Country-by-country guide to MDMA legality: Australia's prescribing program, decriminalization in Portugal and the Czech Republic, and the US executive order.
MDMA is not legal recreationally anywhere in the world. It is classified as a controlled substance in virtually every country. In Europe, Portugal and the Czech Republic have decriminalized personal possession, but those policies reduce penalties without legalizing MDMA or approving clinical therapy. For medical use, Australia and New Zealand permit MDMA-assisted psychotherapy for PTSD. Australia was the first, on July 1, 2023, allowing authorised psychiatrists to prescribe MDMA for PTSD through ongoing applications under the Therapeutic Goods Administration (TGA) Authorised Prescriber scheme. New Zealand became the second country, in September 2026, though under a far narrower pathway: Medsafe granted individual permission under Regulation 22 of the Misuse of Drugs Regulations 1977 to two named practitioners, Dr Gary Wynn in Wellington and Dr Tom Paterson in Auckland, not under a general authorised-prescriber scheme. MDMA was not approved as a general medicine in New Zealand and remains an unapproved controlled substance there. For the broader picture across psilocybin, ayahuasca, and ketamine, not just MDMA, see the international psychedelic law guide.
MDMA's legal status does not vary by U.S. state. It is Schedule I under the federal Controlled Substances Act. That status applies the same way in California, Colorado, Oregon, Texas, New York, and every other state. Several states and cities have separately decriminalized psilocybin or approved it for supervised use. MDMA has not been part of any of those measures. No state has independently legalized, decriminalized, or created a therapeutic access pathway for MDMA. For the psychedelics that do vary state-by-state, see the legal status by state tool. For the full federal-law breakdown, see Is MDMA Legal in the US?
Australia and New Zealand, as of 2026. New Zealand's access is far narrower: two named prescribers, not a general pathway (see below). Since July 1, 2023, authorised psychiatrists in Australia can prescribe MDMA for PTSD under the TGA Authorised Prescriber scheme — making it the world's first country to legally permit MDMA-assisted psychotherapy in clinical practice. In the United States, MDMA-assisted psychotherapy remains Schedule I. The FDA rejected Lykos Therapeutics' application in August 2024 and has required an additional Phase 3 trial. Clinical trial access is the only legal route in the US; see the clinical trial finder for open MDMA studies.
| Country | Status | Details |
|---|---|---|
| Australia | Legal (therapy) | Since July 1, 2023, authorised psychiatrists can prescribe MDMA for PTSD under the TGA Authorised Prescriber scheme. Available in 6 of 8 states/territories. ~87 patients treated by September 2025. Government funding began in 2025–26. Supplied by Optimi Health. |
| New Zealand | Legal (2 prescribers) | In September 2026, Medsafe approved two psychiatrists, Dr Gary Wynn and Dr Tom Paterson, under Regulation 22 of the Misuse of Drugs Regulations 1977 to prescribe MDMA for PTSD. This is an individual approval rather than a class-wide policy, and MDMA remains an unapproved medicine in New Zealand. No Pharmac or ACC funding is allocated, and a course costs approximately NZ$45,000. |
| Portugal | Decriminalized | Since 2001, personal possession of all drugs — including MDMA — is an administrative offense, not criminal. Referred to a dissuasion commission rather than courts. Production, trafficking, and sale remain criminal. No therapeutic access. |
| Czech Republic | Decriminalized | Possession of small quantities of MDMA (typically <4 tablets / <2 g) is a misdemeanor, not a criminal offense. Sale, production, and larger quantities are criminal. No therapeutic program. |
| Canada | Compassionate use | MDMA is Schedule I (CDSA). Health Canada’s Special Access Program (SAP) allows case-by-case requests for patients with serious conditions when conventional treatments have failed. 41 MDMA requests were approved in February 2024, but approvals have declined sharply since. Procurement of pharmaceutical-grade MDMA remains difficult. |
| Israel | Compassionate use | Israel approved a compassionate use program for MDMA in 2019, allowing approximately 50 individuals with PTSD to receive MDMA-assisted therapy outside of clinical trials. MDMA remains a controlled substance; the program is limited and not open enrollment. |
| United States | Schedule I | MDMA is federally Schedule I with no approved therapeutic use. The FDA rejected Lykos’ NDA in August 2024; Lykos (now Resilient Pharmaceuticals) resubmitted the NDA in August 2026. The April 2026 executive order accelerates regulatory review but does not change MDMA's legal status. Access: clinical trials and FDA Expanded Access only. |
| United Kingdom | Class A | MDMA is Class A under the Misuse of Drugs Act 1971 — the highest restriction category. No therapeutic access pathway exists outside of licensed research. Penalties for possession are up to 7 years; for supply, up to life. |
| Netherlands | Prohibited | Despite liberal policies on psilocybin truffles, MDMA sale, possession, and use are prohibited. The Netherlands is a major producer of illicit MDMA but does not permit legal therapeutic or recreational use. |
| Germany | Anlage I (BtMG) | MDMA is classified under Anlage I of the Narcotics Act (Betäubungsmittelgesetz), equivalent to Schedule I. No therapeutic access outside of research. The MIND Foundation conducts MDMA research in Berlin. For Germany's broader psychedelic policy, including its 2025 psilocybin compassionate-use program, see the international psychedelic law guide. |
| Switzerland | Compassionate use | MDMA is a controlled substance, but the Federal Office of Public Health can grant exceptional permissions for compassionate use. Several Swiss psychiatrists have used MDMA and LSD in therapeutic settings under these exemptions. Not a general access pathway. |
| Mexico | Partial decrim | Mexico decriminalized personal possession of small amounts of various drugs in 2009 (MDMA threshold: 40 mg, roughly one dose). Amounts over the threshold remain criminal. No MDMA therapy programs exist. |
| Japan | Prohibited | MDMA is strictly prohibited under the Narcotics and Psychotropics Control Act. Harsh penalties for possession (up to 7 years) and supply (up to life). No research or therapeutic exemptions. |
| Jamaica | Controlled | Jamaica's psilocybin-friendly reputation — the basis for the legal psilocybin retreats covered elsewhere on this site — comes from natural mushrooms never being scheduled under the Dangerous Drugs Act. That loophole does not extend to MDMA: as a synthetic substance, MDMA is controlled there with no therapeutic exemption or retreat equivalent. |
| Belgium | Schedule I | MDMA falls under Schedule I classification under the Law of 24 February 1921, which incorporated the 1971 United Nations (UN) Convention on Psychotropic Substances through amendments including the Law of 25 June 1992. Personal drug use is not directly criminalized under Belgian law, but possession, production, import, export, or sale carries penalties of three months to five years of imprisonment alongside fines of 8,000 to 800,000 euros. No therapeutic or religious exemption exists. |
| Denmark | Controlled (List B) | MDMA is a controlled substance under Denmark's Consolidated Act No. 748 of 1 July 2008 on Euphoriant Substances, administered by the Danish Medicines Agency (Lægemiddelstyrelsen). Under the Danish classification system, List B restricts designated compounds exclusively to medical and scientific purposes, but MDMA currently holds no approved medical or scientific indications. No therapeutic pathway exists. |
| Ireland | Schedule 1 | MDMA is a controlled Schedule 1 drug under the Misuse of Drugs Act 1977, as amended by the Misuse of Drugs Acts of 1984 and 2015 and the Criminal Justice (Psychoactive Substances) Act 2010. Following a 2015 Court of Appeal ruling later overturned by the Supreme Court, a legal loophole technically decriminalized MDMA for roughly 24 hours until emergency legislation closed the opening. No therapeutic access pathway exists today. |
| India | Controlled (NDPS Act) | MDMA is regulated as a psychotropic substance under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985. Under Section 22 of the Act, prosecution depends on quantity thresholds that differentiate small quantities for personal use from commercial quantities, with penalties scaling accordingly. No therapeutic or research exemption pathway exists. |
| South Africa | Controlled | MDMA is scheduled as a controlled stimulant under the Drugs and Drug Trafficking Act 140 of 1992, as amended by the Drugs and Drug Trafficking Amendment Act No. 14 of 2022. Readers frequently search for MDMA therapy alongside Cape Town or Johannesburg, but statutory drug control applies nationally and the legal status does not vary by city. No therapeutic access pathway exists. |
| Thailand | Category 1 | MDMA is classified as a Category 1 substance under Thailand's Narcotics Code B.E. 2564 (2021), the category reserved for drugs considered to have no accepted medical application. Offenses involving Category 1 substances carry penalties of up to 10 years of imprisonment and fines ranging from 20,000 to 200,000 Thai baht. No research or treatment exemption exists. |
On July 1, 2023, Australia became the first country where MDMA can be legally prescribed for PTSD. The Therapeutic Goods Administration (TGA) rescheduled MDMA from Schedule 9 (Prohibited) to Schedule 8 (Controlled Drug) specifically for use by psychiatrists approved as Authorised Prescribers.
How it works: a psychiatrist must apply to the TGA and receive approval from a human research ethics committee. Once authorised, they can prescribe MDMA capsules — currently supplied by Optimi Health — for PTSD under a structured treatment protocol of up to three dosing sessions with psychotherapy.
By September 2025, 35 Authorised Prescriber applications had been approved (18 for MDMA, 17 for psilocybin), and approximately 87 patients had been treated with MDMA-assisted therapy with no serious adverse events recorded. The program has expanded to six of Australia’s eight states and territories, including regional areas. The Australian government has begun funding treatment where eligible, with enhanced supports funded over four years from 2025–26.
Limitations: this pathway is available only to Australian residents, only for PTSD, and only through approved psychiatrists. It is not available to international medical tourists. Treatment costs are significant, though government subsidies are beginning to reduce the barrier.
In September 2026, New Zealand authorised the clinical prescribing of pharmaceutical-grade MDMA for post-traumatic stress disorder (PTSD). The approvals made New Zealand the second country worldwide to permit the treatment, following Australia's rescheduling in 2023.
Medsafe, the national medicines regulator, granted individual permission under Regulation 22 of the Misuse of Drugs Regulations 1977. Only two practitioners received permits. They are Dr Gary Wynn, a trauma specialist in Wellington, and Dr Tom Paterson, an addiction specialist in Auckland.
Medsafe did not approve MDMA as a general medicine, and the compound remains an unapproved controlled substance. Each doctor spent over a year navigating approvals, mirroring New Zealand's parallel Regulation 22 pathway for psilocybin. Australia allows ongoing applications through its Therapeutic Goods Administration (TGA) Authorised Prescriber scheme, whereas New Zealand approves prescribers one person at a time.
Eligibility requires a confirmed PTSD diagnosis in adults aged 18 or older following a comprehensive clinical evaluation. Dosing takes place on-site in a controlled clinical environment alongside psychotherapy. Patients never take MDMA home.
A full course of treatment costs roughly NZ$45,000. That price covers three dosing rounds and approximately 54 hours of therapy at about NZ$15,000 per cycle. Neither Pharmac nor the Accident Compensation Corporation (ACC) provides public funding, so patients pay the full balance themselves.
On April 18, 2026, President Trump signed the executive order Accelerating Medical Treatments for Serious Mental Illness, the most significant US federal action on psychedelics since the Controlled Substances Act of 1970. The order does not legalize MDMA or change its Schedule I status, but it establishes four mechanisms to accelerate the regulatory pipeline (full breakdown in our dedicated Trump psychedelics executive order explainer):
The executive order improves the future outlook for MDMA but does not help today. MDMA currently lacks Breakthrough Therapy designation (required for the priority voucher) and needs a new Phase 3 trial before any NDA resubmission. Realistically, even under the accelerated framework:
The Right to Try pathway is the most immediately relevant provision for MDMA, as it could allow certain patients to access MDMA before full approval — but this pathway is still being established and details have not been finalized.
The legal access routes as of May 2026 are limited:
Underground MDMA therapy exists in many countries but carries legal risk, no quality assurance, and no medical oversight. The main MDMA guide covers the clinical evidence, safety profile, and what the FDA rejection means in more detail.
Australia and New Zealand are the only countries that have approved MDMA for therapeutic use. Under Australia's Therapeutic Goods Administration (TGA) Authorised Prescriber scheme, launched July 1, 2023, authorised psychiatrists treated approximately 87 post-traumatic stress disorder (PTSD) patients through late 2025 with no serious adverse events recorded. In September 2026, Medsafe approved two named psychiatrists, Dr Gary Wynn in Wellington and Dr Tom Paterson in Auckland, to prescribe MDMA for PTSD under Regulation 22 of the Misuse of Drugs Regulations 1977. This individual approval is far narrower than Australia's scheme and does not create a general pathway. MDMA remains an unapproved medicine in New Zealand, restricted to those two clinicians, with no public funding for the approximately NZ$45,000 treatment cost.
Portugal decriminalized personal possession of all drugs in 2001 — MDMA included — treating it as a health matter rather than a criminal offense. The Czech Republic treats possession of small quantities of MDMA (typically under 4 tablets) as a misdemeanor, not a criminal offense. Neither country has legalized MDMA or approved it for therapy; decriminalization means reduced penalties for personal possession, not legal access to treatment.
No. MDMA is Schedule I under the Controlled Substances Act. No US state has legalized or decriminalized MDMA. On April 18, 2026, President Trump signed an executive order directing the FDA and DEA to fast-track psychedelic reviews and allocating $50 million for state research programs. The order does not change MDMA's Schedule I status but creates a pathway for faster future review if a new Phase 3 trial succeeds.
Canada allows access to MDMA through the Special Access Program (SAP), where a licensed practitioner can request MDMA for a patient with a serious or life-threatening condition when conventional treatments have failed. However, SAP approvals for psychedelic-assisted therapy have declined sharply since 2024, and procuring pharmaceutical-grade MDMA remains difficult. MDMA is Schedule I in Canada — the SAP is a narrow compassionate use exception, not general legalization.
No. Despite the Netherlands' comparatively liberal drug policies (psilocybin truffles are legal, for example), MDMA sale, possession, and use are prohibited under Dutch law. The Netherlands is a major producer of illicit MDMA but does not permit legal therapeutic or recreational use.
On April 18, 2026, President Trump signed 'Accelerating Medical Treatments for Serious Mental Illness,' which: (1) directs the FDA to issue National Priority Vouchers to psychedelic drugs with Breakthrough Therapy designation, cutting review timelines from 6–12 months to 1–2 months; (2) requires the FDA and DEA to create a Right to Try pathway for investigational psychedelics including MDMA; (3) allocates $50 million through ARPA-H to match state research investments; and (4) directs the Attorney General to initiate rescheduling reviews upon successful Phase 3 completion. The order does not reschedule MDMA or make it legal — it accelerates the regulatory pipeline. Following the FDA's August 2024 Complete Response Letter rejecting Lykos Therapeutics' MDMA NDA and requiring a new Phase 3 trial, industry analysts project a best-case rescheduling timeline of 2029 to 2030.
Yes, molly is illegal: molly and ecstasy are street names for MDMA, a Schedule I controlled substance under federal law. First-offense simple possession under 21 U.S.C. § 844 carries up to one year in prison and a minimum $1,000 fine. Distribution or manufacture is a federal felony. State penalties vary and can be harsher, and MDMA is not legal for recreational use anywhere.
MDMA-assisted therapy in Australia costs approximately AUD 25,000 to AUD 30,000 per full treatment course, which typically includes two or three medication sessions of six to eight hours each — conducted with two therapists present — plus preparatory and integration appointments. Medicare does not cover MDMA-assisted therapy as of 2026, and most private health insurers do not include it in standard plans. Some funds offer partial coverage under mental health extras. The full out-of-pocket cost for most patients falls in the AUD 25,000 to AUD 35,000 range.
MDMA is not broadly legal in New Zealand. In September 2026, <a href="https://www.health.govt.nz/news/two-psychiatrists-granted-approval-to-prescribe-medicinal-mdma-for-ptsd">Medsafe approved</a> two named psychiatrists to prescribe the medicine for post-traumatic stress disorder (PTSD) under <a href="https://www.legislation.govt.nz/regulation/public/1977/0037/latest/DLM55371.html">Regulation 22 of the Misuse of Drugs Regulations 1977</a>. The permits cover Dr Gary Wynn, a Wellington trauma specialist, and Dr Tom Paterson, an Auckland addiction specialist. Because MDMA remains an unapproved medicine with no funding from Pharmac or the Accident Compensation Corporation, patients pay approximately NZ$45,000 for three dosing sessions and 54 hours of therapy. This matches the June 2025 pathway allowing named psychiatrists to prescribe <a href="/law/new-zealand-psilocybin-approval">psilocybin for treatment-resistant depression</a>. Unlike Australia's class-wide Authorised Prescriber scheme, New Zealand evaluates clinicians one doctor at a time.
Yes — pressed pills and powder sold as MDMA are frequently something else entirely, or MDMA cut with other substances, including fentanyl. Because a "correct" MDMA color reaction does not rule out fentanyl contamination, reagent testing alone is not enough. See our <a href="/guides/mdma-adulterant-testing-kits">MDMA adulterant testing guide</a> for how to reagent-test and fentanyl-strip-test before use.
Simple possession of MDMA is a federal misdemeanor under 21 U.S.C. § 844, punishable by up to one year of imprisonment for a first offense. Repeat offenses carry harsher penalties. MDMA is a Schedule I controlled substance under the federal Controlled Substances Act, and distribution or trafficking penalties under 21 U.S.C. § 841 scale steeply with quantity, reaching decades in federal prison. States also impose their own separate penalties, which can be harsher than the federal misdemeanor for simple possession and vary by state.
No, you cannot legally bring MDMA back to the United States from Portugal or the Czech Republic. Importing MDMA into the United States is a federal drug importation offense under 21 U.S.C. §§ 952 and 960. A first offense carries up to 20 years in federal prison, regardless of the substance's legal status in the country of origin. Portugal and the Czech Republic decriminalized personal possession of small amounts under their own domestic laws, but that status does not travel across the border or create an exemption under federal law.
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