Even if the FDA (the US drug regulator) approves MDMA as a medicine, a separate government agency called the DEA (the Drug Enforcement Administration) controls which drugs are legal to possess. That rescheduling review takes at least a year, so MDMA will almost certainly stay in the most restricted legal category through 2026. This means patients can't just walk into a pharmacy to get it — the two approval processes don't move in sync.
FDA approval triggers a rescheduling review, not automatic descheduling. That process runs 12+ months minimum. My division does not move fast, and abuse-potential concerns remain documented.