South Africa

Spravato is SAHPRA-registered: Reg. No. 53/1.2/0732 (Janssen), Schedule 5, first authorised 6 April 2022 — delivered through private psychiatry.

Ketamine is a Schedule 5 registered medicine (anesthetic label), and private clinics in Johannesburg, Cape Town and Durban legally provide off-label infusions for depression under physician responsibility — one of the more developed markets outside Europe/North America. The national psychiatry association (SASOP, 2022) requires anesthetist administration and proper screening.

Scheduled; no medical framework.

Scheduled; no medical framework.

On paper: private adult use and cultivation are a constitutional right (Prince, ConCourt 2018); the Cannabis for Private Purposes Act 7/2024 was signed 28 May 2024 but is NOT yet in force (no commencement proclamation; draft regulations published Feb 2026 — 750 g / 5 plants proposed). On the ground: private-members grow clubs operate widely, Spain-style — but the Haze Club ruling held the model unlawful. So, clubs remain tolerated in practice but exposed to prosecution — a high-risk gray zone.

Ibogaine is listed in Schedule 6 of the Medicines and Related Substances Act (verified in the consolidated schedules; scheduled by the Medicines Control Council ~Feb 2016) — the strictest prescription-only category, not a prohibition. A narrow legal basis some clinics use; cardiac-risk screening is non-negotiable.

Growing scene — ketamine and psilocybin studies at university hospitals (Cape Town, Stellenbosch). Participation is free; screening is strict; never pay for “trial access”.