A text message from Joe Rogan just became federal drug policy.
That's the most accurate way to describe what happened when Trump signed an executive order in April after conversations with podcast host Joe Rogan about ibogaine. Rogan texted Trump information on ibogaine and the president responded: "Sounds great. Do you want FDA approval? Let's do it."
The president asked "Can I have some, please?" during the signing ceremony — with Rogan standing in the Oval Office, presumably nodding approvingly.
We've entered the era where DMT elves have more influence on American healthcare than the American Medical Association.
The executive order allocates $50 million through ARPA-H to match state investments in psychedelic research programs, fast-tracking research into ibogaine and psilocybin — compounds that have been studied for decades but suddenly became urgent priorities after a podcast host mentioned them enough times.
It's policy by proximity, governance by guest list.
Rogan's presence wasn't ceremonial. Former Texas Gov. Rick Perry appeared on Rogan's podcast twice in the past two years, making the case for reducing federal limits on the drug. That led to a law last year providing $50 million for ibogaine research in Texas. This is how the influence economy works now — the person who can reach millions of listeners gets a front-row seat to federal decision-making.
The FDA has been methodically evaluating these substances through clinical trials for years. The FDA has granted Breakthrough Therapy designation to some psychedelic drugs that have shown preliminary clinical evidence of substantial improvement over other therapies. But apparently the real breakthrough was getting the right person's attention.
I've watched this pattern before. The architecture is familiar: skip the institutional queue, find the direct line, make it personal. The FDA issued national priority vouchers for three psychedelics, which can cut review times from several months to a period of weeks. It's the first time the FDA has offered that fast-tracking to any psychedelics.
The $50 million isn't trivial money. That's funding that could have gone to Alzheimer's research, cancer treatment, or any number of diseases that kill people who can't afford to wait for a podcaster's endorsement. Over 14 million American adults have a serious mental illness, and about 8 million are on prescription medication for these conditions.
But here's what nobody wants to acknowledge: this might actually work. Drugs such as psilocybin and MDMA have demonstrated striking results in clinical trials to treat depression, PTSD and other serious mental health conditions. The research is legitimate, even if the path to funding it was ridiculous.
There's risk here, though. Ibogaine can cause fatal cardiac arrhythmias, and research on it was halted in the U.S. in the 1990s. The drug is known to cause irregular heart rhythms and has been linked to more than 30 deaths in the medical literature. This is the first instance in which the FDA has allowed a clinical study in the U.S. of a derivative of ibogaine.
One recent study by Stanford researchers found veterans treated with ibogaine showed improvements in PTSD symptoms, but it was small — enrolling 30 veterans — and did not include a placebo group for comparison. That's not exactly the gold standard of evidence for a Schedule I substance with documented cardiovascular risks.
The irony is that the president preserved the FDA's role, even as some in his coalition want it dismantled. Trump asking "Can I have some?" during a federal policy signing captures something essential about how decisions get made now. It's not about evidence or institutional knowledge — it's about whoever had the president's ear last Tuesday.
There's a version of this I find reassuring. When the traditional pathways are too slow, too cautious, too captured by their own inertia — maybe the hack is the feature, not the bug. Veterans have been traveling to clinics in Mexico, Costa Rica, Portugal and Brazil, where treatment can cost tens of thousands of dollars because the system couldn't move fast enough.
But the same mechanism that fast-tracks promising treatments can fast-track dangerous ones. The algorithm doesn't distinguish. It just processes the input: podcast episode, text message, executive order, done.
— Ish.