Psychedelic medicine access by country

Where esketamine (Spravato) is approved and covered, where ketamine therapy exists in some regulated form, and where psychedelic therapy is legal — across 41+ countries. Every row is sourced; snapshot 2026-07. One structural fact stands out: an official “find a centre” locator exists only in the United States — everywhere else, patients are left to search. That gap is why this directory exists.

CountrySpravato (esketamine)CoverageKetamine therapyPsychedelic therapyOfficial locatorOur coverage
Germany
source 1 · source 2
Approved (2019)
EMA (EU centralised)
Publicly coveredyes — IV infusion + KAP, private self-pay clinics (~EUR 200-400/session)Compassionate use
EU's first psilocybin compassionate use program (BfArM-listed, ZI Mannheim + OVID Berlin, TRD only, ~50 pts/yr); initial listing ran to 11 Jul 2026 — renewal status must be confirmed; MDMA research-only
NoneVerified providers →
France
source 1 · source 2
Approved (2019)
EMA (EU centralised); ANSM national oversight
Partially coveredno — hospital-only; effectively no private clinic marketTrials only
No compassionate-use or regulated psychedelic route; clinical trials only
NoneVerified providers →
United Kingdom
source 1 · source 2
Approved (2019)
MHRA (EC approval 12/2019 carried over post-Brexit)
Partially coveredyes — most developed private market in Europe, CQC-registered clinics, ~GBP 300-800/infusionTrials only
Psilocybin/MDMA research-only; no compassionate-use route
NoneVerified providers →
Italy
source 1 · source 2
Approved (2019)
EMA (EU centralised); AIFA national
Publicly coveredlimited — off-label prescribing lawful but no developed private clinic marketTrials only
Clinical trials only
NoneVerified providers →
Spain
source 1 · source 2
Approved (2019)
EMA (EU centralised); AEMPS national
Publicly coveredyes — private clinics in Barcelona, Madrid, Mallorca; full KAP programs into the thousands EURTrials only
Clinical trials only
NoneVerified providers →
Netherlands
source 1 · source 2
Approved (2019)
EMA (EU centralised); CBG-MEB national
Publicly coveredlimited — off-label lawful; small clinic market; outcomes-based esketamine contracts pioneeredTrials only
Medically trials-only (incl. recruiting MDMA-PTSD trial at ARQ Centrum'45); psilocybin truffle retreats are legal wellness businesses, not medical care
NoneVerified providers →
Poland
source 1 · source 2
Approved (2019)
EMA (EU centralised); URPL national
Publicly coveredyes — private clinics in Warsaw, Wroclaw and other large cities, self-payTrials only
Clinical trials only
NoneVerified providers →
Czechia
source 1 · source 2
Approved (2019)
EMA (EU centralised); SUKL national
Publicly coveredyes — KAP at Psyon (Prague) with partial coverage from seven insurers — only insurer-supported KAP in EuropeState-regulated
First EU country with full legal framework for medical psilocybin ('psychomodulatory substances'), in force 01/01/2026; treatment not yet started — NUDZ expects delivery H2 2026, no funding route defined
NoneVerified providers →
Switzerland
source 1 · source 2
Approved (2020)
Swissmedic
Publicly coveredyes — legal off-label infusions ~CHF 300-500, self-payLimited medical use
Art. 8 BetmG limited medical use program: individually authorized physicians treat named patients — MDMA since 2014, psilocybin/LSD; ~100 physicians, 723 patients in 2024; self-pay, long waitlists, built for patients in Swiss care
NoneVerified providers →
Austria
source 1 · source 2
Approved (2019)
EMA (EU centralised); BASG national
Partially coveredlimited — off-label lawful; no developed private clinic marketTrials only
Clinical trials only
NoneVerified providers →
Belgium
source 1 · source 2
Approved (2019)
EMA (EU centralised); FAMHP national
Publicly coveredlimited — off-label lawful; no developed private clinic marketTrials only
Clinical trials only
NoneVerified providers →
Ireland
source 1 · source 2
Approved (2019)
EMA (EU centralised); HPRA national
Publicly coveredlimited — off-label lawful; minimal clinic marketTrials only
Clinical trials only
NoneVerified providers →
Portugal
source 1 · source 2
Approved (2019)
EMA (EU centralised); INFARMED national
Publicly coveredlimited — off-label lawful; small/no clinic marketTrials only
Clinical trials only
NoneVerified providers →
Denmark
source 1 · source 2
Approved (2019)
EMA (EU centralised); DKMA national
Publicly coveredlimited — off-label lawful; no developed private clinic marketTrials only
Clinical trials only
NoneVerified providers →
Sweden
source 1 · source 2
Approved (2019)
EMA (EU centralised); Lakemedelsverket national
Partially coveredyes — private clinics (Stockholm ~4,500-5,000 SEK/session; courses 20,000-30,000 SEK)Trials only
Clinical trials only
NoneVerified providers →
Norway
source 1 · source 2
Approved (2019)
EMA-aligned via EEA; NOMA national
Not coveredyes — publicly funded generic IV ketamine in specialist services (hospitals and DPS centers)Trials only
Clinical trials only
NoneVerified providers →
Finland
source 1 · source 2
Approved (2019)
EMA (EU centralised); Fimea national
Publicly coveredlimited — off-label lawful; no developed private clinic marketTrials only
Clinical trials only
NoneVerified providers →
Other EU/EEA member states
source 1 · source 2
Approved (2019)
EMA (single centralised marketing authorization valid in all EU/EEA states)
No public datalimited — off-label prescribing by licensed physicians lawful EU-wide; clinic markets exist only in some countriesTrials only
No compassionate-use or regulated routes outside DE/CH/CZ; clinical trials only
None
United States
source 1 · source 2
Approved (2019)
FDA
Partially coveredyes — large private market: IV/IM infusions, compounded intranasal/oral, telehealth prescribingState-regulated
Oregon (psilocybin service centers, since 2023) and Colorado (healing centers, since 2025) run state-regulated supported-adult-use psilocybin; federally psilocybin/MDMA remain Schedule I trials-only — FDA declined MDMA-AT approval 08/2024 and requested a further Phase 3
Yes (US REMS)
Canada
source 1 · source 2
Approved (2020)
Health Canada
No public datayes — private IV/IM ketamine and KAP clinics in major citiesCompassionate use
Health Canada Special Access Program grants case-by-case psilocybin/MDMA access since 01/2022; s.56 exemptions historically; otherwise trials-only
None
Mexico
source 1 · source 2
Approved
COFEPRIS
No public datayes — private ketamine infusion/KAP clinics (CDMX, Monterrey, coastal hubs)Trials only
No medical framework; indigenous ceremonial use (peyote, psilocybin) tolerated in cultural contexts but not medical care; retreat market operates in legal gray zone
None
Brazil
source 1 · source 2
Approved (2020)
ANVISA
Not coveredyes — private clinics offer off-label IV ketamine and Spravato; court-ordered coverage commonTrials only
Clinical trials (incl. ayahuasca/psilocybin research); religious ayahuasca use legal since 1980s but non-medical
None
Argentina
source 1 · source 2
Approved (2020)
ANMAT
No public datalimited — off-label use possible; small private marketTrials only
Clinical research only
None
Colombia
source 1 · source 2
Not approved
INVIMA — not registered
Not coveredlimited — racemic ketamine (licensed anesthetic) used off-label by some private clinicsTrials only
No medical framework; traditional yage/ayahuasca use legal in indigenous context, non-medical
None
Chile
source 1 · source 2
Approved
ISP
No public datalimited — off-label use possible in private psychiatry; small marketTrials only
Clinical research only
None
Peru
source 1 · source 2
Approved
DIGEMID
No public dataunknown — no verified clinic market dataNone
No medical framework; traditional ayahuasca use legal (cultural patrimony) but non-medical
None
Australia
source 1 · source 2
Approved (2021)
TGA
Not coveredyes — private ketamine/esketamine clinics in major cities, self-payLimited medical use
World-first down-scheduling 07/2023: TGA Authorised Prescriber psychiatrists may prescribe psilocybin (TRD) and MDMA (PTSD); small number of prescribers, high cost, no public funding
None
New Zealand
source 1 · source 2
Approved
Medsafe
Not coveredlimited — off-label prescribing lawful; small private clinic marketLimited medical use
06/2025: Medsafe granted first (and so far only) authorised-prescriber approval for psilocybin — Dr Cameron Lacey (Christchurch), TRD only; prescribing guidelines published to enable more clinicians
None
Israel
source 1 · source 2
Approved
Israeli Ministry of Health
No public datayes — off-label IV ketamine and KAP available in private and some hospital settingsCompassionate use
MoH MDMA compassionate use program for PTSD (running since 2019); psilocybin research active; otherwise trials-only
None
Turkey
source 1 · source 2
Approved
TITCK
No public datalimited — ketamine tightly controlled (red prescription); hospital settings, minimal clinic marketNone
No medical or research access framework
None
United Arab Emirates
source 1 · source 2
Approved
MOHAP
No public datano — ketamine is a controlled narcotic; no off-label depression clinic marketNone
Strict narcotics law; no research or access framework
None
Saudi Arabia
source 1 · source 2
Approved
SFDA
No public datano — controlled; no off-label depression clinic marketNone
Strict narcotics law; no access framework
None
Qatar
source 1
Unconfirmed
MOPH Qatar
No public datano — controlled; no clinic marketNone
Strict narcotics law; no access framework
None
Bahrain
source 1
Unconfirmed
NHRA Bahrain
No public datano — controlled; no clinic marketNone
Strict narcotics law; no access framework
None
South Korea
source 1 · source 2
Approved (2020)
MFDS
Not coveredlimited — ketamine strictly controlled; esketamine at certified hospitals; minimal off-label marketTrials only
Early-stage research only
None
Japan
source 1 · source 2
Not approved
PMDA/MHLW — not approved
Not coveredno — ketamine designated a narcotic since 2007; off-label psychiatric use effectively unavailable outside researchTrials only
Academic psilocybin/ketamine research (e.g. Keio, NCNP); no access framework
None
Taiwan
source 1 · source 2
Approved
TFDA
No public datalimited — ketamine is a Schedule 3 controlled drug; use confined to hospital/clinical settingsTrials only
Research only
None
Singapore
source 1 · source 2
Approved (2020)
HSA
No public datano — ketamine strictly controlled; no off-label clinic market — esketamine via approved channels onlyNone
Strict drug law; no research-access framework of note
None
Thailand
source 1 · source 2
Unconfirmed
Thai FDA
No public datalimited — hospital-based IV ketamine for TRD/suicidality documented in Thai psychiatric practice; ketamine is a Category 2 psychotropicTrials only
Government-backed psilocybin research interest (post-cannabis-reform climate); no access framework
None
India
source 1 · source 2
Not approved
CDSCO — not approved
Not coveredlimited — ketamine Schedule X (strict dispensing); off-label IV use in some private psychiatric hospitals in metrosNone
NDPS Act; no research-access framework
None
South Africa
source 1 · source 2
Approved (2022)
SAHPRA
Not coveredyes — active private IV ketamine/KAP clinic market; SASOP position statement (2022) guides practiceTrials only
Psilocybin trials at SA sites; s21 named-patient route theoretically available but no documented psychedelic program
None
Ukraine
source 1 · source 2
Unconfirmed
State Expert Center MoH Ukraine
No public datalimited — ketamine licensed as anesthetic; growing interest in ketamine-assisted therapy for war-related PTSD, but no verified regulated clinic marketTrials only
Active parliamentary/clinical interest in MDMA and psilocybin research for veteran PTSD; no access framework yet
None

Notes and method

“Approved” follows the national or centralised regulator (EMA approval covers all EU/EEA member states). Coverage reflects the dominant public route and hides regional variation — country guides carry the detail. Psychedelic-therapy levels: state-regulated programmes exist only in two US states and (from 2026) the Czech Republic; compassionate use in Germany (psilocybin) and Israel (MDMA); Switzerland runs individual limited-medical-use authorisations; Australia and New Zealand use authorised-prescriber schemes. Rows marked “Unconfirmed” lacked a public registry entry we could cite — we do not guess. Corrections: hello@psyaccess.health.

See also: where treatment is available in Europe and the country-by-country access guides.