetime? Select yes for any substance you’ve ever used, even if you only tried it one time or it was many years ago.

• Alcohol
• Marijuana (also known as cannabis)—not including CBD-only products or delta-8 THC
• Delta-8 THC—not including CBD-only products
• CBD-only products
• Psilocybin mushrooms (“magic mushrooms”) or synthetic psilocybin—not including Amanita muscaria “fly agaric” mushrooms
• Amanita muscaria mushrooms (also known as “fly agaric” mushrooms)
• MDMA (also known as ecstasy or Molly) or MDA
• LSD (also known as acid)
• DMT (also includes ayahuasca, huasca, or yagé)
• 5-MeO-DMT (also known as 5 or toad)
• Mescaline (also known as peyote or San Pedro)
• Ibogaine or iboga
• Ketamine (also known as K or special K)
• Salvia divinorum (also known as diviner’s sage)
• 2C-B or other synthetic phenethylamines

When was the last time you used it? If you’re not sure, give your best estimate.

• I used it in the past 30 days.
• I used it in the past year, but not in the past 30 days.
• I used it more than 1 year ago.
• I don’t remember.

When was the last time you used [psilocybin mushrooms (“magic mushrooms”) or synthetic psilocybin / LSD / MDMA or MDA]?

• 1–2 years ago
• 3–5 years ago
• 6–10 years ago
• More than 10 years ago
• I don’t remember

Would you consider trying the following substances? [Note: Question was asked if respondents reported no lifetime use or skipped the lifetime use question.]

• Would never try
• Unlikely to try
• Might be willing to try
• Very willing to try
• I’m not sure

Policy Preference Questions

Do you think the use of [substance] should be legal, or not? Substances: psilocybin mushrooms (“magic mushrooms”), LSD (“acid”), MDMA (“ecstasy” or “Molly”), marijuana

• Yes, legal
• No, not legal
• I don’t know

Do you think a veteran would be at risk of losing VA benefits if they spoke to their VA doctors about their use of [substance]? Substances: psilocybin mushrooms (“magic mushrooms”), MDMA (“ecstasy” or “Molly”)

• Yes, I think they could lose VA benefits.
• No, I don’t think they could lose VA benefits.
• I’m not sure.

If the FDA were to approve [psilocybin-assisted therapy / MDMA-assisted therapy], how should VA provide it? [Note: This was asked as two separate questions, one for psilocybin and one for MDMA.]

Psilocybin-assisted therapy is the use of the active ingredients in psilocybin mushrooms (“magic mushrooms”) to treat mental or physical health conditions, often combined with psychotherapy.

MDMA-assisted therapy is the use of the substance MDMA (also known as ecstasy or “Molly”) to treat mental or physical health conditions, often combined with psychotherapy.

• VA should not provide it at all.
• Only VA healthcare professionals should provide it.
• VA should pay for it, but only community health care professionals should provide it.
• VA should pay for it, and either VA or community healthcare professionals should provide it.
• I’m not sure.

TABLE B.1 Weighted Percentages of Missing Values by Survey Question

NOTE: All values are weighted with unadjusted weights. Missingness is generally higher for veterans, who are older and more male, than for nonveterans. When adjusting for age and sex, this pattern disappears, suggesting that it is likely attributable to these demographic characteristics, which are included in adjusted models. N/A = not applicable.

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Research Report

MICHELLE PRIEST, TERRY L. SCHELL, BEN SENATOR, BEAU KILMER

RAND is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.

Notes

1. There are multiple definitions of what is considered a “psychedelic” drug (see discussion in Kilmer et al., 2024, for more details). Although we generally focus on specific substances in this report, our use of the terms psychedelics or psychedelic substances includes classic psychedelics, such as psilocybin mushrooms and LSD, and non-classic psychedelics, such as MDMA and ketamine (see Nutt, 2024). When considering the definition of psychedelics, it should be noted that some of these substances have long histories of use by Indigenous communities in which they are referred to as sacred relatives, spiritual medicines, or sacraments.

2. Instead of using the term psychedelics, NSDUH data files include composite questions for a category of substances it refers to as “hallucinogens,” which includes LSD, also called acid; PCP, also called angel dust or phencyclidine; peyote; mescaline; psilocybin; ecstasy or Molly, also called MDMA; ketamine, also called Special K or Super K; DMT, also called dimethyltryptamine; AMT, also called alpha-methyltryptamine; Foxy, also called 5-MeO-DiPT; and salvia divinorum. Some of these substances are discussed in this report as psychedelics. The rate and 95-percent confidence intervals (CIs) for past-year use of hallucinogens (using the HALLUCYR variable in the online NSDUH Data Analysis System) in 2021 and 2024 are 2.7 percent [95-percent CI: 2.4–3.1] and 3.6 percent [95-percent CI: 3.3–4.0], respectively. SAMHSA discourages comparing NSDUH data from 2021 and later with data from earlier years because of methodological changes (SAMHSA, 2025).

3. In both bills, only people with a permit from the state can purchase psilocybin mushrooms, cultivate their own, or share or receive them as a noncommercial gift. To receive a permit, adults must complete a health screening and educational course. Unlike medical cannabis programs, individuals do not need a qualifying medical condition to be eligible for a permit.

4. On April 24, 2026, the FDA announced that it would issue three national priority vouchers to pharmaceutical companies studying the use of psilocybin for treatment-resistant depression, psilocybin for major depressive disorder, and methylone (which is closely related to MDMA) for PTSD (FDA, 2026b). These vouchers are intended to dramatically speed up the timeline for the review of drugs that align with national health priorities to one to two months (FDA, 2026a).

5. There is also another potential pathway, Expanded Access, for patients “with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available” (FDA, 2025). A major difference between Expanded Access and the federal Right to Try pathway is the role of the FDA. The former requires FDA approval, while the latter does not require “procuring permission from the FDA” (Sheikh, 2021). In 2020, as part of the Expanded Access program, the FDA approved MDMA to be administered to up to 50 patients for the treatment of PTSD (Richard, Garcia-Romeu, and Henningfield, 2025).

6. The U.S. Department of War is also funding a clinical trial to study the use of MDMA to treat PTSD with active-duty military personnel (U.S. Department of War, 2026).

7. Breakthrough Therapy is an FDA expedited development and review designation for therapies for serious conditions that show preliminary evidence of substantial improvement over existing treatment (FDA, 2018).

8. For more on Expanded Access, see endnote 5.

9. The FDA also granted Breakthrough Therapy designation to an oral pharmaceutical formulation of LSD (MM120; lysergide d-tartrate) for treating generalized anxiety disorder (Meara, 2024; Robison et al., 2025).

10. A VA press release published on May 26, 2026, about a forthcoming MDMA clinical trial concluded: “VA strongly discourages self-medicating or attempting to replace other mental health treatment options with psychedelics or any other unprescribed substances. Proven, evidence-based treatments, are currently available at VA facilities to treat Veterans with mental health conditions. Veterans should always consult their health care providers before making any treatment decisions” (VA, 2026b).

11. Individuals who served in the reserves or National Guard are included in VA’s definition of veteran if they have “active service” that includes activation for federal service under Title 10 of the U.S. Code, if they have full-duty status under Title 32, or if they were injured during training. Qualifications for some programs, such as veteran home loan programs, may have slightly different requirements and definitions (VA, 2026a).

12. This data collection effort was part of NORC’s Veteran Profile Survey. All AmeriSpeak panelists who were recruited prior to 2025, as well as those who were recruited in 2025 who indicated that they had previous U.S. military service, were recruited for this survey.

13. Balancing weights were derived from a propensity model and multiplied with the survey weights to produce the final analytic weights for adjusted models.

14. ORs are sometimes misinterpreted as risk ratios—i.e., the percentage of veterans who gave that response divided by the percentage of nonveterans who gave that response. In general, ORs have values further from a value of 1 than the same effect expressed as a risk ratio, so an OR of 2 implies a risk ratio that is less than 2. We do not present effects as risk ratios because those effect sizes cannot be easily compared across outcomes with different prevalences.

15. This estimate is based on a U.S. veteran population estimate of approximately 17,588,000 for 2025 (VA, 2025b).

16. Although the term marijuana has a controversial history, we use that term in this report in place of the preferred term, cannabis, to align our discussion with the survey question wording and facilitate comparability of our findings with other similar surveys.

17. For a complete discussion of public opinion results among the general public from the 2025 RPS, see Senator, Priest, and Kilmer, 2026.