Psilocybin Treatment Legality — the article + the world, ranked

A fuller editorial guide to psilocybin treatment legality is coming soon. For now, the ranking below compares every country we have assessed on it — open a country's report for the cited detail behind its score.

The country comparison

Which countries are best for psilocybin treatment legality

The destinations ranked high→low under this lens — each with the reasoning behind its score, the cited evidence one click down, and its full report. The verdict is free; the report is the depth.

19 / 19 Countries ranked

Researched and assessed by the Epidaurus editorial pipeline against our published scale. A country below the rule is not yet assessed enough — never ranked last.

1 United States US 4.0/5 Good The United States presents a good but geographically limited legal framework where psilocybin therapy is fully operational and explicitly legal in Oregon and Colorado, with comprehensive regulatory frameworks and prov... Full report
The evidence behind this score 5 cited points
- Oregon and Colorado have fully operational licensed psilocybin treatment programs with 21,246 items sold in Oregon (as of March 2024) and 34 licensed healing centers in Colorado operational as of February 2026
- International patients explicitly permitted with no residency requirements; more than 60% of Oregon patients are from out of state, confirming proven medical tourism infrastructure
- Comprehensive regulatory frameworks with licensing of facilitators (371 in Oregon), service centers (30 in Oregon, 34 in Colorado), manufacturers, and testing labs with mandatory safety protocols
- Psilocybin remains Schedule I controlled substance under federal law with no medical exemptions outside FDA-approved clinical trials, creating federal-state legal conflict
- Geographic limitations restrict legal access to 2 operational states and specific counties within those states, with legal barriers preventing nationwide access
Read the full United States report →
2 Israel IL 3.5/5 Moderate Israel permits psilocybin access only through authorized clinical trials, with no commercial treatment available for paying patients or medical tourists. However, the country demonstrates a strong and evolving regulat... Full report
The evidence behind this score 6 cited points
- Psilocybin is a dangerous drug under the Dangerous Drugs Ordinance 5733-1973, illegal for possession and supply outside authorized research; penalties up to 20 years for supply offences.
- At least 5 institutions (IPR-TLV, Be'er Yaakov, Sheba, HaEmek, Hadassah) hold Ministry of Health approvals for psilocybin clinical trials as of 2025–2026, spanning Phase 1 (safety), Phase 2a (PTSD/OCD feasibility), and Phase 2b (SUMMIT-90 macrodose PTSD trial, 160 patients).
- Ministry of Health issued September 2022 notification explicitly recognizing therapeutic potential of psilocybin and establishing cannabis-analogous research-supervision pathway.
- Clinical trials are the only legal access pathway for psilocybin in Israel; no commercial psilocybin therapy available for paying patients.
- Medical tourists may potentially access psilocybin through clinical trial enrollment, but trials impose fixed protocols, placebo probability, stringent eligibility criteria, and multi-month in-country commitments (~4.5 months for SUMMIT-90); no explicit published framework governs international patient participation.
- Israel established global-first MDMA compassionate-use program in February 2019, setting precedent for rapid psychedelic policy evolution and institutional willingness to approve psychedelic research.
Read the full Israel report →
3 Germany DE 3.5/5 Moderate Germany has established the EU's first compassionate use program for psilocybin (BfArM authorization, July 2025) with two operational licensed treatment centers, a clear regulatory framework, and government support—re... Full report
The evidence behind this score 5 cited points
- BfArM authorized EU's first psilocybin compassionate use program on July 11, 2025, with two licensed centers (CIMH Mannheim and OVID Clinic Berlin) operational
- Clear regulatory pathway exists through §41 AMG compassionate use framework with defined medical eligibility (treatment-resistant depression, failed ≥2 antidepressants); licensed psychiatrists make eligibility determinations without case-by-case regulatory applications
- Severe capacity constraint: approximately 50 treatment slots annually across entire EU region, with demand expected to far exceed supply from domestic patients alone
- Program designed within German statutory health insurance system; international patients without German health insurance have no coverage provisions and face uncertain out-of-pocket costs; no published international patient admission policies or tariffs exist
- DiMension Phase III trial (700+ patients) planned for 2025–2026 to support future EMA market authorization; program annually renewable through at least July 2026
Read the full Germany report →
4 Poland PL 2.0/5 Poor Poland classifies psilocybin as a Group I-P controlled substance with no recognized medical use exemptions, placing it among the most restrictive categories in Polish drug law. Criminal penalties of up to 3 years impr... Full report
The evidence behind this score 5 cited points
- Psilocybin and psilocin are Group I-P controlled substances under the Act of July 29, 2005 on Counteracting Drug Addiction, representing the most restrictive tier permissible only for authorized research
- Criminal penalties of up to 3 years imprisonment for possession, rising to 10 years for 'significant quantities,' with no medical exemptions or therapeutic use allowances
- PSINAPSE trial funded with 16.1 million PLN by the Medical Research Agency but as of early 2025 had not yet received required approvals from the European Medicines Agency and Chief Pharmaceutical Inspector, and patient recruitment had not opened
- No licensed psilocybin treatment clinics, no compassionate use programs, and no legal pathway for international patients; foreign nationals face up to 3 years imprisonment and Schengen Area entry bans
- Polish Psychedelic Society and academic researchers formally advocate for reclassification from Group I-P to Group IV-P, indicating institutional momentum for future reform despite no pending legislation as of mid-2026
Read the full Poland report →
5 Brazil BR 2.0/5 Poor Brazil maintains a complete prohibition on psilocybin therapy with no medical exemptions for patient treatment. While narrow research pathways exist for preclinical pharmaceutical development and ethics-approved clini... Full report
The evidence behind this score 5 cited points
- Psilocybin and psilocin classified as List F2 proscribed substances under ANVISA's Portaria 344/1998 with no medical exemptions for patient treatment
- No licensed psilocybin therapy program operates for patients; BioCase Brasil authorization limited to preclinical pharmaceutical development only
- No formal medical tourism infrastructure; underground market operates without regulation, medical oversight, or safety protocols
- Conflicting court rulings (April 2025 acquittal vs. STJ trafficking convictions) create unpredictable legal environment with pending STF ruling
- BioCase's drug development timeline projected at 5+ additional years before any patient access could occur
Read the full Brazil report →
6 Thailand TH 2.0/5 Poor Thailand receives a score of 2 (Poor) because psilocybin remains a Category 5 narcotic with severe criminal penalties despite the April 2024 ministerial notification. While the regulatory change creates a theoretical ... Full report
The evidence behind this score 5 cited points
- Psilocybin classified as Category 5 narcotic with criminal penalties: up to 1 year imprisonment or 20,000 baht fine for users; up to 15 years and 1.5 million baht fine for commercial distribution
- April 2024 ministerial notification permits research and medical use but requires FDA approval of drug formulations and production licenses—none have been granted as of early 2026
- No operational licensed treatment programs for routine therapy; public databases show no report of official clinical trials as of mid-2024
- Zero legal pathways for international patients; medical tourists accessing underground retreat centers face active prosecution risk (December 2024 incident resulted in tourist death and police arrests)
- Cannabis policy reversed June 26, 2025 from decriminalization back to strict medical-only restrictions, demonstrating unstable regulatory environment
Read the full Thailand report →
7 Colombia CO 2.0/5 Poor Psilocybin remains fully prohibited under Colombia's Schedule I classification with no therapeutic medical exemptions, no operational treatment programs, and active regulatory enforcement. While research infrastructur... Full report
The evidence behind this score 4 cited points
- Psilocybin and psilocin classified as Schedule I controlled substances under Law 30 of 1986 and Article 376 of Law 1453 of 2011, with no medical use exemptions
- No operational psilocybin therapy clinics, licensed treatment centers, or approved medical programs for domestic or international patients
- INVIMA Health Alert No. 308-2024 actively targets illegal psilocybin microdose distribution, reflecting official enforcement against commercialization
- 2022 congressional plans to legalize psilocybin have not resulted in legislation; cannabis legalization remains stalled in Senate as of mid-2026
Read the full Colombia report →
8 Spain ES 2.0/5 Poor Spain maintains strict prohibition on psilocybin therapy with no approved medical programs, compassionate use pathways, or licensing frameworks for treatment clinics. While Spain participates in international clinical... Full report
The evidence behind this score 5 cited points
- Psilocybin and psilocin are Schedule I controlled substances under Real Decreto 2829/1977 with no medical exemptions outside authorized clinical trials
- COMPASS Pathways COMP006 Phase 3 trial active across five Spanish hospital sites (Barcelona, Madrid, Sant Boi, Valladolid) but enrollment is closed and study is in follow-up phase
- No approved psilocybin therapy clinics, licensed treatment centers, or compassionate use programs exist in Spain
- No legal pathway for international patients; foreign nationals cannot obtain psilocybin therapy through medical channels
- No psilocybin policy reform legislation introduced in Spanish parliament as of June 2026; medical cannabis reform (2025) shows potential precedent but has not been applied to psilocybin
Read the full Spain report →
9 Japan JP 2.0/5 Poor Japan maintains a strict prohibition on psilocybin for all non-research purposes, classifying it as a Tier 2 narcotic (equivalent to cocaine) with zero medical exemptions. While government-funded research through Keio... Full report
The evidence behind this score 4 cited points
- Psilocybin classified as Tier 2 narcotic under Narcotics and Psychotropics Control Act (1953, amended 2002); mushrooms explicitly banned June 6, 2002; no therapeutic exemptions
- No licensed psilocybin therapy clinics or treatment programs; only AMED-funded Keio University research trial (12 participants, follow-up phase, not open to new patients)
- Foreign nationals face up to 7 years imprisonment and permanent re-entry ban; zero legal pathway for international medical tourists
- Keio-Otsuka partnership (May 2025) explicitly building foundational infrastructure; no near-term therapeutic access anticipated; PMDA approval would require Japan-specific Phase 2/3 data not yet collected
Read the full Japan report →
10 Mexico MX 2.0/5 Poor Mexico's psilocybin legal status remains largely restrictive despite emerging opportunities. While a cultural/ceremonial exemption in Article 195 bis and a 2021 Supreme Court amparo offer limited legal pathways, there... Full report
The evidence behind this score 5 cited points
- Psilocybin is Schedule 1 prohibited under federal law with criminal penalties of 4-7 years for unauthorized possession outside ceremonial contexts
- No COFEPRIS-approved medical psilocybin therapy framework exists; Article 195 bis exemption applies only to traditional spiritual/ceremonial use by indigenous communities, not therapeutic medical use
- Retreat centers operate in legal ambiguity under cultural exemptions; enforcement is inconsistent and subject to change, creating legal uncertainty for international patients
- First clinical research protocol published August 2023 but not yet operational; proposed October 2023 decriminalization bill remains stalled in Senate committee
- Supreme Court case pending that challenges the prohibition as violation of fundamental rights (case in First Chamber 2024), but complete judicial transition with new judiciary (September 1, 2025) creates profound uncertainty about outcome
Read the full Mexico report →
11 United Kingdom GB 2.0/5 Poor Psilocybin remains a Class A, Schedule 1 controlled substance with no medical exemptions for therapeutic prescription. While the UK hosts world-leading clinical research at Imperial College London, King's College Lond... Full report
The evidence behind this score 5 cited points
- Psilocybin is classified as Class A and Schedule 1 under the Misuse of Drugs Act 1971 and Misuse of Drugs Regulations 2001 — the most restrictive dual classification, explicitly designated as having 'no recognised medical use'
- No medical prescription programme, compassionate use programme, or special access scheme exists; access is exclusively through limited clinical trials at research institutions
- No operational treatment programs or licensed psilocybin therapy clinics provide therapeutic access; COMPASS Pathways Phase 3 success is significant but the company prioritizes FDA approval with no confirmed MHRA submission timeline
- The July 2025 government reforms reduce research licensing barriers for universities and NHS hospitals but explicitly do not create any patient treatment pathway or alter the Schedule 1 classification
- International patients cannot legally access psilocybin therapy in the UK; import of psilocybin without Home Office licensing constitutes serious criminal offence
Read the full United Kingdom report →
12 Jordan JO 1.0/5 Poor Jordan imposes a complete prohibition on psilocybin with no medical exemptions, no clinical trials, and no therapeutic access pathways whatsoever. The substance is criminalized under the Narcotic Drugs and Psychotropi... Full report
The evidence behind this score 4 cited points
- Psilocybin is a prohibited narcotic/psychotropic substance under Jordan's Narcotic Drugs and Psychotropic Substances Law No. 11 of 1988 (amended 2016 and 2021), implementing the 1971 UN Convention on Psychotropic Substances Schedule I classification
- No government-approved psilocybin therapy programs, licensed treatment centers, clinical trials, or compassionate use pathways exist in Jordan
- Possession of psilocybin carries 1–3 years imprisonment and fines of JD 1,000–3,000 (approximately USD 1,400–4,200), with equal penalties applying to foreign nationals
- Jordan's enforcement apparatus actively prosecutes drug offenses with 25,260 cases and 38,782 individuals processed in 2024; no medical tourism exception or therapeutic exemption exists
Read the full Jordan report →
13 Hungary HU 1.0/5 Poor Psilocybin is completely illegal in Hungary under Act C of 2012 with zero medical exemptions, no clinical trials, and no legal access pathways for domestic or international patients. The April 2025 constitutional amen... Full report
The evidence behind this score 7 cited points
- Psilocybin classified as fully prohibited narcotic substance under Act C of 2012 (Büntető Törvénykönyv, BTK) with no recognized medical exemptions
- April 2025 15th Amendment to Fundamental Law constitutionally embedded prohibition on 'production, use, distribution and promotion of narcotics,' making Hungary the first country in the world to do so
- Zero government-approved psilocybin therapy programs, licensed treatment centers, or clinical trials; OGYÉI has not approved any psilocybin research protocol
- Criminal penalties: up to 2 years imprisonment for possession of small quantities; 5-20 years or life imprisonment for providers/trafficking
- Foreign nationals subject to identical criminal law as Hungarian citizens; no medical exemption or special pathway for international patients
- June 2025 legislation eliminated the separate category for new psychoactive substances, further consolidating psilocybin under standard criminal provisions
- Dedicated anti-drug enforcement unit (KBEH) established March 2025 with 150 officers; new powers allow 72-hour detention and asset confiscation
Read the full Hungary report →
14 India IN 1.0/5 Poor India maintains a complete prohibition on psilocybin with no medical exemptions, licensed treatment programs, or clinical trials. Possession remains a criminal offense under the NDPS Act with strict penalties, and no ... Full report
The evidence behind this score 5 cited points
- Psilocybin classified as illegal psychotropic substance under NDPS Act, 1985 with no medical exemptions; possession of small quantities carries imprisonment and fines
- Zero government-approved psilocybin therapy programs, licensed providers, or active clinical trials currently operating in India
- No legal pathways for domestic or international patients; medical tourists face same criminal penalties as Indian citizens under NDPS provisions
- Government official stance remains conservative with no public indication of amending NDPS Act despite Kerala High Court ruling in January 2025 questioning mushroom classification
- Enforcement environment remains restrictive with NCB and police authorized to register cases under NDPS Act, despite inconsistent enforcement practices
Read the full India report →
15 United Arab Emirates AE 1.0/5 Poor Psilocybin is completely illegal in the UAE with no medical exemptions, no operational treatment programs, and no clinical trials. Criminal penalties are severe and have intensified recently, with 2025 amendments mand... Full report
The evidence behind this score 5 cited points
- Psilocybin explicitly classified as prohibited hallucinogen under Federal Decree-Law No. 30 of 2021 with no medical exemptions granted
- Possession carries minimum 3-month prison sentence or AED 20,000-100,000 fine; trafficking carries life imprisonment or death penalty; 2025 amendments mandate minimum 5-year sentence and mandatory deportation for foreign nationals
- No government-approved psilocybin therapy programs, licensed treatment centers, registered clinical trials, or compassionate use pathways exist
- Foreign nationals face criminal liability, mandatory deportation, and GCC-wide entry bans with no legal access pathway for medical tourists
- Recent policy trend is toward stricter enforcement (2025 amendments), not legalization; exploratory discussions remain at education/investment level without regulatory commitment
Read the full United Arab Emirates report →
16 South Korea KR 1.0/5 Poor Psilocybin is completely illegal in South Korea with no medical exemptions, no approved treatment programs, and no operational therapy centers. The substance is classified as a psychotropic drug under the Narcotics Co... Full report
The evidence behind this score 6 cited points
- Psilocybin classified as psychotropic drug under Article 2(4) of Act on the Control of Narcotics with complete prohibition for all purposes
- Criminal penalties of up to 10 years imprisonment or 100 million won fines for possession; 5 years to life imprisonment for manufacturing, importing, or distributing
- No government-sanctioned clinical trials, approved treatment programs, or licensed therapy facilities exist
- Foreign nationals convicted of drug offenses face deportation and permanent re-entry ban in addition to prison sentences
- Korean Customs maintains rigorous border enforcement with high-efficiency drug testing at all entry points and international mail monitoring
- Documented 2021 prosecution of individual attempting to import 90g of magic truffles from Netherlands, receiving 3-year suspended sentence with 4 years probation
Read the full South Korea report →
17 Malaysia MY 1.0/5 Poor Malaysia maintains complete criminal prohibition of psilocybin with no medical exemptions, authorized clinical trials, treatment programs, or legal access pathways for any patients. The Dangerous Drugs Act 1952 classi... Full report
The evidence behind this score 4 cited points
- Psilocybin is classified as a dangerous drug under the Dangerous Drugs Act 1952 (Act 234) with no therapeutic exemption; possession or sale constitutes a serious criminal offence with no medical use pathway
- No government-approved psilocybin therapy programs, authorized clinical trials, compassionate use pathways, or licensed treatment facilities exist in Malaysia
- Foreign nationals and medical tourists face identical criminal jeopardy to citizens; penalties for possession range from fines to life imprisonment to death, with no legal exemptions
- The legal definition of 'trafficking' is extraordinarily broad and includes administering or receiving the substance, creating extreme legal exposure for both practitioners and patients
Read the full Malaysia report →
18 Singapore SG 1.0/5 Poor Singapore maintains absolute prohibition of psilocybin as a Schedule A Class A controlled substance with zero medical exemptions, no operational treatment programs, no clinical trials, and no legal access pathway for ... Full report
The evidence behind this score 6 cited points
- Psilocybin explicitly listed as Schedule A Class A controlled substance under Misuse of Drugs Act 1973, highest-risk penalty category alongside heroin and cocaine, with no therapeutic exemptions in law
- Zero active clinical trials or approved psilocybin therapy programs in Singapore; no compassionate-use pathways exist
- Misuse of Drugs (Amendment) Act 2023 (effective June 2024) extended criminal liability to all psychoactive substances and formally scheduled tryptamines as New Psychoactive Substances, moving regulatory framework further away from therapeutic access
- Ministry of Home Affairs maintains explicit zero-tolerance drug policy with no exceptions for therapeutic or research-oriented use
- International patients cannot legally import psilocybin regardless of home-country prescription status; Singapore Customs and CNB enforce prohibitions against personal importation of controlled substances
- Statutory penalties: possession up to 10 years imprisonment and S$20,000 fine; trafficking/manufacturing/importation up to 30 years imprisonment and 15 strokes of cane or S$500,000 fine
Read the full Singapore report →
19 Turkey TR 1.0/5 Poor Turkey maintains complete prohibition of psilocybin with no medical exemptions, clinical trials, research programs, or legal access pathways for any form of medical use. Criminal penalties are severe—5 to 20 years imp... Full report
The evidence behind this score 5 cited points
- Turkey maintains complete prohibition of psilocybin and psilocybin-containing mushrooms with no medical exemptions, therapeutic access pathways, or clinical trial permissions
- Psilocybin classified as controlled substance under Law No. 2313 on the Control of Narcotic Drugs with zero medical exemptions and no physicians legally authorized to prescribe psilocybin therapy
- Criminal penalties: trafficking carries 5 to 20 years imprisonment plus fines and asset forfeiture; possession for personal use carries 1 to 2 years imprisonment
- No publicly available evidence indicates active psilocybin research trials, compassionate use programs, or academic research initiatives in Turkey
- Turkish drug policy framework has remained consistently prohibitionist since the 1970s with no pending legislation to create medical exemptions or clinical trial frameworks
Read the full Turkey report →

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