Portugal

Publicly financed for hospital use since 7 May 2025 (INFARMED) — under some of Europe’s strictest criteria: at least three failed antidepressant strategies in the current episode, prior psychotherapy, and a documented position on ECT (resistance, contraindication, lack of access or refusal). The route runs through hospital psychiatric services.

A small legal market concentrated in Lisbon: The Clinic of Change publishes a KAP programme at €3,900 with insurance / €5,500 without (evaluation €120); Liminal Minds (ERS-registered) runs infusion therapy and KAP without published prices. No Portuguese insurer routinely covers the ketamine-assisted component itself.

KAP €3,900–5,500/programme

The most misunderstood status in Europe: Law 30/2000 removed criminal penalties for personal possession of all drugs — it licensed nothing. No legal supply, no retreats, no therapy programme. What Portugal does have: the PsyPal psilocybin trial recruiting at the Champalimaud Foundation (NCT06782724), and national clinical recommendations on psychedelics presented in May 2025 — a system preparing, not yet offering.

Same Law 30/2000 logic: personal possession decriminalized, supply illegal, no medical route. No Portuguese MDMA trial is recruiting as of July 2026.

Medical cannabis by prescription since 2018 (Law 33/2018).

Small but institutionally serious: 3 studies tracked, 1 active — anchored by the Champalimaud Foundation in Lisbon. Recruiting: PsyPal (palliative care). Participation is free; screening is strict; never pay for “trial access”.