Spain

Publicly financed as a hospital-dispensed medicine for adults 18–74 whose current moderate-to-severe episode failed at least 3 treatment strategies including an augmentation. Access varies noticeably across the 17 autonomous communities — a refusal at one hospital is not a final answer for all of Spain.

Legal from licensed physicians in authorized facilities — clinics in Barcelona, Madrid and Mallorca; full KAP programmes run to thousands of euros.

KAP: thousands of €

Research-only; Spanish sites took part in the completed BPL-003 Phase 2b (NCT05870540).

Research-only — no medical access route.

Medical — newly real: Royal Decree 903/2025 (7 Oct 2025) regulates standardized cannabis magistral formulas for spasticity due to multiple sclerosis, severe forms of refractory epilepsy, nausea and vomiting due to chemotherapy, and refractory chronic pain — hospital specialist prescription, hospital-pharmacy dispensing, oral-oil solutions only (flower and home cultivation explicitly excluded); rollout during 2026. Non-medical: private use and cultivation are not criminal (public possession fined); ~1,000+ cannabis social clubs operate under shared-consumption jurisprudence — bounded by the Supreme Court’s 2015 trafficking doctrine (STS 484/2015: large, organized, persistent clubs count as trafficking; small, closed, non-commercial groups don’t) and by mixed regional outcomes — Catalonia’s and Navarre’s club laws were annulled by the Constitutional Court (2018), while the Basque Country’s was upheld (2019), precisely because it stopped short of regulating distribution. A tolerated gray zone, not a licensed system.

24 studies tracked, 4 active — psilocybin, 5-MeO-DMT and ketamine studies. Participation is free; screening is strict; never pay for “trial access”.