Medical Access and Reimbursement in France

Psilocybin and psilocin are listed in the French narcotics framework, and no routine medical prescribing route exists. Patient access is currently limited to authorised clinical research, including France-based studies at CHU Nimes and the Paris COMP006 and PSILOTRAZ pipeline. # # # # #

MDMA is listed in the French narcotics framework. No French market authorisation, reimbursement route or routine therapeutic pathway for MDMA-assisted therapy was identified in the official sources reviewed. #

Esketamine nasal spray is authorised as Spravato, but practical access is hospital-centred. The public medicines database lists the marketed nasal presentation as prescription-only, hospital use, approved for collectivity, and non-reimbursable in community pharmacy. #

HAS supports restricted use in treatment-resistant depression but was unfavourable for the depressive-emergency extension involving acute suicidal ideation. France's 2026 anti-suicidal access change therefore comes through racemic ketamine CPC, not a broad retail reimbursed Spravato route. # # #

Ketamine is an authorised hospital medicine for anaesthesia and selected emergency, pain and palliative indications. The French medicines database lists Ketamine Renaudin as prescription-only, hospital-use, and a controlled medicine with restricted prescription and administration conditions. #

In March 2026, ANSM established a CPC for IV racemic ketamine in severe suicidal ideation in adults. This is a hospital-based compassionate prescribing framework with pharmacovigilance obligations, not a broad outpatient psychiatric ketamine market. ANSM has also warned about risks from prolonged or repeated ketamine use. # # #

DMT is listed in the French narcotics framework. No French market authorisation, reimbursement route or routine medical access pathway for DMT-assisted therapy was identified in the sources reviewed. #

No French market authorisation, reimbursement route or routine medical access pathway for 5-MeO-DMT was identified in the reviewed public sources. The report avoids a definitive compound-level scheduling claim for 5-MeO-DMT pending manual verification in current primary law. #

No French market authorisation, reimbursement route or routine medical access pathway for ibogaine was identified in the reviewed public sources. Any future legal-status table should verify ibogaine directly against the current French narcotics list. #

France added several ayahuasca-source plants and related alkaloids to the narcotics list in 2005, including Banisteriopsis caapi, Psychotria viridis, Peganum harmala and harmala alkaloids. No ceremonial or medical access carve-out was identified in the official framework reviewed. #

Mescaline is listed in the French narcotics framework. No French market authorisation, reimbursement route or routine medical access pathway for mescaline-assisted therapy was identified in the sources reviewed. #

No French authorised or reimbursed medical pathway for the broad 2C-X category was identified. Because the category covers multiple compounds, any legal-status grid should verify specific molecules rather than relying on a generic class label. #