The Colombian government recently confirmed that cannabis medicines would be covered by the healthcare system, making it one of the few countries in the world to introduce such a policy.
Dr Sandra Carrillo, of the Colombian Medical Cannabis Association, tells Cannabis Health how attitudes are finally shifting, thanks to research, education and the power of patient voices.
On 30 December 2022, the Ministry of Health of Colombia confirmed that all plant-based medical cannabis products would be included in the mandatory insurance coverage system, becoming one of just a handful of countries, after Israel and Germany to introduce such an initiative.
This means that prescription fees and clinic costs are now covered under the Colombian health system and more than 25,000 patients will no longer have to fund it themselves.
Dr Sandra Carrillo, the co-founder and vice president of the Colombian Medical Cannabis Association (ASOMEDCCAM), lobbied in her home country for patients to be able to access medicinal cannabis the same way they could any other prescribed medication.
Dr Carrillo, who also runs a group of clinics throughout Colombia, is a medical doctor and world-renowned specialist in cannabinoid medicine, having spoken on the subject in more than 20 countries, across three different continents. She sits on the board of leading organisations focused on cannabis medicine in the US, Portugal, Colombia and Panama.
Cannabis Health spoke to Dr Carrillo to find out more about what legal access to cannabis looks like in Colombia and the significance of this latest development.
CH: You have been working in the field of cannabinoid medicine for almost a decade now; what was it that initially sparked your interest in cannabis?
SC: I was an ER doctor for many years, but around seven years ago I started studying cannabinoid therapies. I am a volunteer of a children’s foundation that helps children with epilepsy, and their mothers would travel to other countries to get cannabis treatment. I saw how these children were improving, but, as a doctor, you always need to see the scientific evidence.
I trained in Canada, the United States, Puerto Rico and Colombia, and I’ve been advocating for the legalisation of medical cannabis in different countries, as well as lecturing and educating in Latin America, which is one of my main passions along with research and, of course, clinical practice.
CH: Have you seen an increase in the amount of research being published in recent years?
SC: I’ve seen an incredible increase in the amount of research in the last five years. It’s very encouraging because I advocate for the legalisation of medical cannabis and promoting safe access for patients, but I think it’s very important that people do not trivialise the use of cannabinoids. As a treatment it should be prescribed and monitored by a doctor, following the guidelines and quality standards that we apply to all other medicines. We shouldn’t treat it any differently.
I am the Latin American lead for the International Phytomedicines Institute, which aims to eliminate disparities in the absence of research for countries that don’t have resources to conduct their own. We are expecting to start soon with preclinical trials on pancreatic cancer and then chronic pain being led by Harvard University. It is a beautiful initiative, which will involve many different countries. The first one is going to be a large multicentric study involving Latin America, Africa, Europe and the United States.
CH: Medicinal cannabis has been legal in Colombia since 2016. How have attitudes changed in that time?
SC: There is still a lot of stigma because we have lived through the war on drugs in Colombia, but I have seen a shift. I think education is helping us to remove the stigma little by little. Education is allowing doctors, healthcare practitioners, politicians, regulators and patients to understand that this is an ancient medicine. This is not something that we’re just discovering now; we are rediscovering the potential of the cannabis plant as a treatment for different ailments. For doctors and scientists, when you present scientific evidence, that is a game changer.
Of course, it is not a panacea or a cure-all, but when as a doctor you understand about the endocannabinoid system (ECS) and see the scientific evidence, it makes sense. Sadly, in medical schools and universities, they don’t teach us about the ECS. This is one of the main things that I am advocating – for it to be taught to doctors, as well as nurses and veterinarians.
CH: What, in your view, is the key to really shifting attitudes towards cannabis in Latin America and across the world?
SC: Education. If we want to encourage more clinicians to prescribe, it is so important to educate them. Once clinicians are educated, they feel confident and safe prescribing medication. The more doctors who are prescribing, the more patients will benefit.
In my clinic, I can see eight patients a day, but if I want more patients to have access, then I need to train doctors. If I train 100 doctors, each one of them can see eight patients a day, so it’s now 800 patients who can benefit. Education has this multiplying effect and that’s why I am so dedicated to it. But it’s also about educating patients and the general population about the fact they can get this treatment prescribed by a doctor, who will tell them what products are safe and comply with standards. All of this education is very important.
Dr Sandra Carrillo
CH: And do you think there is an appetite among healthcare professionals to learn more?
SC: More countries are legalising medical cannabis, and scientists, researchers and doctors are willing to talk about it more. I don’t see the long faces that I used to see seven years ago when I was in a room full of doctors.
I feel very privileged in that I’m launching a certification in cannabinoid medicines, in alliance with the Colombian College of Physicians, which has around 25,000 doctors affiliated with it and is one of the most important academic institutions in the country. It was their proposal that they wanted to teach the doctors about the therapeutic applications of cannabinoids, which is a very big deal for me. It shows that the scientific community and the doctors are interested in learning.
I think this trend is going to keep growing but we have to be very responsible and stay away from making false claims.
CH: Could you explain more about that, why do you think false claims can be so damaging?
SC: We are working hard to show the doctors that there is evidence backing up these treatments, so when [a company] says that CBD is good for everything and these claims that are not supported by the evidence, it can make the scientific community think that this is not a serious treatment.
We need to show that there are clinical and preclinical clinical studies that back up the use of cannabinoid therapies for certain pathologies. Sometimes it is not a first line treatment, so we need to be very accurate about this if we want doctors to keep prescribing and new doctors to start. At the end of the day what we want is to promote safe access for patients, and by safe we mean that the doctor knows how and when to use it and when not to.
CH: The Colombian Ministry of Health has recently confirmed the inclusion of cannabis medicines under the healthcare system – what is the significance of this?
SC: Until recently, the medicine was not covered by the healthcare system, so patients had to pay for their prescription and their consultation, and that was very restrictive for them. I have been advocating and meeting with government and insurance companies about the importance of this, as it’s of benefit to both the patients and the healthcare system.
Now with this amazing news and the good will of the Colombian government, as of 1 January 2023 the Colombian insurance companies (EPS) have the responsibility to provide cannabinoid therapies (magistral preparations) to patients under a doctor’s prescription, following specific parameters stipulated by the Ministry of Health.
CH: What impact do you think this will have on patient access?
SC: The impact will be huge since the economic limitations were the number one reason for patients’ lack of adherence to the treatments. Patients were coming to my clinics and starting the treatment with great results, but, unfortunately, after a few months many were unable to afford to keep going – despite the great improvement in their quality of life – and would have to return to the medications which the healthcare system was covering for them.
This big shift is positioning Colombia as the leading country in Latin America with regards to getting the healthcare system to cover cannabinoid therapies for patients.
Our voices have been heard, and I feel very proud of this big achievement for our patients. I hope more countries follow this amazing initiative since the right to have proper healthcare and safe access to medicine is a human right.
You can hear more from Dr Sandra Carrillo on Twitter @md_carrillo and Instagram @drsandracarrillo
The post Dr Sandra Carrillo: exploring medicinal cannabis in Colombia appeared first on Cannabis Health News.
