Growing number of cannabis-based medicines and products in Brazil

Registration of products and medicines based on cannabis, popularly known as marijuana, already total nine in Brazil, according to information from Anvisa (National Health Surveillance Agency).

They are used to treat epilepsy, multiple sclerosis and chronic pain reduction, among other applications.

In addition to the nine registrations granted, Anvisa currently has another 14 requests for analysis of products and medicines made with Cannabis.

The use of the plant for medicinal purposes dates back approximately 5,000 years ago, when the Chinese began to use the herb for this purpose, says Pedro Pierro, functional neurosurgeon physician and technical director of the CEC (Cannabinoid Center of Excellence). Even so, modern science took a long time to study the Cannabis with the intention of treating pathologies.

“Until the 1990s, I thought it was like a home remedy,” he says.

Fabrício Pamplona, ​​cannabinoid pharmacologist and doctor in pharmacology from UFSC (Federal University of Santa Catarina), explains that only from the 1980s on in the United States, marijuana was adopted with three medicinal purposes: promoting the well-being of patients , increased appetite and decreased pain in people with HIV or cancer.

Even so, it was still used in a much less sophisticated way than it is used today. “There was no such attempt to standardize the plant or purify the compost. It was another time. A Cannabis, it was even smoked”, says the pharmacologist.

In the 2000s, there was the first registered marijuana drug that was indicated for the treatment of multiple sclerosis, a neurodegenerative disease.

The pharmacologist still speaks of a third wave of the use of the plant to manufacture medicines: since 2015, research has skyrocketed to develop drugs against epilepsy.

In Brazil, Anvisa regulated the use of marijuana-derived drugs and allowed their sale in pharmacies in 2019.

The nine registrations that Anvisa has already granted are divided into two types: product and medicine. According to the regulatory agency, those cataloged as products “follow manufacturing, control, inspection and monitoring requirements similar to those applied to medicines”, but they are not “obligated to present complete studies of safety and efficacy”.

“These products can be used by the Brazilian population, according to medical advice and prescription, while clinical studies confirming their effectiveness are concluded so that they can then be registered as medicines”, the organization added.

Currently, there are eight marijuana-based products already authorized by Anvisa. They use cannabidiol (CBD) in their composition or are extracts from Cannabis.

According to Pamplona, ​​they are mainly used to treat epilepsy, but they also help patients with sleep and anxiety problems.

The pharmacologist explains that there is a small difference between pure cannabidiol and the extract version. “A product that comes from a plant and maintains the other components, not just CBD, is an extract. [Já] the product that is either synthetic or purifies CBD is described as cannabidiol,” he says.

From the drug category, Anvisa reported that the country has authorization for only one drug, called Mevatyl, indicated for multiple sclerosis.

Pamplona explains that his formula has an equal ratio between CBD and THC (tetrahydrocannabinol), another substance found in marijuana, but there are no psychoactive effects on patients.

In addition to the more common illnesses for which cannabis is destined, there is already evidence of other pathologies where the herb’s properties could also be useful.

“Today, for example, there is a compendium by Health Canada, a Canadian regulatory agency, which mentions nearly 40 pathologies in which there is potential for Cannabis“, says Pamplona. He mentions uses for antitumor treatment and the possibility of expanding to other neurodegenerative diseases, such as Parkinson’s and Alzheimer’s.

The herb’s high potential for use is related to the way it acts in the human body. “It’s as if the plant acts to maintain the body’s balance and it does this mainly by regulating the release of neurotransmitters and promoting the control of inflammatory mediators that are associated with diseases,” he explains.

In June, a special committee of the Chamber of Deputies already approved a bill that authorizes companies to grow marijuana for scientific or medicinal purposes. However, it still needs to be voted on in plenary and, if approved, be sanctioned by President Jair Bolsonaro (PL) — a staunch critic of this type of measure.

Another obstacle to the expansion of marijuana-based drugs is the price. Pierro says that the drugs are very expensive and are not made available at the federal level by the SUS.

One way out, then, would be to plant and produce the medicine itself, but this is still a reality that is not very present in the country. The neuroscientist estimates that, currently, there are about 500 preventive habeas corpus that authorize the planting of the Cannabis for medicinal purposes.