Article in Folha de S.Paulo: “Patient safety hinges on passing the Cannabis Act”

The following article, written by the president of the Humanitas360 Institute, Patrícia Villela Marino, was originally published in Portuguese in the newspaper Folha de S.Paulo on December 13, 2022.

In the democratic process, it is up to the state to perceive society’s needs and, based on them, to create sustainable solutions. When this tuning does not happen in a fluid and automatic way, it is up to society to organize itself to signal the problems and point directions to solve them.

This is exactly how doctors, lawyers, patients, and families won the right to medical cannabis treatment in Brazil. And, today, they fight for a legislation that guarantees this right to all Brazilians, independently of the financial situation of each one and the prejudice originated in the secular demonization of the plant.

It is worth remembering that we are talking about a long journey, which had its first victory in 2014, when hundreds of desperate mothers made public their feelings of pain and agony stemming from the state’s denial to authorize the only effective therapy to alleviate their children’s suffering.

That year Anny Fischer, 6, who had a rare genetic syndrome that caused 80 seizures a week, was granted the first official authorization to import cannabidiol for medicinal use. The story of resilience of the Fischer family and many others was told, at the time, in the documentary “Ilegal”.

The then unprecedented decision opened the door for the construction of a market, regulated by Anvisa – National Health Surveillance Agency, which currently has at least 20 extracts of CBD – cannabidiol, a substance derived from cannabis without psychoactive effect – authorized to be sold in Brazilian pharmacies, and approximately 300 thousand patients in treatment.

It was also in 2014 that the Federal Council of Medicine (CFM) issued the first specific guidance for cannabis treatment. It restricted – and still restricts – the administration to cases of refractory childhood epilepsy by neurologists and psychiatrists. At the time, the substance was considered experimental.

In the last eight years, researches have advanced and proved other applications of the treatment to be successful, such as for chronic cancer pain, fibromyalgia, and depression.

For this reason, the market was already insisting on updating the 2014 regulation. It took eight years for the CFM to respond with the publication of a new one, but without any advance that reflected the evolution of cannabis medicine.

Civil society quickly expressed itself forcefully against the CFM’s retrogression.

Jurists and lawyers formed the Medical Advocacy Coalition, a group of 229 professionals working in the field, to publish a letter of repudiation. The Brazilian Society for the Study of Cannabis Sativa prepared a petition that reached 170,000 signatures in two days. Meanwhile, in Congress, congressman Paulo Teixeira (PT-SP) filed a request to annul the CFM determination.

Ten days later, social pressure led to the revocation of the decision, bringing back the 2014 regulation. This month, the entity opened a public consultation on the subject, open to doctors and society in general.

Laws should not be created to impede the development and well-being of the population. They need to be organic to facilitate the implementation of social changes, leveraged mainly by advances in research and science.

We recently saw the Covid-19 vaccine being developed, manufactured, and distributed globally in less than a year. In the world, this agility was due to the joint work of laboratories and governments. In Brazil, specifically, the vaccine saved lives because it was made possible by the Unified Health System. We saw poor and rich people in the same queue to receive the immunizer.

The pandemic period also revealed the idiosyncratic character of the Federal Council of Medicine. At the height of the contamination, the possibilities of treatment for the symptoms of the infection were being discussed, among them the controversial chloroquine, supported by the current government and classified as ineffective by the World Health Organization.

In this debate, the CFM defended the doctor’s freedom to choose the best treatment for his patient – the opposite position to the one recently adopted in relation to medical cannabis.

So that no patient is at the mercy of the moods and prejudices that surround the subject, it is imperative that the country returns to discussing the need for a de facto law, which also provides democratic access to medical cannabis, as it did with the vaccine recently.

By the way, a new Brazilian study pointed out that 58 thousand people over 60 years old did not die precisely because they received the immunization. But this group could have had 47 thousand people more, if the vaccine campaign had not been politicized and if it was intensively paced from the beginning.

It is high time to unveil the PL 399/2015, which regulates the medicinal and industrial use of hemp, a type of cannabis without the psychotropic effect of the plant used to manufacture marijuana.

Patricia Villela Marino
Founder and president of the Humanitas360 Institute and cofounder of Civi-co, a work space that brings together civic-social entrepreneurs