Netherlands

In the basispakket since 1 September 2021, following the Zorginstituut’s package advice — but only at specialized centers meeting national quality criteria (many cooperate in the ENC-NL consortium), and only after three failed medication steps in the current episode: two antidepressants plus an augmentation strategy. Stricter than the EU label; psychiatrist referral required.

Hospital psychiatric departments run (es)ketamine infusion units under specialist or research protocols — there is no UK-style private clinic market. Oral esketamine is being studied under the Zorginstituut’s “promising care” scheme with results due around 2029; outside that research it is not reimbursed.

The famous quirk: psilocybin mushrooms were banned in 2008, but truffles (sclerotia) were never scheduled — legally sold and taxed, the basis of the open retreat industry. Honesty required: retreats are wellness businesses, not healthcare — no medical screening obligations, facilitators usually not clinicians, no insurer coverage. Medical psilocybin therapy itself exists only inside research.

Opium Act List I. An MDMA-assisted psychotherapy trial for PTSD is recruiting at ARQ Centrum’45 (NCT06954025), and the 2024 Dutch State Commission report proposed further therapeutic research — momentum, not an access route.

Medical: prescription via the national Office of Medicinal Cannabis. Non-medical: coffeeshop sale of ≤5 g is tolerance (gedoogbeleid), not legality — but since 7 April 2025 the wietexperiment’s full phase means ~80 coffeeshops in 10 municipalities sell only legally produced, quality-controlled cannabis (running to ~2029).

54 studies tracked, 12 active — Maastricht is the historic hub, plus UMCG, LUMC, UMC Utrecht and ARQ Centrum’45. Participation is free; screening is strict; never pay for “trial access”.