Switzerland limited medical use of psychedelics

Domain VII · Transpersonal, psychedelic & altered states · Gasser, Oehen · 2014 · Switzerland

What it is

This is a regulated access programme. It is not a single therapy. Under Art. 8 para. 5 of the Narcotics Act (BetmG/NarcA, SR 812.121), the BAG can grant one treating physician an exceptional, case-by-case authorisation (Ausnahmebewilligung) to use a prohibited substance (LSD, MDMA or psilocybin,…

Format

• Operational treatment resistance (Oehen & Gasser 2022): for trauma disorders, at least two unsuccessful courses of psychotherapy plus a failed trial of a standard antidepressant class. For depression or anxiety, insufficient response to several antidepressants, augmentation and psychotherapy.
• Psychiatric and somatic screening, consent (Section 4), and a complete, hand-signed paper application to the BAG. The application includes patient and physician data, the physician's evidence of experience, medical information according to the BAG checklist, the supply pharmacy, financing, and the…

Who practises it, and how they are trained or regulated

• The programme sets a legal and administrative frame. Clinicians fill it with a preparation, session and integration structure. Phases 1 and 6 below are regulatory and are run by the physician. Phases 2 to 5 are clinical.
• Who may apply: only the treating physician who is entitled to practise in Switzerland. Patients cannot apply. A first-time applicant must show experience, for example through further training, membership of a specialist society (SÄPT, ASPT, SSPM/swisspsychedelic, Fondazione Alaya) and exchange with experienced colleagues. Psychologist-psychotherapists cannot hold the authorisation, but they work in the team and…
• Goals: psychoeducation, a stable alliance, emotion-regulation and safety skills, a working hypothesis linking symptoms to biography, realistic expectations, and intentions.

Evidence status, as the guide reports it

• Psychiatric and somatic screening, consent (Section 4), and a complete, hand-signed paper application to the BAG. The application includes patient and physician data, the physician's evidence of experience, medical information according to the BAG checklist, the supply pharmacy, financing, and the…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• late renewals, which interrupt treatment.
• rigid goals. Encourage openness to whatever comes.
• high anticipatory anxiety. Offer to sit beside the person.
• repeated rule-testing, which is usually avoidance (see 4.16).
• your own urge to interpret. Save content work for integration.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.