Cayman Islands

Reimbursed Care Access

The Cayman Islands maintains strict drug control under its Misuse of Drugs legislation; most classic psychedelics (psilocybin, MDMA, DMT, 5‑MeO‑DMT, mescaline, 2C‑X, ibogaine, ayahuasca) are treated as controlled substances with no authorised medical use outside approved research. Ketamine is available and used in medical settings (primarily as an anesthetic) but psychedelic/psychiatric uses of ketamine remain off‑label and are not covered by public reimbursement. There is no publicly available evidence of local regulatory approval or public reimbursement for esketamine (Spravato) in the Cayman Islands; medicinal cannabis is the notable exception to total prohibition (separately regulated).