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Past, Present, and Future: Medical Cannabis in Brazil

In the ever-evolving world of global medical cannabis policy, Latin American countries don’t always make the headlines. Yet, Brazil, one of the region’s largest markets, is quietly, if incrementally, making advances toward a powerful medical cannabis program.  


Medical cannabis in Brazil may face some steep political hurdles, but the waves of reform are slowly making it possible for more patients to access more medicine. 


Here is a look at what medical cannabis has looked like in the country over the years and where it’s headed.


The Past and Present of Cannabis in Brazil


Brazil is the largest South American country, both in landmass (8,515,770 square km) and population (over 211 million). The GDP per capita is $15,388 USD. 


At the time of writing, there are several different estimates about the number of people currently authorized as medical cannabis patients. For example, there may be 14,500 or more patients served by the country’s only legal patient association and 20,000 more citizens approved to import products into the country. It’s unclear if any of these numbers overlap in any way.


Brazil’s history with cannabis began with the transatlantic slave trade, when its presumed colonizers and perhaps even the enslaved brought cannabis seeds for hemp cultivation. As happened elsewhere in the colonies, people quickly became aware of the intoxicating qualities, which led to Rio de Janeiro enacting the world’s first cannabis prohibition in 1830.


Now, 150 years later, Brazil’s historically anti-cannabis policies are slowly shifting to provide patients access under medical allowances.


First, in 2015, the National Health Surveillance Agency (ANVISA) allowed for low-THC CBD prescriptions. Then, the Government authorized ABRACE in 2017, the first patient association allowed to cultivate and provide medical cannabis. In 2017, Brazil also approved the first cannabis-based pharmaceutical. 


What Patient Access Looks Like in Brazil


According to a Filter Mag article on the subject, there are currently three ways patients can access medical cannabis in Brazil.


  1. Through a Pharmacy: Two products are available through Brazilian pharmacies, including a CBD isolate produced by Prati-Donaduzzi and a THC:CBD option (Mevatyl, or Sativex). Both are expensive, often out of reach for patients. The Brazilian average monthly income is equivalent to $200 USD, while a bottle of these CBD-rich medicines can cost upwards of $400 USD.
  2. Through a Patient Association: Today, there is only one patient association in the country, but it is legally allowed to provide full-spectrum cannabis preparations to its members. ABRACE is the only organization allowed to grow cannabis in the country and the most affordable option by far. However, through patients associations, products may lack the certification and analysis seen elsewhere in the sector. It’s also only available to patients living in the area.
  3. Through Imports: Patients may also import their own medicine. As per Filter Mag’s investigation, this is more affordable for patients than when purchased through a pharmacy but requires an application through ANVISA. The process now takes about two weeks.

In Filter Mag’s assessment, “Access to medical cannabis in Brazil is therefore fraught.” For most patients in Brazil, medical cannabis products are far too expensive, and few people live close enough to the only patient association, ABRACE, to access more affordable options. 


Furthermore, unlike the medicinal options available in other countries, the Brazilian program primarily focuses on high-CBD, low-THC options. 


The Current Circumstances Stalling Progress


As of 2021, medical cannabis policy in Brazil is hampered by the current political powers. The International Drug Policy Consortium highlighted the climate in a post on September 8, 2021, titled “Big pharma seizes the Brazilian market while medical cannabis bill is stalled.”


National and international players have been banking on the passage of the Medical Cannabis Bill 399/2015. This bill had aimed to solve one of the biggest hurdles of expanded access in the country: the local cultivation of hemp and medical cannabis.


Besides the limited capacity of ABRACE, it still is illegal for any person or company to cultivate cannabis for medicinal purposes. Without local production, medical cannabis prices remain far outside the reach of the average citizen. 

Unfortunately, this bill seems to have reached a stalemate, waiting for the approval of the Bureau of the Chamber of Deputies before it can continue. Until it’s legal for Brazilian firms to cultivate and process cannabis locally, the market will be dominated by large international exporters, like MedPharm Labs and PharmaCielo.


It is worth noting that the Brazilian patent office has revoked a 20-year CBD patent held by Prati-Donaduzzi, which should have protected its monopoly over CBD sales until 2036. It is unclear what this means for the sector and whether this move indicates the Government will open up the market to other producers.


Increasing Demands for Access, But Politics in the Way


Brazil seems poised at the top of a crest. Slow legislative reforms have been building for years, gradually offering patients more options for medical cannabis. But the country isn’t quite there yet.


A few additional pieces need to fall into place to finally open the flood gates, including legalizing the local cultivation of medical cannabis and hemp. With the current political climate in the country pushing against the tide, it remains uncertain when this legislation will finally come to pass.

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