What did Donald Trump do today?
He let a comedy podcaster write prescription drug rules for the FDA.
Trump spent a rare Saturday in the White House today, with only one event on his schedule: he signed an executive order speeding up review of two psychedelic drugs. He did this at the behest of podcaster Joe Rogan (who shares with Trump the distinction of having hosted a reality game show on NBC) and his Secretary of Health and Human Services, Robert Kennedy Jr. Perhaps even more influential for Trump, right-wing tech billionaire and Trump patron Peter Thiel has also advocated for the legalization and commercialization of these drugs, and owns a company that will profit if they are made legal for prescription.
Trump's remarks made clear that he was skipping past the normal scientific procedures for assessment and study as a favor to Rogan personally, who let Trump use his popular platform late in the election to reach young male voters. As Rogan described it, he sent Trump a text message mentioning the possibility, and Trump responded with "Sounds great. Do you want FDA approval? Let's do it."
By the standards of some medical theories Trump has advanced, ibogaine and psilocybin are probably relatively harmless. Taking controlled, small amounts of psilocybin (the active ingredient in hallucinogenic mushrooms) under medical supervision is absolutely safer than injecting bleach or household cleaners, which Trump famously mused aloud about as a potential COVID-19 cure during a press conference. And ibogaine, while known to have certain dangerous side effects, is safer on balance than taking massive doses of the veterinary antiparasitic drug Ivermectin, which Trump also touted as a cure for COVID. (Some Americans followed his "advice" and suffered serious illnesses or death as a result.)
Kennedy, for his part, has used his tenure as HHS head to slash funding for cancer research, and medical research in general. He's an advocate for several discredited and unscientific health practices, including fad diets and using over-the-counter medicines to treat serious infectious diseases. He's expressed skepticism about the basic germ theory of disease, campaigned against vaccinations, and in one case personally sparked a fatal measles epidemic. A recovering heroin addict, Kennedy's mental health and cognitive stability have been called into question almost as much as Trump's, most notably by his own family. He's most recently been in the news amid fresh reports of his bizarre habit of picking up roadkill for later study or consumption: Kennedy has, by his own admission, made off with the carcasses of bears, whales, and—as revealed this week—a raccoon's penis.
For the most part, because most data comes from reports of recreational use, the effects of ibogaine and psilocybin aren't well understood—including how severe the established negative effects and toxicity are. Under normal circumstances, the FDA would grant permission for small-scale lab studies, then escalate to a larger scale if the evidence pointed to a clear and statistically meaningful benefit that outweighed any risks that were discovered. Final approval for use as legally prescribed medicines would come after a series of carefully designed clinical trials in human patients, with specific safeguards built in based on earlier data.
Trump's order, done on the say-so of a podcaster, short-circuits that process and orders the FDA to jump in blind.
Why does this matter?
- Decisions about how the United States government helps Americans get and stay healthy shouldn't come from comedy podcasters the president owes a favor to.