Official position of the Brazilian Association of Psychiatry on the use of cannabis in psychiatric treatments

PDF em inglês: https://doi.org/10.47626/1516-4446-2022-0043

Abstract

Question:
In view of the various studies carried out in Brazil and around the world that try to find out if there is really effectiveness in the use of cannabidiol (CBD) in the treatment of various diseases, the Brazilian Association of Psychiatry - ABP publishes its official position on the subject.

ABP Position:
1- There is not enough scientific evidence to justify the use of any cannabis derivatives in the treatment of mental illness. On the other hand, several studies associate the use and abuse of cannabis, as well as other psychoactive substances, with the development and worsening of mental illnesses.1-6

2- The use and abuse of psychoactive substances present in cannabis cause chemical dependence, can trigger psychiatric conditions and also worsen the symptoms of mental illnesses already diagnosed. This is the case with schizophrenia - it is estimated that the risk of developing the disease is four times greater and the use of cannabis worsens the prognosis of the disease. Cannabis use is also associated with baseline mood change, depression, bipolar disorder, anxiety disorders, attention deficit hyperactivity disorder, and suicidal ideation.1,4,7-9

3- Research on CBD must continue, but studies on side effects and the likelihood of dependence must also be carried out and intensified.4,9

4- Some Brazilian media outlets have endorsed studies on the possible "benefits" of cannabis, corroborating misinterpretations and contributing to the impression that marijuana is a completely safe and harmless product for consumption, especially by younger people.1,9 This positive "publicity" refers to the time when cigarettes were marketed with the media and even part of the medical community to meet financial interests.

5- In Brazil, the Federal Council of Medicine - CFM authorizes the compassionate use of CBD only for children and adolescents with difficult-to-treat epilepsy, through Resolution No.

6- Like the ABP, the American Psychiatric Association (APA)6 does not endorse the use of cannabis for medicinal purposes. One of the excerpts from the document produced by the APA says that "there is no current scientific evidence that cannabis is beneficial for the treatment of any psychiatric disorder. In contrast, the current evidence supports, at the very least, a strong association of cannabis use with onset of psychiatric disorders.6 Adolescents are particularly vulnerable to harm due to the neurodevelopmental effects of cannabis."1

7- The treatment of any disease must be carried out based on scientific evidence and doctors who prescribe the use of cannabis for medicinal purposes must be fully aware of the risks and responsibilities inherent in the prescription.4

8- There is no convincing scientific evidence that the use of cannabidiol or any of the cannabinoids can have any therapeutic effect for any mental disorder. It is important to note that it does not matter whether a substance is synthetic or natural, without well-designed clinical trials, no substance can be indicated for the treatment of any disease.2,4

9- The ABP supports all lines of scientific research in the search for new solutions for untreated diseases, as long as it obeys all the rules relating to scientific research.

10- The ABP, after careful evaluation, in view of the various damages highlighted, at the moment, does not support the use of cannabis and its derivatives for medicinal purposes in the area of ​​Psychiatry, nor does it support its use for recreational purposes.

It is important to keep in mind that there is no record with any international regulatory agency of any cannabinoid for the treatment of any psychiatric illness.