MDMA — or “molly” as today’s youngsters call it — is a longtime club drug with some limited medical uses. It may gain a new legitimate use, as the Food and Drug Administration has okayed the last human trial of MDMA as a treatment for post-traumatic stress disorder, opening the door for possible approval down the road.

While the drug has risks, the problem is that our current toolkit for dealing with psychiatric illnesses isn’t very effective on PTSD, which is a condition that returning military, victims of violent crimes, survivors of abuse, and people who have suffered other trauma that has left a lasting mark.

“PTSD can be very hard to treat,” the head of psychiatry at New York University explained to the New York Times. “Our best therapies right now don’t help 30 to 40 percent of people. So we need more options.” Even using drugs that are currently illegal and that do have the potential for abuse.

The most recent positive study gave small doses of the drug to survivors of different types of events that may have caused them to have PTSD. The group included first responders, veterans, and people who have been sexually assaulted.

The study found that their symptoms were still better a year after receiving the three doses. Patients didn’t just chill out and listen to music while on the drug: clinicians worked with them to reprocess difficult memories while their brain was in an altered state.

If the larger study is effective, what then? The treatment idea has been fast-tracked at the FDA and could be approved as early as 2021, but the idea has critics. They fear that even administering the drug just a few times in a psychiatrist’s office could lead to abuse, causing further damage to the brain chemistry of vulnerable people.

“[The study] sends the message that this drug will help you solve your problems, when often it just creates problems,” a researcher in Wales who has studied the problems of chronic MDMA users explained. Manufacturing the drug commercially for the legitimate market and prescribing it to patients could lead to some of it reaching the recreational market.

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