Mexico

Esketamine is COFEPRIS-registered: registro sanitario 236M2021 (Janssen-Cilag, 2021), treatment-resistant depression — access via private psychiatry.

Ketamine sits in Art. 245 fracción III of the Ley General de Salud (reclassified DOF 07-01-2014) — a controlled prescription medicine physicians may use off-label. Clinics operate legally in major cities and border towns serving US patients; screening quality varies enormously — verify the physician’s license and demand cardiac/psychiatric screening.

Psilocybin, psilocin and hallucinogenic mushrooms are scheduled in LGS Art. 245-I. The indigenous and Afro-Mexican exemption sits in the Código Penal Federal, Art. 195 bis, fracción II: prosecutorial non-prosecution, but only for peyote or hallucinogenic mushrooms, in quantities and circumstances consistent with the ceremonies, uses and customs of indigenous or Afro-Mexican peoples and communities recognized by their own authorities. Retreats marketing to foreigners sit in a gray zone, not a legal framework.

No medical framework.

Supreme Court rulings (amparos 2015–2019; general declaration of unconstitutionality resolved 28 Jun 2021) protect personal use and home grow via COFEPRIS permits; medicinal framework since 2017 (Art. 235 Bis, reglamento 2021); ≤5 g possession decriminalized (2009). Congress has never passed the regulated-market law — a legal limbo, not a market.

Ibogaine is absent from the Ley General de Salud schedules — not prohibited, and also not regulated: clinics operate without a specific framework, making Mexico the world’s main destination for ibogaine treatment (mostly opioid dependence), including the cohort behind Stanford’s 2024 Nature Medicine veterans study. The critical caveat is safety, not law: ibogaine carries serious cardiac risk (QT prolongation; deaths in unscreened settings) — ECG screening, cardiac monitoring and medical staffing are non-negotiable, and many clinics don’t meet that bar.

Site of major observational research (Stanford veterans ibogaine study, 2024 Nature Medicine); formal trial registry activity limited. Participation is free; screening is strict; never pay for “trial access”.