Belgium

Reimbursed since June 2021 under INAMI/RIZIV Chapter IV: hospital-administered, per-patient prior authorization by the insurer’s advising physician, for moderate-to-severe depression after at least two failed antidepressants.

Effectively no private clinic market — off-label IV ketamine exists inside hospital psychiatry under prescriber responsibility (typically resistant depression or acute severe suicidal distress).

Trial-only under the FAMHP annexes — but two hospital studies are recruiting: Ghent for treatment-resistant depression (NCT06378229) and CHU Brugmann, Brussels, for severe alcohol use disorder (NCT06160232).

No Belgian MDMA trial is recruiting and no compassionate-use programme is open.

Sativex is the only marketed cannabis-based medicine since 2015 (MS spasticity; neurologist prescription, hospital pharmacy); raw cannabis and magistral preparations may not be dispensed. Recreational: illegal, with lowest prosecution priority for adult possession of up to 3 g / 1 plant (2005 directive) — de facto tolerance, no clubs.

18 studies tracked, 4 active — a hospital-led ecosystem: Brussels, Ghent, Leuven, Liège. Participation is free; screening is strict; never pay for “trial access”.