Abstract
Introduction: In clinical scenarios where available medications prove ineffective, prescriptions of imported and/or unregistered drugs with ANVISA (National Health Surveillance Agency) are sometimes necessary. Cannabidiol (CBD), a substance found in Cannabis sativa oil, commonly known as marijuana, is one such product currently used for various therapeutic purposes. Due to economic, legal, and health-related factors, patients and/or their families seek legal recourse to guarantee the right to import cannabis seeds, cultivate Cannabis sativa plants, and extract their oil rich in CBD for therapeutic use in various clinical conditions, supported by legal principles. Objective: To characterize the judicialization of medicinal cannabis use in Brazil between 2016 and 2019, focusing on judicial instance, location, year of sentence, and medical condition. Methods: Data were collected from court rulings available on the JusBrasil Portal and other secondary sources such as news portals. Results: A total of 17 court rulings from federal courts authorizing the cultivation of cannabis for medicinal purposes were identified, comprising 16 individual cases and 1 collective case. In individual actions, patients had diagnoses including pituitary adenoma, Silver Russell syndrome, autism, epilepsy, herniated disc, depression, Parkinson's disease, West syndrome, Dravet syndrome, retinitis pigmentosa, and neuropathic pain. Nine patients were aged between 4 and 16 years, five between 32 and 60 years, and three had indeterminate ages. The rulings were issued by Federal Courts in the states of Acre, Bahia, Ceará, Paraíba, Rio de Janeiro, Rio Grande do Norte, Rio Grande do Sul, São Paulo, and the Federal District. Conclusion: Prompted by the "fumus boni iuris" (smoke of good law), the Judiciary has been breaking legal barriers to ensure the right to health. It is noteworthy that these decisions also address health-related aspects such as the number of plants authorized for cultivation, dosage regimen, declarations from scientific institutions regarding the possibility of using their laboratories for drug standardization, indicating a path towards future legal and health regulations. In 2015, ANVISA removed CBD from the list of prohibited substances and placed it under special control. More recently, ANVISA approved two public consultations related to the regulation of controlled cultivation of Cannabis sativa for medicinal and scientific use, and the registration of medications produced with active principles from the plant. This opens up space for society to contribute to the development of clear, transparent regulations that meet patients' interests regarding cannabis cultivation for medicinal use and potentially integrating cannabinoid-based medications into the Brazilian Unified Health System (SUS).
