Reimbursed Care Access in French Polynesia

Currently classified as a strictly controlled substance under French national scheduling (listed on the arrêté/ lists of stupéfiants); there is no authorised routine medical prescription or reimbursement for psilocybin outside of specific, ANSM‑authorised clinical research. The classification as a stupéfiant prohibits production, importation, possession, sale or use except under express ANSM authorisation for research. # #.

Currently classified as a strictly controlled psychotropic/stupefiant under French law with no authorised medical availability or reimbursement outside approved clinical trials. Any therapeutic administration requires prior ANSM approval and a formal clinical trial framework; recreational possession/trafficking remains criminalised under the Code de la santé publique and the Penal Code. # #.

Esketamine (Spravato) is an authorised medicinal product in the European Union and France for adults with treatment‑resistant major depressive disorder (used in combination with an SSRI or SNRI) and is distributed under controlled conditions (supervised administration in healthcare settings). It received EU marketing authorisation (European Commission) on 18 December 2019 and the EMA EPAR describes the specific indication, supervised in‑clinic administration, and safety monitoring requirements. #.

In France the Haute Autorité de Santé (HAS) has issued opinions on esketamine reimbursement and conditions: HAS has evaluated and supported listing and periodic re‑evaluations of reimbursement scope and conditions (HAS publications document clinical criteria, age restrictions, and that it is to be used only after failure of at least two oral antidepressants in the current episode). Reimbursement decisions and the practical requirement for supervised administration (in authorised centres, with blood‑pressure monitoring and post‑administration observation) are defined by the national/regional healthcare system and the product's summary of product characteristics. Where national reimbursement applies in metropolitan France, access in French overseas collectivities (including French Polynesia) follows French regulatory authorisations — clinicians and hospitals in French Polynesia may access and prescribe esketamine consistent with national marketing authorisation and local healthcare organisation, but practical availability depends on local hospital/pharmacy procurement and regional reimbursement arrangements. # #.

Ketamine is a recognised and authorised medicine for anaesthesia, emergency analgesia and other standard hospital uses in France and therefore is available for medical care in French territories where hospital services exist. As an anaesthetic and analgesic agent ketamine is part of routine hospital formularies and its use for those indications is within standard reimbursed healthcare care pathways (public and private hospital billing). Off‑label use of ketamine (for depression) is practiced in some settings internationally but, in France, such psychiatric/off‑label use is not an established reimbursed indication and would ordinarily be delivered under research protocols or individual hospital authorisations; reimbursement for off‑label psychiatric use is not standard and depends on local agreements and payer rules. # #.

Currently classified as a strictly controlled psychotropic/stupefiant under French national drug‑scheduling rules; there is no authorised medical use or reimbursement in routine care outside of ANSM‑authorised clinical research. Possession, production, importation, transport or distribution is prohibited outside explicit research authorisations. # #.

Currently classified and controlled under French drug law as a prohibited psychotropic/stupefiant (no authorised medical use or routine reimbursement). Any use outside authorised clinical trials would be criminal under the Code de la santé publique and penal provisions. Research projects require ANSM authorisation. # #.

Currently classified as a strictly controlled substance under French scheduling or otherwise prohibited in practice; there is no authorised medical programme or reimbursement for ibogaine in France and therefore none in French Polynesia outside exceptional ANSM‑approved research. Activities involving ibogaine (possession, distribution) are prohibited absent specific authorisation. # #.

Plant materials or preparations that contain controlled alkaloids (notably DMT or harmala alkaloids) are treated as prohibited when they result in possession or distribution of scheduled substances; therefore ayahuasca is not authorised for routine medical care or reimbursement and is subject to criminal prohibition except within ANSM‑authorised research or very limited, case‑by‑case legal exceptions which are rare. French court history (and subsequent regulatory updates) has led to strong controls on plant preparations containing scheduled substances. # #.

Mescaline is listed among controlled psychotropes/stupefiants under French law and is not available for routine medical treatment or reimbursement; possession, manufacture or distribution outside authorised research is prohibited. # #.

Members of the 2C family (designer phenethylamines) are controlled under French law (listed or captured by analogue/psychotropic definitions) and are prohibited for possession, sale or use outside ANSM‑authorised research; there is no authorised medical use or reimbursement. Enforcement treats these substances as high‑risk new psychoactive substances. # #.