Pakistan

Reimbursed Care Access

Pakistan maintains a restrictive controlled-substance regime under the Control of Narcotic Substances Act, 1997 (CNSA), which broadly prohibits possession, manufacture, distribution and trafficking of narcotic and psychotropic substances except where specifically authorised for medical, scientific or industrial purposes. Ketamine is routinely available and used in medical settings (anesthesia) and is also used off‑label in some private-sector psychiatric settings for depression, but there is no national reimbursement or formal public program for psychedelic-assisted therapies; most other classic psychedelics (psilocybin, MDMA, DMT, 5‑MeO‑DMT, ibogaine, mescaline, 2C‑X, ayahuasca) are treated as controlled/illegal with access limited to authorised clinical research or wholly prohibited. Key enforcement agencies include the Anti‑Narcotics Force (ANF) and provincial drug-control departments, while regulatory oversight for registered medicines sits with the Drug Regulatory Authority of Pakistan (DRAP). [https://www.legislation.pk/browse-legislation/federation-of-pakistan/28-the-control-of-narcotic-substances-act-1997|Control of Narcotic Substances Act 1997] [https://www.anf.gov.pk/lib-details.php?folder=acts&title=ACTS+%2F+SROs+%2F+RULES+%2F+POLICIES+%2F+INSTRUCTIONS&type=ACTS|Anti‑Narcotics Force (ANF) - Acts] [https://pmc.ncbi.nlm.nih.gov/articles/PMC12552226/|Esketamine for TRD in Pakistan - review].