From São Paulo, a Wave of Medical Cannabis Reform Across Brazil

May 4, 2023

On 4/20, São Paulo State Deputy Caio França (Socialist Party) filed a bill that that would authorize domestic cannabis cultivation within the Brazilian state. With São Paulo already preparing to roll out medical cannabis access via public insurance, a fresh determination to legalize and regulate cannabis has sparked at the federal level, too.

Brazil has allowed medical cannabis products to be imported since 2015, and a limited number of approved options have been available at pharmacies since 2016. But the federal government never allowed for cannabis to be cultivated domestically. França’s state-level bill, if passed and signed into law, it has extraordinary potential for democratizing a life-saving treatment that is out of reach for most people in São Paulo, as well as in the rest of Brazil.

In Januaryquite unexpectedly—São Paulo Governor Tarcísio de Freitas, a conservative, signed into law an earlier bill authored by França, making medical cannabis available through the state’s Universal Health System (SUS). The working group appointed to implement the new strategy—representatives from the state’s public health and education sectors, judicial government and civil society groups—has coverage of medical cannabis products slated to begin mid-May, though Brazilian bureaucracy at any level is not necessarily known for being on time.

A single bottle of CBD oil currently retails for almost $500.

But even though SUS coverage of medical cannabis is in the public’s best interests, the strain on Sao Paulo’s health care system will be considerable. It is illegal to cultivate cannabis in Brazil, and importing the raw materials is exorbitantly expensive—a single 30 ml bottle of CBD oil with a concentration of 200mg/ml currently retails for almost $500 USD. França’s 4/20 bill proposes that São Paulo alleviate that strain by legalizing and regulating everything domestically, thus bypassing the costly importation process.

At the federal level, a bill to authorize domestic cultivation has already has passed through the lower house of Brazil’s National Congress—in June 2021, since when it has lingered in a drawer rather than actually being sent on to the Senate. It’s possible that the ripples from São Paulo will reach Chamber President Arthur Lira, especially because we’re already seeing a similar effect play out with the SUS legislation.

On March 22, Senator Paulo Paim (Workers’ Party) filed a bill that would place medical cannabis on SUS at the federal level. “If São Paulo can do it, why cannot the rest of the country do it as well?” he asked when introducing the legislation. He went on to criticize the high price of cannabis products as well as the judicialization of access to them, and the toll that the costs and length court processes take on patients struggling to access the medicine they need.

On 4/20, the same day França filed his domestic cultivation bill, senators listened to public testimony both for and against adding medical cannabis to the federal SUS.

The current administration needs the push.

São Paulo, Brazil’s financial capital since the early 20th century, is often described as a “modern” state with respect to its economy and culture. But its people have never elected even a center-left governor in the history of the state; from the time of the military dictatorship that spanned 1964 to 1985, center-right to far-right administrations have occupied the governor’s office continuously. The state’s politics remain conservative, aligned with the rest of the country. But with conservative politicians setting the tone for cannabis reform, the momentum coming from São Paulo bodes well.

The current administration needs the push. President Luiz Inácio Lula da Silva (Workers’ Party) has taken no meaningful action toward drug policy reform, and has in fact taken action against it. Lula, often touted as “progressive,” is a fairly conservative left-wing politician who has embraced many neoliberal principles. It’s won him three elections.



Image via State of New Jersey

Felipe Neis Araujo

Felipe is a Brazilian anthropologist. He's a criminology lecturer at the University of Manchester, where he researches drug policy, state violence, structural racism and reparations for historical inequalities. He lives in London.

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