Republic of North Macedonia

Reimbursed Care Access

In the Republic of North Macedonia classical psychedelics (psilocybin, MDMA, DMT, 5‑MeO‑DMT, mescaline and most research chemistries) are controlled under national drug‑control law and have no authorised outpatient medical therapy or routine reimbursement. Ketamine is available and used within the formal health system as an anaesthetic and acute medical agent; however, psychedelic‑specific products (e.g., esketamine nasal spray/Spravato) and most psychedelic medicines are not authorised for reimbursed psychiatric indications and access is limited to hospitals, approved research or exceptional/compassionate pathways. Personal possession in very small amounts is treated as an administrative offence (fine) rather than an immediate criminal sentence, while trafficking and supply are criminal offences under the Law on Control of Drugs and Psychotropic Substances. [https://tripsitter.com/legal/north-macedonia/|Tripsitter — North Macedonia] [https://legalitylens.com/what-is-the-legality-of-psilocybin-in-north-macedonia/|LegalityLens — North Macedonia drug law summary].