Strictly Illegal

Reimbursed Care Access in Andorra

Andorra maintains strict national drug control laws that criminalize possession, consumption and trafficking of controlled psychoactive substances; there is no public, nationwide reimbursement program for psychedelic-assisted therapies and no evidence of authorized, reimbursed access to classic psychedelics outside regulated research. Certain pharmaceutical derivatives with formal regulatory approvals in the EU (e.g., esketamine/Spravato) are authorized at the European level but there is no clear evidence of routine public reimbursement or formal national programmatic access in Andorra. All other listed classic psychedelic compounds are subject to strict control with no authorized medical use outside approved clinical research or exceptional importation under medical protocols.

Psilocybin

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. Andorran public law reforms and criminal code provisions treat possession, consumption and trafficking of ‘toxic drugs’ as punishable offences; there is no national program authorizing medical psilocybin or reimbursement for psilocybin therapy. #

MDMA

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. MDMA is not available through reimbursed medical channels in Andorra and would only be accessible within a formally approved clinical trial or under exceptional regulatory authorisation. #

Esketamine

Authorized in EU (No confirmed Andorran reimbursement)

Esketamine (marketed as SPRAVATO) has an established regulatory approval and controlled-distribution framework in the European Union for treatment-resistant depression (EMA authorisation), including explicit safety controls requiring supervised administration and monitoring. The European Medicines Agency product assessment and prescribing/safety restrictions are described in the EMA EPAR for SPRAVATO. #

However, Andorra is not an EU Member State and there is no public documentation that SPRAVATO (esketamine nasal spray) is included in a reimbursed national formulary or routinely funded by any Andorran public health reimbursement programme. I found no official Andorran ministry-of-health published reimbursement listing or national guidance making esketamine a reimbursed item; given the country’s small health system and the national drug-control provisions, routine public reimbursement appears not to be in place. Importation or private provision might be possible on a case-by-case basis under hospital procurement or private clinic arrangements, but such access would be exceptional and not a nationally reimbursed pathway. # #

Ketamine

Off-label Medical

Ketamine is listed on global essential medicines lists for anaesthesia and is widely used internationally in medical practice (WHO Model List of Essential Medicines references ketamine as an essential injectable anaesthetic). #

In Andorra ketamine as a pharmaceutical anesthetic/analgesic would fall under standard controlled-medicine supply and hospital pharmacy channels rather than an open, reimbursed psychedelics programme. There is no evidence of a publicly funded psychedelic ketamine infusion programme or national reimbursement for ketamine therapy for psychiatric indications; any use of ketamine for psychiatric or off-label indications would be handled at the level of hospital/clinical governance and private provision, and subject to national controlled-substances law. Given ketamine’s status as a medically established anaesthetic (WHO) it may be present in health services for procedural sedation/anaesthesia, but psychiatric off-label infusion programs would not be reimbursed as a national programme unless explicitly adopted by the health service. # #

DMT

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. There is no national framework or reimbursement for DMT-assisted therapy in Andorra. #

5-MeO-DMT

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. No authorized or reimbursed medical pathways exist in Andorra for 5‑MeO‑DMT. #

Ibogaine

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. Andorra has no documented reimbursed ibogaine programmes or authorised medical use. #

Ayahuasca

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical or religious exemption frameworks publicly documented in Andorra; there is no reimbursed access for ayahuasca-assisted therapy outside approved research. #

Mescaline

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. No reimbursed medical pathway exists in Andorra for mescaline. #

2C-X

Strictly Illegal

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. There is no medical or reimbursement pathway for 2C‑X compounds in Andorra. #