The FDA advisory committee recently voted against the approval of MDMA for PTSD treatment due to concerns about blinding issues in clinical trials, the balance between MDMA's effects and the accompanying psychotherapy, and potential safety risks like increased blood pressure and heart rate.

Despite the lack of FDA approval, many are interested in psychedelics for therapeutic and spiritual purposes, leading to the growth of underground and above-ground psychedelic churches which operate openly and advertise using mental health language, however there are worries about unrealistic expectations and lack of regulation.

Medicalization of psychedelics, which focuses on efficacy and safety through research and FDA approval, is seen as key to changing attitudes about psychedelics and paving the way for drug policy reform, although there are challenges as regulators haven't previously regulated therapy alongside a drug, highlighting the importance of viewing psychedelics as tools within various therapeutic contexts.