Some 200,<> patients have already been authorized for controlled cannabis cultivation in Argentina, according to April data from the Ministry of Health. The figure speaks of a reality that those who understand the subject recognize the low: the country extended an umbrella of containment not only to patients with diagnosed chronic diseases, but also to some people who make recreational consumption.
Today, the Drug Law 23,737, which prohibits the possession, use and sale of drugs, including marijuana, and Law 27,350 on medicinal cannabis, which creates an exception for those who cultivate or make medicinal use of the plant, coexist at the national level. The regulation creates the Cannabis Program Registry (Reprocann) for patients and qualified growers.
It is the doctors who put the signature to approve the link to Reprocann. And in that context, there are those who charge $ 15,000 or up to $ 20,000 for registration to the registry: "Unmissable promotion. With the registration of two people, $ 4,999 each", offers an announcement.
Some 200,<> patients have already been authorized for controlled cannabis cultivation in Argentina. Photo Maxi Failla
Social organizations and health professionals call for a serious debate on "responsible adult consumption", a historic claim among activists.
A range of realities
Julian (24) – he asks not to give his real name – the doctor told him that he was going to register him with insomnia. "I had been occasionally smoking the plant that a friend grew and when I went to a club to buy they gave me the number of this doctor. It was immediate, he didn't ask me anything. He just explained how to sign up. It was $ 8,500 for the procedure, "he explains.
In the case of Facundo (31), starting to cultivate was "something therapeutic in itself". He had already been smoking recreationally for years and when the Reprocang was enabled, to be legally covered, he decided to sign up. He found a "cannabis clinic" online and had a 15-minute online interview — $4,000 at the end of 2021 — in which he was signed up to treat anxiety. "Sometimes I come home and had a super stressful day in the laburo, I smoke a joint and with that I relax," he explains to Clarín.
Cannabis plants powered by artificial light. Photo Maxi Failla
Adriana (37) – it is not her name – tells this newspaper that in her case she started smoking recreationally and 7 years ago she started growing and making oil for her grandmother, who had pain in her knees. "Later, I started working at night and had problems getting a good night's rest, so I consulted with a specialized doctor and enrolled in Reprocann," he says. Thus, it went from recreational consumption to solidarity cultivation and medicinal self-cultivation.
The cannabis "doc"
In recent years, postgraduate courses in therapeutic cannabis have already been taught at at least ten universities. Cannabis doctors promote themselves on 420 sites, among activist social networks and much by word of mouth. It is also common for patients to arrive by referral from another doctor.
"I know that there are people who work very seriously and others who tell you come, I charge you 8 ml pesos and I sign the link, and they have made a business of this," the president of the Argentine Chamber of Cannabis (Argencann), Pablo Fazio, tells Clarín, and compares that something similar happens with NGOs. that were constituted to make solidarity cultivation: "There are a lot that have follow-up of their users and others that do not".
Cannabidiol. Cannabis oil. Photo Shutterstock.
In that sense, he puts a brake: "I do not know if it is not even legitimate for a doctor to link a 25-year-old boy who does not want to open a case and who feels anxiety or fear about having five plants in the house. And seen in another way, health is also, for an adult, to make a marijuana use eventually because it improves their quality of life, their mood or their rest. "
"But I think this gray is not the best possible solution. We must debate the regulation of adult use, because as a society we owe it to ourselves and because even today there are people who are exposed to a criminal risk, "he adds and points out that "this reality in the United States has already passed and continues to happen. You have the 'Green doctors' with a stand 25 meters from the premises that sell marijuana and it's just a formality."
"We need a mature debate"
Pablo Morante is one of the doctors with the most experience in the country in the use of cannabis for therapeutic purposes. In addition, he currently represents the Ministry of Health in the Regulatory Agency for Medicinal Cannabis and Industrial Hemp (Aricame), which was created within the framework of the Industrial Hemp and Medicinal Cannabis Law, enacted in 2022.
"The tension required by the coexistence of the Narcotics Law and the Medicinal Cannabis Law is what made the Ministry of Health have to develop tools to protect the right to access to health and have, in turn, a much more comprehensive look, understanding that perhaps the main adverse effect of those who decide to consume this therapeutic tool is to be reached by the criminal law," Explains.
And it specifies that of the records approved by Reprocann, most doctors indicate cannabis for pain or another pathology, but "others directly put 'responsible adult use', and that is also approved, because it is understood that the doctor evaluated that person, determined what other medications the patient was taking, gave him recommendations and will follow up. "
CBD oil from Cannava, the state company of Jujuy.
On the other hand, Morante emphasizes that "in contrast to what some doctors propose in the networks, any doctor with current registration can accompany, indicate and process the authorization by the Ministry of Health." It is always best for the person who has the concern to talk to the family doctor or with the one with whom he has more confidence, be it the cardiologist, an oncologist or a gynecologist.
In that sense, he points out that it is key to "continue working on training" for both the short and long term, and contrasts that, however, "there must be an initiative to go in search of the modification of criminal legislation so that not everything remains in the scenario of the Ministry of Health of the Nation, but that one can modify this narcotics law (23,737) and surely we will be having a more mature debate regarding the use of certain substances in their context of responsibility and care for our freedoms. "
Medical cannabis: how are the consultations
In medical cannabis "it is like in any medical consultation of any specialty", describes nephrologist Gloria Schneier, who directs the medical cannabis office of the Syrian Lebanese Hospital in the City of Buenos Aires. And it reviews: "The medical history, the reason for consultation, history and current status, medication consumed and the physical examination is performed."
"A thorough interrogation is done that takes a long time and the patient is listened to attentively, since in most consultations unfortunately patients come looking for cannabis as their last option in the face of the failure of their treatments or without great improvement in symptoms," he says.
In general, inquiries come through referrals made by other doctors in the hospital and by people who come through a website. "Until now it never happened that someone came to ask for a registration for responsible adult consumption. In the private sphere it has happened to me, but at the beginning of the consultation I explain what Reprocann is and what it does not include".
Specialists call for a serious debate on "responsible adult consumption". Photo Maxi Failla
Listening to the patient is essential, especially when people report a "well-being" product of a "responsible" consumption of the plant. "Depending on what context, they could be evaluated as a therapeutic outcome, but it needs to be thoroughly analyzed. For now, I believe that Reprocann should be put to good use, taking care of the program that has been a great advance in our country. That is what I determine in my usual activity."
Mayra Mendilahatxou is an intensive care physician at a hospital in Mar del Plata and, in addition, attends a private medical cannabis practice in that city. Among the consultations he receives, "most are patients with diagnosed pathologies who were referred by doctors from other specialties, such as rheumatologists, oncologists or mental health professionals, but there are also people who are already using cannabis for specific pathologies but do not dare to raise this issue with their doctor. "
Also, says the doctor, there are "patients who never consumed, but have some health condition in which they see that cannabis could collaborate" in the treatment. "And there are minimal, extremely sporadic, patients who arrive because they have been using responsible adults and want to enroll in Reprocann."
"In those cases, my perspective is one that seeks integrity in health and covers many aspects, such as understanding, for example, the social framework in which the patient is inserted. And my primary and essential intervention in many cases is the reduction of risks and damages," he says and explains that "if the patient is using a preparation with combusted cannabis, try to explain that there is a route with lower pulmonary risk such as vaporization."
On other occasions, "when you begin to inquire about the frequency in which they use cannabis, the dose and for what reasons, it ends up showing that they also make a therapeutic use, to improve, for example, rest," says the doctor and explains that "although the plant has a psychoactive molecule, which is THC, used in low doses gives certain patients an effect that can be anxiolytic, relaxing and facilitating the night's rest."
Master formulas with cannabinoids
Mendilahatxou explains that the scenario for doctors is complex not only because of the Drug Law, but because even today, five years after the law was passed, "the greatest access is to non-standardized cannabis preparations, and pharmacological ones do not contemplate the entire spectrum (of cannabinoids)".
Many people make therapeutic use of cannabis, especially for rest. Photo Maxi Failla
At this point Jorge Alonso, a reference doctor in the country in phytomedicine and professor at the UBA, agrees and explains that so far Argentina has only two CBD oils, one of the cannabinoids with therapeutic action of cannabis, published in the Vademecum, which is the registry of medicines authorized nationally by Anmat.
Apart from that, there are at least three provinces – Jujuy, Misiones and Santa Fe – that have already launched their oils, also CBD. These are all products for which the patient needs a prescription, but not registration in Reprocann.
"There is also the possibility of making master prescriptions, so that the patient takes the personalized prescription to a pharmacy and they put together a master preparation. For example, if I want to treat insomnia, I make a personalized formula because the product I want to prescribe is not on the market," Alonso explained and explained that "this possibility is established in the law but there are no suppliers for the system to work yet."