Paraguay

Reimbursed Care Access

Paraguay maintains a restrictive national control regime for classic psychedelics and empathogens; most substances (psilocybin, MDMA, DMT, 5‑MeO‑DMT, mescaline, 2C‑X, ibogaine, ayahuasca preparations) are controlled and have no authorized medical reimbursement pathway outside approved clinical research. Ketamine is an approved medicinal anesthetic available in the health system and is being used in clinical settings (including emerging, limited programs for refractory psychiatric indications), but reimbursed, on‑label psychiatric use (e.g., for depression) and access to esketamine (Spravato) are not established. Regulatory control and enforcement are administered primarily by the Secretaría Nacional Antidrogas (SENAD) together with DINAVISA and Ministry of Health rule‑making. [https://senad.gov.py/senad/marco-legal/|SENAD Marco Legal]