New legislation
From 2026 it will be possible to legally use psilocybin in the treatment of selected forms of depression in the Czech Republic. The change is based on an amendment to the Criminal Code and a related government regulation, which precisely define the conditions under which this previously banned substance can be used in medical practice.
The government-in-demise has approved a regulation that will allow the therapeutic use of synthetic psilocybin in selected patients with depression unresponsive to standard treatment. The key legal basis is an amendment to the Criminal Code that explicitly exempts the therapeutic use of psilocybin from criminal liability, but only under strict conditions. Psilocybin remains an addictive substance, but within a strictly defined medical framework it is no longer ‘taboo’. Self-medication, home experiments and the collection of psilocybin are certainly not legal with this decision – the law is clear on this.
The regulation and related professional procedures also detail who can prescribe and administer psilocybin. Only psychiatrists or clinical psychotherapists working in health facilities established by the Ministry of Health or with its special permission will be authorised. Dosage limits (maximum 75 mg per month), requirements for a specialised team and the obligation to combine with psychotherapy are laid down. An open legal question for the time being is the reimbursement of treatment by health insurance – without its resolution, the new legal option risks remaining a privilege rather than a standard part of care. The legislation has therefore taken the first step. Practice will now show how wide the door it has opened will be.
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