Reimbursed Care Access in Cook Islands

Currently classified as a strictly controlled substance under the Cook Islands narcotics/controlled‑drugs framework, with no authorised medical use outside of approved clinical research or explicit regulatory exceptions. The Cook Islands’ health and medicines importation rules require strict documentation for controlled drugs and there are no public national approvals or reimbursement pathways for psilocybin therapy reported by Te Marae Ora. # #

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. There are no public Cook Islands regulatory approvals or reimbursement mechanisms for MDMA‑assisted therapy; access would be limited to formal, approved clinical trials or exceptional regulatory approvals (none publicly reported). #

No publicly available evidence of national approval, listing, or reimbursement of esketamine (Spravato®) for depression in the Cook Islands health system; any importation or use would be subject to Te Marae Ora controlled‑drugs procedures and specific product registration/import licence processes. The international branded product (Spravato®) has regulatory approvals in other jurisdictions, but the Cook Islands has not published a national approval or funded programme for esketamine as of February 20, 2026. Patients or clinics attempting to import esketamine would need to comply with the Cook Islands’ controlled‑drug importation rules and the Ministry’s medicine‑listing/approval processes. # #

Ketamine (injectable) is an internationally recognized essential anaesthetic agent and appears on the WHO Model List of Essential Medicines, supporting its legitimate availability for anaesthesia and acute medical use in health systems; in the Cook Islands such controlled medicines are regulated by Te Marae Ora and may be imported/used in healthcare settings under the prescribed controlled‑drugs rules, but there is no publicly documented national programme reimbursing ketamine for psychedelic psychotherapy or routine outpatient antidepressant use. # #

Regulatory/coverage details: the Cook Islands’ Ministry of Health requires specific documentation and limits quantities for controlled drugs brought into the country (e.g., one month’s supply for controlled drugs) and designates which medicines are classed as controlled; this implies that ketamine may lawfully be used in hospitals/medical settings with appropriate importation/dispensing paperwork, but there is no public evidence of a funded national outpatient ketamine‑for‑depression service or formal reimbursement scheme. Patients seeking ketamine for non‑anaesthetic (psychiatric) indications should expect that access would be exceptional, clinician‑led, and subject to importation/controlled‑drug regulation rather than an established reimbursed therapy. # #

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. There are no published Cook Islands approvals or reimbursement pathways for DMT or DMT‑containing preparations. Access would be limited to authorised research projects should any be approved by national regulators. #

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. The Cook Islands have not published regulatory pathways that permit medical or reimbursed therapeutic use of 5‑MeO‑DMT. #

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 public evidence of government‑approved medical or reimbursed ibogaine programmes in the Cook Islands. #

DMT‑containing botanical preparations such as ayahuasca are treated under the same controlled‑substances framework; currently there is no authorised medical use or reimbursement for ayahuasca in the Cook Islands outside of regulated clinical research. Importation and possession of DMT‑containing products would be subject to the Narcotics/Misuse of Drugs legislative regime and Ministry of Health controls. #

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. Mescaline (and peyote) has no reported national approval or reimbursement pathway in the Cook Islands. #

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research. There are no Cook Islands regulatory approvals or reimbursement programmes for 2C‑series phenethylamines. Possession, importation or distribution outside authorised research would be prohibited under the narcotics/misuse framework. #