Is psychedelic therapy legal in the UK? Psilocybin, MDMA, ketamine and the NHS

At a glance

How UK drug law treats psychedelics

Two layers of law apply. The Misuse of Drugs Act 1971 puts controlled drugs into Classes A, B and C, which set the criminal penalties. The Misuse of Drugs Regulations 2001 then put each drug into a Schedule, which decides whether it can be used in medicine. Northern Ireland has its own equivalent regulations.

• Class A includes psilocin, lysergide (LSD), DMT and MDMA. The Act also covers "fungus (of any kind) which contains psilocin or an ester of psilocin", wording added by the Drugs Act 2005, so magic mushrooms are Class A whether fresh or dried (Home Office list).
• Penalties: for Class A drugs, up to 7 years in prison for possession and up to life for supply or production (GOV.UK; Schedule 4).
• Schedule 1 drugs, which include psilocin, LSD, DMT and MDMA, cannot be prescribed. The government says drugs are typically placed in Schedule 1 "when there is no established medical use in the UK" (written answer, 5 November 2025).
• Ketamine is Class B and sits in Schedule 2, the same schedule as many prescribable controlled medicines (Home Office list).

Is psilocybin therapy legal?

Only inside approved research. On 5 November 2025 the Home Office told Parliament that psilocybin-based medicines "have to date not been assessed on the basis of their safety, quality and efficacy and granted a marketing authorisation" by the MHRA. It also said that research with Schedule 1 drugs, including psilocybin, "proceeds in the UK under Home Office licence" (written answer 85461).

The same answer said that reconsidering how psilocybin is scheduled "would ordinarily follow" an MHRA assessment of a psilocybin medicine. It also said the government "has no current plans" to ask the Advisory Council on the Misuse of Drugs (ACMD) to review its scheduling. A new question asking for exactly that review was tabled on 22 October 2026 and is due for an answer by 27 October (written question 37245). We will update this page when it is answered.

The most advanced psilocybin medicine, Compass Pathways' COMP360, is going through a rolling FDA submission in the US. In the UK, the company says it holds an ILAP innovation designation, which is not a licence. See the COMP360 tracker row. As of 23 October 2026, we found 4 psilocybin trials with UK sites recruiting: see UK psilocybin trials.

Changes to research licensing

On 16 July 2025 the government responded to ACMD advice on barriers to research. It agreed "in principle" that research with Schedule 1 drugs in universities, university colleges and hospitals, and clinical studies with HRA and MHRA approval, could be exempted from needing a Home Office domestic licence, starting with a pilot (GOV.UK). This would not change the drugs' legal status or allow prescribing.

The change is not in force yet. On 27 April 2026 the Home Office said a cross-government officials group was developing the policy and that it would "publish further plans in due course" (written answer 128850). On 19 October 2026 the health department said it is working with the Home Office on the ACMD recommendations (written answer 31239).

Psychedelic therapy and the NHS

The Royal College of Psychiatrists (RCPsych) said in September 2025 that "other than ketamine and esketamine, these treatments are not currently available in the UK on a legal basis outside of clinical research trials". It did not recommend using them in routine clinical practice except where licensed (RCPsych PS02/25; news release).

• Esketamine (Spravato) is licensed for treatment-resistant depression, but NICE guidance TA854 says it "is not recommended, within its marketing authorisation" for that use on the NHS (NICE TA854). See the esketamine tracker row.
• Ketamine is licensed as an anaesthetic (Ketalar SmPC). For depression, RCPsych recommends its use "in specialist settings with appropriate oversight and long-term monitoring", and says take-home ketamine dosing "is not currently recommended" (RCPsych PS02/25).
• Psilocybin and MDMA are reached only through trials, some of which run at NHS sites. The NIHR-funded PsiDeR psilocybin trial ran in an NHS setting in England and published results in August 2026 (KCL).

MDMA-assisted therapy

MDMA is a Class A drug in Schedule 1 and is not a licensed medicine in the UK (Home Office list). RCPsych says that, apart from ketamine and esketamine, psychedelic treatments are not available legally in the UK outside research trials (RCPsych). Outside the UK, a US marketing application for MDMA-assisted therapy for PTSD has reportedly been resubmitted, and Australia lets authorised psychiatrists prescribe it. Both are sourced in the MDMA tracker row.

How the UK compares with Europe

Some European countries now allow limited legal access outside trials. Germany has a psilocybin compassionate use programme, Czechia has a national medical framework that took effect on 1 January 2026, and Switzerland grants case-by-case limited medical use. The UK has no equivalent route. See the Germany and Czechia tracker rows, and the European services in our directory. Our first issue covers the wider picture: Issue #1.

Why this guide names no clinics

UK law bans advertising prescription-only medicines to the public (Human Medicines Regulations 2012, reg. 284). Ketamine and esketamine are prescription-only, and psilocybin and MDMA are unlicensed. This guide therefore explains the law and does not promote any provider, drug or treatment. Our directory lists regulated services and registered trials neutrally, for information.

Sources

All facts and links checked 23 October 2026. Tracker rows carry their own sources and dates.

1. Misuse of Drugs Act 1971, Schedule 2 (controlled drugs by class). https://www.legislation.gov.uk/ukpga/1971/38/schedule/2
2. Misuse of Drugs Act 1971, Schedule 4 (maximum penalties). https://www.legislation.gov.uk/ukpga/1971/38/schedule/4
3. Misuse of Drugs Regulations 2001, Schedule 1. https://www.legislation.gov.uk/uksi/2001/3998/schedule/1
4. Misuse of Drugs Regulations 2001, Schedule 2. https://www.legislation.gov.uk/uksi/2001/3998/schedule/2
5. Misuse of Drugs Regulations (Northern Ireland) 2002. https://www.legislation.gov.uk/nisr/2002/1/contents
6. Drugs Act 2005, section 21 (fungi containing psilocin). https://www.legislation.gov.uk/ukpga/2005/17/section/21
7. Home Office: list of most commonly encountered controlled drugs. https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation
8. GOV.UK: drugs penalties. https://www.gov.uk/penalties-drug-possession-dealing
9. UK Parliament written answer 85461 (Home Office, 5 November 2025). https://questions-statements.parliament.uk/written-questions/detail/2025-10-27/85461
10. UK Parliament written question 37245 (Home Office, tabled 22 October 2026, awaiting answer). https://questions-statements.parliament.uk/written-questions/detail/2026-10-22/37245
11. GOV.UK: Government response to the ACMD report on barriers to research, part 2 (16 July 2025). https://www.gov.uk/government/publications/government-response-to-the-acmds-report-on-barriers-to-research-part-2/government-response-to-the-acmds-report-on-barriers-to-research-part-2-accessible
12. UK Parliament written answer 128850 (Home Office, 27 April 2026). https://questions-statements.parliament.uk/written-questions/detail/2026-04-21/128850
13. UK Parliament written answer 31239 (Department of Health and Social Care, 19 October 2026). https://questions-statements.parliament.uk/written-questions/detail/2026-10-09/31239
14. Royal College of Psychiatrists: position statement PS02/25, Psychedelic and related substances (PARS) for medical use. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/position-statements/position-statement---ps02_25-pars-for-medical-use.pdf
15. Royal College of Psychiatrists news release, 19 September 2025. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2025/09/19/more-research-needed-into-psychedelics-as-potential-treatments-for-mental-disorders--calls-rcpsych
16. NICE technology appraisal TA854: esketamine nasal spray for treatment-resistant depression. https://www.nice.org.uk/guidance/ta854/chapter/1-Recommendations
17. Ketalar (ketamine) Summary of Product Characteristics, electronic medicines compendium. https://www.medicines.org.uk/emc/product/2231/smpc
18. King's College London news: PsiDeR trial results (August 2026). https://www.kcl.ac.uk/news/promising-results-from-first-publicly-funded-uk-randomised-trial-of-psilocybin-for-depression
19. Human Medicines Regulations 2012, regulation 284 (advertising to the public). https://www.legislation.gov.uk/uksi/2012/1916/regulation/284