Medicinal cannabis in Latin America: History, current state of regulation, and the role of the pharmacist in a new clinical experience with cannabidiol oil

Guido, Paulo Cáceres; Riva, Natalia; Calle, Graciela; Dell'Orso, Marta; Gatto, Mariana; Sberna, Norma; Schaiquevich, Paula

doi:10.1016/j.japh.2019.09.012

Cited by 13 publications

(11 citation statements)

References 7 publications

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“…Such limits, however, vary significantly from country to country (Table S1, Supplementary Material ). It is not uncommon for patients or associations that practice the authorized cultivation of medicinal cannabis to prepare extracts and other types of processed materials so as to allow the use by routes other than inhalation (Cáceres Guido et al 2020 ).…”

Section: Medical Cannabis Regulation Around the Worldmentioning

confidence: 99%

“…Although self-cultivation is sometimes advocated as a less costly access alternative, this practice raises several concerns regarding the risks to which patients are exposed when using such “homemade” products (Dinis-Oliveira 2019 ). The lack of standardization and appropriate controls inherent to this type of activity results in the obtaining of heterogeneous materials with unpredictable toxicological and pharmacological effects (Dinis-Oliveira 2019 ; Cáceres Guido et al 2020 ). In fact, this would be an additional variability factor to deal with in therapeutic practice, adding to the inherent variability of the species, the complexity of its phytochemical profile, and the variability of individual patients’ responses (Dinis-Oliveira 2019 ).…”

Section: Medical Cannabis Regulation Around the Worldmentioning

confidence: 99%

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Medical cannabis regulation: an overview of models around the world with emphasis on the Brazilian scenario

2022

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Cannabis sativa has accompanied humankind since ancient times, permeating the most diverse aspects of its existence, among which the search for health promotion and well-being stands out. Nevertheless, during the twentieth century, a series of restrictions and controls have been adopted internationally to prevent the abusive use of this species. Despite that, there has been an increased demand for the medical use of cannabis and its derivatives in the last few decades, especially among patients with debilitating conditions for which the existing therapeutic alternatives are limited. Accordingly, several countries have adopted regulatory strategies to allow access to cannabis-based products. This study aimed to overview the existing regulatory frameworks for medical cannabis around the world, focusing on the current Brazilian scenario. In addition to supply and access regulation aspects, some quality-related issues regarding cannabis-based pharmaceutical products were addressed, with emphasis on risks to patients. The literature research was performed between October 2020 and March 2021. According to the retrieved information, by the time the data collection was completed, thirty-six countries had already implemented regulatory frameworks regarding medical cannabis, and sixteen countries had models under development or in the process of implementation. The characteristics of the assessed regulatory strategies vary considerably from country to country, reflecting sociocultural, historical, and political aspects. Among the key aspects that differed between the assessed models, one can highlight the type of cannabis products that are made available and the technical requirements applied to them, as well as the possible access mechanisms. Different supply regulation strategies were also observed regarding cannabis cultivation, production licensing, and distribution mechanisms. In Brazil, an evolution of the regulatory framework has been noticeable since 2015, even though pending points are still to be addressed, among which are the species’ cultivation and the access to it for scientific research purposes. Constructing a regulatory model which provides access to good quality cannabis-based medicines that may meet the patient’s needs is still a challenge in the coming years, requiring the engagement of various stakeholders, including regulators, members of the academic community, prescribing professionals, and patients.

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Section: Medical Cannabis Regulation Around the Worldmentioning

confidence: 99%

Section: Medical Cannabis Regulation Around the Worldmentioning

confidence: 99%

Medical cannabis regulation: an overview of models around the world with emphasis on the Brazilian scenario

2022

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“…The medical use of preparations derived from Cannabis sativa L. has a long history [1,2]. In Asia, mainly in China and India, cannabis has been used for centuries for religious and medical purposes to treat neuralgias, convulsions, migraines [3,4], rheumatic pain, intestinal constipation, sexual disorders [4], asthma, malaria [5] and gout [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Herbal Preparations of Medical Cannabis: A Vademecum for Prescribing Doctors

et al. 2020

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Cannabis has been used for centuries for therapeutic purposes. In the last century, the plant was demonized due to its high abuse liability and supposedly insufficient health benefits. However, recent decriminalization policies and new scientific evidence have increased the interest in cannabis therapeutic potential of cannabis and paved the way for the release of marketing authorizations for cannabis-based products. Although several synthetic and standardized products are currently available on the market, patients’ preferences lean towards herbal preparations, because they are easy to handle and self-administer. A literature search was conducted on multidisciplinary research databases and international agencies or institutional websites. Despite the growing popularity of medical cannabis, little data is available on the chemical composition and preparation methods of medical cannabis extracts. The authors hereby report the most common cannabis preparations, presenting their medical indications, routes of administration and recommended dosages. A practical and helpful guide for prescribing doctors is provided, including suggested posology, titration strategies and cannabinoid amounts in herbal preparations obtained from different sources of medical cannabis.

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“…Medicinal cannabis (or medical cannabis) concerns the use of Cannabis sativa (and of other species) -defined as the unprocessed plant, a part of it, or a plant-derived preparation -for therapeutic purposes 16,17 .…”

Section: History Of Therapeutic Usementioning

confidence: 99%

Cannabinoids in Neurology - Position paper from Scientific Departments from Brazilian Academy of Neurology

Brucki

Adoni

Almeida

et al. 2021

Arq. Neuro-Psiquiatr.

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Cannabinoids comprehend endocannabinoids, phytocannabinoids, and synthetic cannabinoids, with actions both in the central and peripherical nervous systems. A considerable amount of publications have been made in recent years, although cannabis has been known for over a thousand years. Scientific Departments from the Brazilian Academy of Neurology described evidence for medical use in their areas. Literature is constantly changing, and possible new evidence can emerge in the next days or months. Prescription of these substances must be discussed with patients and their families, with knowledge about adverse events and their efficacy.

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Medicinal cannabis in Latin America: History, current state of regulation, and the role of the pharmacist in a new clinical experience with cannabidiol oil

Cited by 13 publications

References 7 publications

Medical cannabis regulation: an overview of models around the world with emphasis on the Brazilian scenario

Medical cannabis regulation: an overview of models around the world with emphasis on the Brazilian scenario

Herbal Preparations of Medical Cannabis: A Vademecum for Prescribing Doctors

Cannabinoids in Neurology - Position paper from Scientific Departments from Brazilian Academy of Neurology

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