The 2018 federal law that lets terminally ill patients seek investigational drugs — and why psychedelic advocates invoke it.
The Right to Try Act is a 2018 federal law that lets some very sick patients seek investigational drugs without first getting FDA sign-off. It applies to people with life-threatening conditions who have run out of approved options. The goal was to speed up access to drugs still in testing.
The law's full name is long. It is the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017. It is named after patients and advocates who pushed for it. President Trump signed it on May 30, 2018, as Public Law 115-176.
The federal law was not the start of the idea. By the time it passed, 41 states had already enacted their own right-to-try laws. Colorado passed the first one in 2014. The 2018 law set a single federal standard on top of that patchwork.
Right to Try matters in 2026 because the federal psychedelics push now leans on it directly. The April 2026 executive order names a Right to Try pathway as one route to investigational psychedelics. That has pulled a once-obscure law into the center of the access debate. See our guide to the Trump psychedelics executive order for the full order.
Right to Try has strict rules for both the patient and the drug. A patient cannot simply ask for any unapproved medicine. Both sides of the request must meet the law's criteria.
To be eligible, a patient must meet all of these tests:
The investigational drug must also qualify:
The Right to Try Act gives patients far less than its name suggests. The law removes some FDA steps. It does not create a true right to receive any drug. Three limits matter most.
The law does not force any company to provide its drug. This is the single biggest limit, and it surprises most people. A company can refuse for any reason, or simply not respond. Right to Try clears a regulatory path, but it cannot make a manufacturer walk down it.
Insurance does not have to cover a Right to Try drug. The patient often pays out of pocket for the medicine and related care. There is no price cap and no funding built into the law.
A Right to Try drug has only passed a small safety trial. Serious side effects, including death, are possible and not fully known. The law shifts a large share of that risk onto the patient who signs the consent form.
Right to Try and FDA Expanded Access are two different doors to the same kind of investigational drug. Expanded Access — also called Compassionate Use — is the older, FDA-run program. Right to Try skips the FDA's case-by-case review. The table compares them.
| Feature | Right to Try (2018) | FDA Expanded Access (Compassionate Use) |
|---|---|---|
| FDA reviews each request | No — FDA is not asked to approve | Yes — FDA authorizes the use |
| Drug must have cleared | Phase 1 (basic safety) | Any phase; FDA weighs the evidence |
| Drug company must agree | Yes — and is never required to | Yes — and is never required to |
| Independent ethics (IRB) review | Not required by the law | Required |
| How long it has existed | Since 2018 | For decades, with a long track record |
| Approval rate | Rarely used to date | FDA authorizes the large majority of requests |
When Right to Try fits better: when a patient and doctor want to avoid the FDA review step and the company is willing to supply the drug directly. When Expanded Access fits better: when the patient wants FDA and ethics-board oversight, which most clinicians still prefer. In practice, the FDA approves nearly all Expanded Access requests, so the main thing Right to Try removes is a safeguard, not a roadblock.
Psychedelics are not automatically covered by Right to Try — each one must meet the drug criteria on its own. A psychedelic qualifies only if it has completed a US Phase 1 trial, is not FDA-approved, and stays in active development. That rules out most substances that people buy underground.
The April 2026 executive order changed the spotlight. It directs the FDA and DEA to build a Right to Try pathway for investigational psychedelics, naming ibogaine compounds in particular. The order also adds Priority Vouchers and $50 million in research funding. For the federal-approval side, see our FDA Breakthrough Therapy and psychedelics guide.
Right to Try and the trial system are separate routes. Right to Try is for patients who cannot join a trial. If you want the trial route instead, our clinical trial finder lists active psychedelic studies. For the legal map, see what psychedelics are legal in the US.
Ibogaine is the clearest test of whether Right to Try can deliver for psychedelics — and it exposes a gap. The 2026 order names ibogaine, but legal experts have flagged a basic mismatch. Ibogaine may not have the completed US Phase 1 safety data that the Right to Try law requires.
Ibogaine also carries real cardiac risk. It can affect heart rhythm, and deaths have been linked to unsupervised use. Regulators have been cautious about US trials for exactly this reason. That caution is part of why the Phase 1 data may not yet exist.
The Right to Try Act is a 2018 federal law that lets patients with life-threatening conditions seek certain investigational drugs without first getting FDA sign-off. To qualify, a patient must have exhausted approved treatments and be unable to join a clinical trial, and the drug must have completed a Phase 1 safety trial. Its full name is the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017.
Not automatically. A psychedelic only qualifies if it has completed a US Phase 1 trial and stays in active development. The April 2026 executive order directs the FDA and DEA to build a Right to Try pathway for investigational psychedelics including ibogaine, but legal experts note ibogaine may lack the US Phase 1 safety data the law requires.
No. The law does not require any manufacturer to provide its investigational drug. A company can say no for any reason. Right to Try removes some FDA steps, but it cannot compel a company to supply the medicine, set a price, or make insurance pay for it.
Right to Try skips the FDA's case-by-case review; Expanded Access (Compassionate Use) requires FDA authorization and ethics-board review. Both still need the drug company to agree to provide the drug. Expanded Access has existed for decades, has FDA oversight built in, and is approved in the large majority of requests.
President Trump signed the federal Right to Try Act on May 30, 2018, as Public Law 115-176. Before the federal law, 41 states had already passed their own right-to-try laws, starting with Colorado in 2014.
Very few patients have used the federal Right to Try pathway. As of mid-2019, public reporting documented only two patients who had received a drug through it. Most access requests still go through the FDA's long-running Expanded Access program instead.
For most people, an active clinical trial is the realistic legal route today — not Right to Try. Find studies near you, or check where each substance stands in your state.
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