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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
controlled substances; approval; use; research
Purpose
Allows 3,4-methylenedioxymethamphetamine (MDMA) that is approved by the U.S. Food and Drug Administration (FDA) and rescheduled to a schedule other than Schedule I to be prescribed and authorizes workers' compensation coverage to include MDMA treatment for outlined first responders diagnosed with post traumatic stress disorder (PTSD). Appropriates $10,000,000 from the state General Fund (state GF) in FY 2027 to the Department of Health Services (DHS) to award grants for trials or other research relating to MDMA as a treatment for PTSD. Prescribes conditions for enactment, treatment stipulations and reporting requirements.
Background
In 2024, an application was filed with the FDA for the approval of MDMA, also known as midomafetamine, for the treatment of PTSD in adults (FDA). MDMA is a synthetic drug that alters mood and perception and is chemically similar to both stimulants and hallucinogens. MDMA increases the activity of dopamine, nonrepinephrine and serotonin in the brain and its effects last about three to six hours. MDMA is currently in clinical trials as a possible treatment aid for PTSD, anxiety in terminally ill patients and for social anxiety in autistic adults (National Institute on Drug Abuse). The FDA has designated MDMA-assisted psychotherapy for PTSD as a breakthrough therapy drug, which are intended to treat a serious or life-threatening disease or condition and means that preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints (FDA).
Drugs, substances and certain chemicals used to make drugs are classified by the U.S. Drug Enforcement Administration (DEA) into five categories or schedules depending upon the drug's acceptable medical use and abuse or dependency potential. Schedule I drugs, substances or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse (DEA).
The Industrial Commission of Arizona (ICA) administers workers' compensation laws and adjudicates workers' compensation claims. An injured employee, or a dependent of a deceased employee, is entitled to receive workers' compensation for an accident arising out of and in the course of employment (A.R.S. § 23-921).
PTSD is a mental health condition that is triggered by either experiencing or witnessing a terrifying event. Symptoms may start within one month of a traumatic event but may not appear until years later and can cause significant problems in social and work situations as well as in relationships. Symptoms may include flashbacks, nightmares, severe anxiety and uncontrollable thoughts about the event (Mayo Clinic).
S.B. 1542 appropriates $10,000,000 from the state GF in FY 2027 to DHS. If requiring MDMA-assisted therapy for firefighters and peace officers increases workers' compensation coverage costs, there may be further fiscal impact to the state GF.
Provisions
Rescheduling
1. Deems that any compound, mixture or preparation that contains MDMA and that is approved by the FDA and rescheduled by the DEA to a schedule other than Schedule I is a controlled substance and may be prescribed in Arizona.
MDMA Treatment for Firefighters and Peace Officers
2. Requires employers to provide workers' compensation coverage to firefighters and certified peace officers who have been diagnosed with PTSD by a licensed mental health professional and who have accepted a workers' compensation claim for PTSD.
3. Allows workers' compensation coverage to include one complete course of a treatment protocol of MDMA as prescribed by a psychiatrist if an independent medical examination reveals that the treatment is deemed reasonable and necessary and follows treatment guidelines established by the ICA.
4. Requires a prescribed MDMA treatment to meet statutory requirements for a controlled substance.
5. Requires, by January 1, 2029, and each January 1 thereafter, the ICA to submit a report to the Joint Legislative Budget Committee of the costs of MDMA treatment for firefighters and certified peace officers.
6. Conditions the enactment of legislation authorizing MDMA treatment for firefighters and certified peace officers on the FDA approving the use of MDMA to treat PTSD by January 1, 2029.
7. Requires, by February 1, 2029, the Executive Director of the Arizona State Board of Pharmacy (Board of Pharmacy) to notify the Directors of the Arizona Legislative Council (Leg Council) and the ICA in writing of the date on which the condition was met or that the condition was not met.
8. Directs the ICA, on notification from the Board of Pharmacy that the condition has been met, to assign reimbursement values in its schedule of fees and publish guidelines on billing and reimbursement practices for MDMA.
Appropriation and Grants
9. Appropriates $10,000,000 from the state GF in FY 2027 to DHS to award grants for clinical trials, applied clinical research and training of clinicians in the use of MDMA to treat PTSD and specifically the safe administration of MDMA to first responders and veterans who are affected by PTSD.
10. Allows DHS to award grants for eligible projects to one or more of the following entities:
a) a sponsor of record or principal investigator that has completed at least one related, late-stage clinical trial and is currently participating in an FDA drug review process relating to the use of MDMA to treat PTSD;
b) a public institution of higher education in Arizona that:
i. delivers clinical care in the field of mental health or substance use disorders;
ii. provides accredited professional education or clinical training programs in behavioral health disciplines; or
iii. conducts clinical, translational or implementation research related to mental health or substance use disorder treatment; or
c) a qualified public institution of higher education that serves as the lead institution on behalf of a collaborative partnership or formal consortium, which includes the sponsor of record, that is formed for the purpose of carrying out an eligible project.
11. Requires each grant application to identify a sponsor of record that will be responsible for regulatory compliance, product supply and safety oversight for the eligible project.
12. Allows the sponsor of record for a qualified institution of higher education to serve as the lead applicant, a co-applicant or a subrecipient.
13. Allows a qualified institution of higher education to serve as the lead applicant and the sponsor of record to be a co-applicant or subrecipient.
14. Requires each eligible project to support at least one of the following objectives:
a) applied clinical research and clinical trials by conducting practice-oriented research to evaluate and improve models of care, treatment protocols or patient outcomes for the administration of MDMA to residents of Arizona, specifically veterans and first responders, who are impacted by PTSD; or
b) clinical training through the design and delivery of evidence-based training programs to prepare health care providers in Arizona to safely and effectively administer MDMA to treat PTSD, including veterans and first responders.
15. Requires the application for any eligible project involving the administration of MDMA or reliance on prior clinical data to include documentation, which must be issued by the sponsor of record, of:
a) product supply sufficient to complete the project; and
b) a right of reference or other regulatory authorization, as applicable, to rely on FDA submissions relating to MDMA.
16. Exempts the appropriation from lapsing.
17. Conditions enactment of the appropriation on the following occurring by January 1, 2027:
a) the approval of an MDMA investigational product as a prescription medication;
b) the control of an MDMA investigational product under a federal interim final rule; and
c) the publication of an MDMA investigational product in the Federal Register.
18. Requires, by February 1, 2027, the Executive Director of the Board of Pharmacy to notify the Director of Legislative Council in writing of the date on which the conditional enactment was met or that the conditional enactment was not met.
Miscellaneous
19. Specifies that MDMA is included by the official, common, usual, chemical or trade name designated.
20. Conditions enactment on the legislation relating to MDMA nomenclature on the following occurring by January 1, 2029:
a) the approval of an MDMA investigational product as a prescription medication;
b) the control of an MDMA investigational product under a federal interim final rule;
c) the publication of an MDMA investigational product in the Federal Register; and
d) for outlined portions, the enactment of the legislation authorizing MDMA treatment for firefighters and peace officers.
21. Requires, by February 1, 2029, the Executive Director of the Board of Pharmacy to notify the Director of Leg Council in writing of the date on which the conditional enactment was met or that the conditional enactment was not met.
22. Defines treatment protocol of MDMA as a process of treatment that has received FDA approval for PTSD and that uses MDMA in conjunction with therapy sessions.
23. Defines terms.
24. Makes conforming changes.
25. Becomes effective on the general effective date or later, subject to the provisions of the conditional enactments.
Prepared by Senate Research
February 16, 2026
KJA/SDR/hk