Medical use of marijuana changes paradigms in the region11/04/2018 - Manoel Giffoni
Five of the twelve UNASUR countries already have regulations for the medical use, while other three are on the same path.
In 2016, a total of 422.1 tons of morphine was produced in the world. The opioid is one of the most efficient analgesics and has the same origin of heroin and other variants of synthetic and semisynthetic narcotics. Despite the problem of addiction to the mentioned drugs mentioned being enormous, it is essential to prescribe morphine, whose value in palliative care is not questioned. Its circulation is, though, heavily regulated and there are measures to prevent the misuse.
Had the same reasoning always been applied to marijuana, perhaps the early childhood of Anny Bortoli Fischer would have been easier. With one type of severe epilepsy, the CDKL5 syndrome, which used to cause up to 60 seizures per week, her parents had no way of knowing that a marijuana substrate, cannabidiol (CBD), could mitigate the discomfort that affected their child’s health and well-being. “During her first 4 years of life, the daily seizures caused a quite evident neuro-psychomotor delay, but after that the problem intensified,” says the father, Norberto Fischer. “In 4 months, she lost everything she had achieved because the crises increased a lot, she did not move, she spent the day lying down. Our feeling was that Anny’s life was slipping through our fingers.”
After reading about the effects of CBD on a support website for parents of children with CDKL5, they did not hesitate. Within two months of use, the seizures decreased significantly and nowadays occur sporadically. In addition, after years of activism for the legalization of the medical use of cannabis by her parents, the girl was granted an unprecedented authorization from the Supreme Federal Court of Brazil to use it. Subsequently, in 2015, the National Health Surveillance Agency of the country (ANVISA) withdrew Cannabidiol from the list of prohibited substances.
“Once somebody asked me if I was afraid that Anny would become addicted to marijuana, but even if it was the case, I prefer my daughter to be addicted rather than dead,” confessed the mother, Katiele Fischer. In fact, one of the issues that spark debates most frequently on the medical use of marijuana are the potential adverse effects.
A 2014 report presented by the Minister of Health of Colombia, Alejandro Gaviria, however, sheds light on the subject. “There is some link between the use of marijuana and certain mental illnesses and respiratory failures, but the connection is not substantial from a statistical point of view,” he affirms.
After decades of a quite radical position regarding the medical use of some drugs considered illegal, including marijuana, some South American countries are now undergoing a change of attitude towards their approach. Colombia is one of them. In 2015, a law allowing the cultivation of medical marijuana was passed and, on August 11 of last year, the Government finalized the regulatory process.
“It is important that people can access a product that matches other medicines, that is, that they have quality, safety and efficacy,” says the Director of the country’s National Narcotics Fund, Andrés López, adding that Colombia develops its principles based on the foundations of scientific evidence, human rights and public health. “The evidence shows that in the case of smoked or homemade forms, edible forms or products that are sold illegally in the streets, it is not guaranteed that patients access a dose that is equal in all conditions, free of contaminants, agrochemicals, which It’s not fair to them.”
What can prevent crops for medical use not leak into the illegal market?
“We have established a complete legislation that goes from the seeds to the products that the patients will receive. In Colombia we will have the so-called homeopathic, phytotherapeutic, drugs of greater sophistication and medicines made to measure. In order to produce any of these, standardized extracts and oils are required. Thus, manufacturing licenses will be issued by the Ministry of Health. This license is the gateway to the system, since the subsequent cultivation license is issued by the Ministry of Justice. The legislation establishes strict safety standards for cultivation and guarantees that all plants have a definite destination for the market, be it national or for export”
Andrés López, Director of Colombia’s National Narcotics Fund
López states that, during the regulatory process, he maintained frequent contact with his counterparts in Uruguay, as well as those in Peru and Mexico. “We are totally willing to share experiences and establish cooperation ties with the countries in the region,” he says. In recent years in our region, Argentina, Paraguay, Peru and Uruguay approved and transformed into law the authorization for the medical use of marijuana.
In the rest of the world, the medical use was decriminalized in several countries, such as Germany, Canada, Spain, the United States (some states), Portugal, United Kingdom and South Africa, among others. It shows that, in fact, there was a significant cultural change of global reach. However, even with increasingly robust evidence, some taboos persist that respond to moral and even religious issues, not necessarily scientific ones. It is necessary to reflect and debate as a society, to ensure that the population can access the most effective therapies in order to continue improving their quality of life.