RAND Report: Veterans Support Psilocybin Therapy at the VA

RAND Report Finds Veterans Want a Bigger Role for Psychedelic Therapy at the VA

A new RAND report gives us one of the clearest pictures yet of what American veterans actually think about psychedelics—and the answer is more complicated than either side of the debate might expect.

According to the report, approximately 4.8 million U.S. veterans have used psilocybin, LSD or MDMA at some point in their lives. Nearly one in four veterans supports legal psilocybin use. More importantly, 53.9% support the Department of Veterans Affairs providing or paying for psilocybin-assisted therapy if the treatment receives FDA approval.

But the most alarming finding may be this: nearly half of veterans do not know whether discussing psychedelic use with a VA doctor could put their benefits at risk.

That is not a drug problem. That is an information problem.

What Did the RAND Report Find About Veterans and Psychedelics?

Published on June 23, 2026, U.S. Veterans and Psychedelics: Prevalence of Use and Policy Preferences analyzed results from the 2025 RAND Psychedelics Survey.

The nationally representative survey included 10,122 U.S. adults, including an oversample that produced an analytic group of 1,339 veterans. Researchers weighted the results to better represent the U.S. veteran population by age, sex, race, region, education and income.

Here are the headline findings:

• Approximately 4.8 million veterans have used psilocybin, LSD or MDMA during their lifetime.
• 23% of veterans support legal psilocybin mushroom use.
• 11.4% support legal LSD use.
• 8.5% support legal MDMA use.
• 53.9% support VA-provided or VA-funded psilocybin-assisted therapy if FDA-approved.
• 44.9% support VA-provided or VA-funded MDMA-assisted therapy if FDA-approved.
• 48.1% are unsure whether talking to a VA doctor about psilocybin use could threaten their benefits.
• 46.3% are unsure whether disclosing MDMA use could threaten their benefits.

These numbers do not show universal enthusiasm. They show something more useful: veterans are separating different substances, different legal models and different medical contexts instead of treating “psychedelics” as one giant category.

Psilocybin Has More Support Than MDMA or LSD

Among the three substances included in RAND’s legalization questions, psilocybin was the clear leader.

Nearly one in four veterans supported legal psilocybin use, compared with roughly one in nine for LSD and fewer than one in ten for MDMA. After researchers adjusted for age, sex, race and ethnicity, veterans were slightly more likely than demographically similar nonveterans to support legal psilocybin and LSD use.

The gap also appeared when veterans who had never used a particular substance were asked whether they would consider trying it. About 11.1% were willing to try psilocybin, compared with 5.1% for LSD and 7.6% for MDMA.

That matters because public opinion about psychedelics is substance-specific. Someone may support supervised psilocybin therapy for depression while opposing the general retail sale of LSD. Asking whether a person supports “psychedelics” without naming the substance, setting or purpose can hide those differences.

This report does a better job. Policy should do the same.

Veterans Are Already Familiar With Psychedelics

RAND estimated lifetime psychedelic use among veterans at:

• 19.6% for LSD
• 18.6% for psilocybin
• 7.7% for MDMA or MDA
• 7.7% for mescaline
• 2.9% for ketamine
• Less than 1% for ibogaine or iboga

Veterans remained more likely than demographically similar nonveterans to report lifetime LSD use. However, recent use was uncommon: past-year use was below 3% for every substance studied.

That distinction is important. A high lifetime number does not mean millions of veterans are currently taking psychedelics, and the survey does not establish why they used them. Lifetime use could have occurred decades ago, recreationally, ceremonially, therapeutically or for another reason.

Most Veterans Support Some VA Role if Therapy Is FDA-Approved

The RAND survey asked veterans how the VA should handle psilocybin-assisted therapy and MDMA-assisted therapy if the FDA eventually approves them.

For psilocybin, 53.9% supported some combination of VA payment or VA provision. For MDMA, support was 44.9%.

The most popular model was also the most practical: allow the VA to cover treatment delivered by either VA clinicians or qualified community providers. That option received support from 28.8% of veterans for psilocybin-assisted therapy and 23.3% for MDMA-assisted therapy.

In other words, many veterans are not asking for a psychedelic free-for-all. They are asking that an FDA-approved treatment be treated like a treatment—with standards, trained professionals, patient choice and a way to pay for care.

Nearly Half of Veterans Are Unsure About Their VA Benefits

This is the finding policymakers should not ignore.

When asked whether a veteran could lose VA benefits for telling a VA doctor about psilocybin use, 48.1% said they were unsure. For MDMA, 46.3% were unsure.

Only 35.6% felt confident that disclosing psilocybin use would not cost a veteran benefits. For MDMA, that figure fell to 32.9%.

When patients believe honesty might cost them health care or other benefits, honest health conversations become less likely. A doctor who does not know what a patient is taking cannot properly discuss possible drug interactions, mental-health risks or warning signs.

RAND’s researchers point to the VA’s history with cannabis. It took nearly two decades after the first state legalized medical cannabis for the VA to issue guidance making clear that patients would not lose benefits for discussing cannabis use with VA providers. The report argues that conversations about similar guidance for certain psychedelics should begin now.

The government does not have to endorse unsupervised psychedelic use to tell veterans whether they may speak honestly with their doctors. Clarity is not legalization. Clarity is basic health care.

What the Study Does—and Does Not—Prove

The report is valuable because it uses a probability-based, nationally representative survey rather than relying only on veterans already involved in psychedelic advocacy. Still, the findings have limits.

The survey is observational and based on self-reported answers. It does not prove that psychedelics are safe or effective treatments for PTSD, depression, substance-use disorders or any other condition. It also does not tell us why each veteran used a substance or whether that experience helped or harmed them.

Estimates for rare substances and recent use were based on small groups and sometimes had wide confidence intervals. The survey may also underrepresent people experiencing homelessness, severe mental illness or other circumstances that make participation more difficult. Finally, veterans are not a single uniform population; experiences vary by service era, branch, combat exposure, health status and use of VA care.

The survey tells us what veterans reported and what policies they prefer. Clinical trials must answer the medical questions.

Why This RAND Report Matters

Veterans are frequently placed at the center of the psychedelic policy debate, especially when PTSD, depression, traumatic brain injury, addiction and suicide are discussed. Until now, much of that conversation has been driven by powerful personal stories and smaller convenience samples.

Those stories matter. But national policy needs national data.

RAND’s findings suggest three immediate priorities:

1. The VA should give veterans and clinicians clear guidance about confidential discussions of psychedelic use and any potential effect on benefits.
2. Researchers should continue rigorous clinical trials without presenting promising treatments as proven cures.
3. Policymakers should discuss psilocybin, MDMA, LSD, ibogaine and other substances separately, because veterans clearly do not view them as interchangeable.

The real headline is not that every veteran wants psychedelic therapy. They do not. The headline is that a meaningful number of veterans want the VA prepared to cover these treatments if the science and FDA review support them—and far too many veterans are currently unsure whether they can even discuss the subject safely with their own doctors.

Legalization through education begins with accurate information. On this issue, veterans deserve more of it.

Frequently Asked Questions

How many veterans have used psychedelics?

RAND estimates that approximately 4.8 million U.S. veterans have used psilocybin, LSD or MDMA at least once in their lifetime. This does not mean all used them recently or for therapeutic reasons.

Do veterans support psilocybin legalization?

About 23% of veterans surveyed supported legal psilocybin mushroom use. Support for legal LSD use was 11.4%, while support for legal MDMA use was 8.5%.

Do veterans support psychedelic therapy through the VA?

If the treatments receive FDA approval, 53.9% supported the VA providing or paying for psilocybin-assisted therapy, and 44.9% supported a VA role in MDMA-assisted therapy.

Can veterans lose VA benefits for discussing psychedelics with a doctor?

The RAND survey measured what veterans believed, not the definitive legal answer in every situation. Nearly half were unsure whether disclosing psilocybin or MDMA use could put benefits at risk. Veterans should seek current guidance from the VA or a qualified legal professional rather than relying on a survey or blog post.

Does this study prove psychedelics treat PTSD?

No. The study measured psychedelic use and policy opinions; it was not a clinical trial and did not test whether psilocybin, MDMA or other substances safely or effectively treat PTSD.