Medical Only (Private)

Reimbursed Care Access in Uruguay

Uruguay maintains a conventional controlled‑substances approach to classic and novel psychedelics: most classical psychedelics (psilocybin, MDMA, DMT, 5‑MeO‑DMT, mescaline, 2C‑X, ibogaine, ayahuasca) are treated under national drug control schemes with no routine reimbursed medical programs; ketamine is an accepted medical/veterinary anesthetic and is used off‑label in some private clinical settings for psychiatric indications. There is active public debate, some private/‘grey‑area’ practice and interest from clinicians/entrepreneurs, but no broad public insurance reimbursement framework for psychedelic‑assisted therapies as of the searches performed for this report.

Psilocybin

Strictly Controlled

Currently classified as a controlled/illicit substance under Uruguay’s drug control regime; there is no authorized, reimbursed clinical psilocybin program in the national health system. Public reporting and reviews of the legal framework note that classical psychedelics (including psilocybin) remain subject to national controls and are generally prohibited for non‑scientific uses; research activity and public debate exist but any therapeutic use would be limited to approved clinical research or exceptional regulatory pathways. #

MDMA

Strictly Controlled

Currently classified as a strictly controlled substance under Uruguay’s drug control/scheduling framework, with no authorized routine medical MDMA‑assisted psychotherapy or public reimbursement program; government agencies (Ministerio de Salud Pública / Secretaría Nacional de Drogas / Junta Nacional de Drogas) publish alerts on MDMA presence and risks, and MDMA possession/trafficking is treated under criminal drug statutes. Any therapeutic use would be confined to formally approved clinical trials or tightly controlled research settings. #

Esketamine

Off‑label Medical

Esketamine (commercial product Spravato) is an approved pharmaceutical for treatment‑resistant depression in jurisdictions with regulatory authorization, but there is no publicly documented, widely‑accessible national reimbursement program for esketamine in Uruguay; by contrast, standard ketamine remains a registered/used anesthetic in medical and veterinary practice and is used off‑label by some clinicians for psychiatric indications. In Uruguay ketamine is regulated for medical and veterinary use and is available in clinical settings as an anesthetic; its off‑label psychiatric use (e.g., sub‑anesthetic ketamine infusions for depression) has been reported in private practice and appears to operate largely outside public reimbursement schemes. Reporting on Uruguay’s ketamine market and regulation notes veterinary availability and medical use but does not identify a national, reimbursed esketamine (Spravato) program. # #

Ketamine

Off‑label Reimbursed

Ketamine is an established, legally‑distributed anesthetic in Uruguay (medical and veterinary uses) and is available within hospitals and veterinary practices; veterinary channels have been identified as a major source of diversion for non‑medical use, and the Ministry of Health has issued guidance about risks associated with ketamine. Clinically, sub‑anesthetic ketamine infusion protocols or intramuscular/intravenous ketamine for depressive disorders are used in some private clinics and by individual practitioners (off‑label); however, there is no evidence of a national public insurance (FONASA/ASSE)–funded, standardized ketamine‑assisted psychotherapy program or routine reimbursement for ketamine antidepressant treatment. Private payment or out‑of‑pocket arrangements and clinic‑level billing are the dominant models where used. Regulatory oversight for ketamine (as an anesthetic) is exercised by the Ministerio de Salud Pública (MSP), and national reporting highlights both medical uses and non‑medical diversion. # #

DMT

Strictly Controlled

Currently classified as a controlled substance under Uruguay’s drug laws (DMT and DMT‑containing preparations such as many ayahuasca brews are treated under the general prohibitions on controlled psychotropic substances). There is growing scholarly and public attention to ritual/therapeutic ayahuasca use in Uruguay, and surveys/studies have been published about ritual/ceremonial ayahuasca practices, but routine medical or reimbursed clinical DMT therapy is not authorized outside regulated clinical research. # #

5-MeO-DMT

Strictly Controlled

Currently classified under Uruguay’s drug control framework as an illicit/controlled psychoactive; there is no documented, reimbursed clinical access to 5‑MeO‑DMT in Uruguay and any therapeutic research would be limited to sanctioned clinical trials. Public and academic commentary discusses interest in research but not any public reimbursement or routine medical programs. #

Ibogaine

Clinical Trials Only

There is regional/regional‑private interest in ibogaine for addiction treatment and news reporting that entrepreneurs and clinicians have sought to import or develop ibogaine services in Uruguay; however, ibogaine is not part of a reimbursed national treatment program and clinical use would be exceptional, private, or confined to formal research approvals. Recent reporting describes interest from private operators and an ongoing public conversation about risks (notably cardiac risks) and potential clinical offerings, but no established, reimbursed public program. Any therapeutic use outside approved clinical research would face legal/regulatory barriers. #

Ayahuasca

Decriminalized

Ritual/ceremonial use of ayahuasca has been documented and surveyed in Uruguay and is the subject of academic/public‑health attention; Uruguayan literature and government studies point to a ‘growing ritual use’ phenomenon. Nevertheless, ayahuasca preparations containing DMT remain controlled under national drug laws for non‑authorized medical use — in practice ritual groups operate in a legal grey area and there is no reimbursed medical program for ayahuasca‑based therapies. Therapeutic uses would be local/private and not part of national reimbursement. # #

Mescaline

Strictly Controlled

Mescaline (and mescaline‑containing cacti) are regulated as controlled substances under Uruguay’s drug laws; there is no routine medical authorization or national reimbursement for mescaline therapy and any use would be limited to formally approved clinical trials or exceptional authorizations. Public reporting groups mescaline among classical psychedelics that remain prohibited except for research uses. #

2C-X

Strictly Controlled

Novel phenethylamine derivatives in the 2C family (2C‑B, 2C‑I, etc.) are illegal/controlled in Uruguay and have been the subject of recent law‑enforcement actions; there is no authorized medical program or reimbursement for 2C‑series compounds, and they are treated as illicit/controlled substances with penal and public‑health responses. Recent police and judicial reports in Uruguay document seizures and prosecutions involving 2C‑B/related products. #