Vaporized cannabis opens discussion on therapeutic alternative in Brazil

In 2023, Dr. Lina Dantas received two patients in her office who found inhalation to be an effective alternative for regaining quality of life.

In the first case, a 20-year-old woman with cerebral palsy, a consequence of a choking incident when she was just two years old. After numerous attempts with medications — including methadone, which brought severe side effects — it was with the smoking of the flower that she began to experience something close to relief. “She depended on THC. That was what really helped relieve the spasticity and pain resulting from this condition,” Lina reports.

When she went into crisis, just a few puffs — inhaling smoke or vapor — were enough to achieve immediate relief. The improvement was so significant that she began to walk up to 10 kilometers a day — an unthinkable feat for someone who, until recently, could barely get out of her wheelchair.

Lack of adaptation to cannabis oil 

In the second case, a man diagnosed with Autism Spectrum Disorder (ASD), due to not adapting to the oil extracted from the plant, opted for inhalation. This time, vaporization was his choice. The almost instant effect was decisive during his moments of anxiety and hyperactivity. “When you vaporize, the effect occurs in minutes. With the oil, it can take up to an hour,” explains the doctor.

Given the clinical improvement, Lina even considered prescribing medications imported from an Australian company, where the inhalation administration of cannabis is already regulated. But the Brazilian reality soon imposed its limits.

Regulatory barriers: the impasse of ANVISA

Technical Note No. 35/2023 from the National Health Surveillance Agency (ANVISA) prohibited the importation of cannabis flowers for medicinal purposes. After this agency's decision in 2023, Lina had to interrupt the prescription of the inhalation route. “In Brazil, we are very behind on this. Australia, the United States, Canada, and some European countries have already made significant progress,” she laments.

Despite the obstacles, the doctor defends the effectiveness of cannabis vaporization as a legitimate therapeutic route. Although she acknowledges that smoking also brings relief, she highlights its limitations: in addition to losing about 30% of the flower material — including terpenes and cannabinoids — there is the impact of smoke and heat on the lungs.

Why is vaporization safer?

By better preserving the active compounds of the plant, vaporization reduces harm to the body. “The temperature entering the body, instead of exceeding 300 °C from combustion, stays between 180 °C and 220 °C — which is the usual limit of vaporizers,” details Lina.

This thermal precision allows for the release of specific compounds. “For example, at 190 °C we can release more CBD,” says the doctor, emphasizing that, as with any prescription, it is necessary to weigh the risks and benefits. “When the benefits outweigh the risks, the use is indicated.”

Studies reinforce the preference for less concentrated methods

A study published in 2015 by scientists Mallory Loflin and Mitch Earleywine showed that many medicinal users prefer vaporized cannabis flower to more concentrated extracts, precisely because it provides quick effects and a lower risk of tolerance with prolonged use.

Still, combustion remains the most common method of consumption — usually through cigarettes, pipes, bongs, or improvised objects. However, smoking cannabis is not without risks: frequent users may experience coughing, wheezing, airway inflammation, and excess mucus. Nevertheless, studies indicate that smoking cannabis is less harmful than tobacco, especially in countries with regulation and quality control.

Gender, age, and new consumption habits

According to data from the National Survey on Drug Use and Health (NSDUH), conducted between 2022 and 2023, consumption preferences vary according to user profile. Among men, nearly 20% still prefer to smoke. Among women, only 14.3% reported a preference for smoking, increasingly opting for alternatives such as vaporizers, edibles, and lotions.

The age group between 18 and 25 years shows the highest rates of experimentation: nearly 28% use three or more consumption methods. Although smoking remains popular, there is a clear trend toward migrating to less aggressive methods, such as vaporizers.

The debate on regulation in Brazil

The proposal to revise RDC 327/2019 — whose public consultation ended in June — reignited the debate on the permitted forms of administration of cannabis-based products. In this sense, in addition to the oral and nasal/inhalation routes that are already permitted, the agency opened discussions for the inclusion of dermatological, sublingual, and buccal routes. 

The urgency of regulating cannabis vaporizers was addressed in a column on the Sechat portal, signed by lawyers Konstantin Gerber and Paulo Thiessen — the latter also known for his international work in defense of rights related to the plant.

The main barrier is precisely the interpretation of Technical Note No. 35/2023, which prohibits the importation of flowers under the justification of insufficient scientific evidence, as highlighted in the column. 

However, experts argue that this justification has already lost strength, especially in light of the growing judicialization of the issue. “It becomes evident the urgency of ensuring safe and regulated access to devices that enable the inhalation administration of medicinal cannabis — especially vaporizers,” affirm Gerber and Thiessen.