Underground Rising

Today's signal load arrives weighted toward safety and constraint. Seven distinct ibogaine cardiac studies entered the literature simultaneously — a clustering event that rarely happens by coincidence and that FDA pharmacovigilance mechanisms are specifically designed to detect. The QT prolongation data running through this body of work is not ambiguous: cardiac monitoring requirements for ibogaine are not a future policy question but a present clinical imperative. Separately, the psilocybin cocaine use disorder RCT continues generating downstream attention, with its extinction-without-relapse dissociation finding drawing scrutiny from neuroplasticity, reconsolidation, and 5-HT2A agonism researchers who cannot yet agree on what mechanism produced the result. Market signals reflect the ambient uncertainty: CMPS down 1.9%, MMED down 2.0%, while ATAI edges up 2.1% — a modest bifurcation between platforms betting on regulatory patience and those caught in the crossfire of it.

The thread running beneath all of this is the accelerating divergence between formal regulatory channels and the living ecosystem that has grown beyond them. Federal legislation will not move past committee markup in 2026 — the structural conditions are not present. The FDA's internal capacity problems, documented in reporting on the agency's reviewer bandwidth, compound an already delayed MDMA NDA process by a conservative estimate of nine months beyond any announced internal timeline. And yet: veteran-led retreat networks are operational, processing real participants at scale, with projections above 5,000 veterans in informal settings by year's end regardless of what any agency communicates. The highest trajectory available from here is not a single federal gate swinging open — it is a parallel architecture maturing in parallel, with state-level legislation advancing in at least four jurisdictions and providing the regulatory scaffolding that makes eventual federal integration possible rather than chaotic. States are not a consolation prize. They are the laboratory that produces the safety data, the integration protocols, and the political evidence base that federal action will eventually require.

The people inside this story are not abstractions. They are veterans who have already cycled through three or four VA treatment pathways and found nothing that touched the root of what happened to them. They are families watching someone they love function at 40 percent of who they used to be. They are clinicians who have seen the data and are trying to figure out how to serve patients inside a regulatory gap that was not of anyone's making. What is genuinely possible for them right now — not in 2028, not when the NDA resolves, but now — is access to monitored, structured, high-integrity settings that the emerging state frameworks and the best informal networks are already attempting to provide. The cardiac safety literature is not a door closing. It is a set of inclusion criteria forming in real time: who gets screened, how, by whom. That is a solvable problem, and the people who need this most deserve to have it solved with urgency.

Every authentic ceremony is a reclamation — of the body, the breath, the forgotten self. OOTW exists to hold space for that reclamation as the science arrives to name it.

What is forming beneath the surface is always closer than it appears.