Certainly MDMA won't work for everyone—no treatment does. It may not be the first line therapy, and instead be reserved for particularly stubborn trauma cases. It might only be prescribed to specific subsets of patients, and likely only for use in the presence of a licensed therapist. Regardless of the eventual details, the results have clearly gotten the FDA's attention. Breakthrough status is reserved for very promising therapies, and they don't hand out the designation lightly. It indicates a strong motivation to get the drug to market, and MDMA could be in the hands of therapists across the U.S. in the very near future. And whether or not you think that illicit drugs should be used in psychotherapy, the results suggest that such a move could help millions of Americans who suffer from PTSD get their lives back.