On January 28, Brazil’s health regulator Anvisa voted unanimously to let companies grow cannabis on Brazilian soil for the first time. The decision could reshape Latin America’s largest pharmaceutical market.
The problem: two of the world’s most respected medical journals just published evidence suggesting the product may not work the way millions believe.
The rules permit cultivation with up to 0.3% THC, allow cannabidiol in compounding pharmacies, and create a trial program for patient groups.
The sector hit R$971 ($183) million last year, 670,000 Brazilians use cannabis products, and over 660,000 import permits were filed in a decade. Advocates celebrated: domestic production means lower prices.
The World Is Pulling Back on Cannabis. Brazil Just Doubled Down
Then there is the science. A Cochrane review published this January — 21 trials, 2,100 patients — found no solid evidence cannabis relieves nerve pain better than placebo. A JAMA review of 2,500 studies went further: evidence is insufficient for chronic pain, anxiety, and insomnia.
Proven uses are narrow: chemotherapy nausea, HIV appetite loss, rare childhood epilepsy. The JAMA data also showed 29% of medical users developed dependency, 12.4% on high-potency products experienced psychotic symptoms, and daily inhalation doubled heart disease risk.
Psychiatrist Ronaldo Laranjeira of Unifesp called the regulation “a bizarrice” driven by industry lobbying. Cannabis prevalence surged from 3% to over 15% of Brazilians, and THC potency has risen from 1% to 20% over four decades in Canada. The Brazilian Psychiatric Association is blunt: “medical marijuana does not exist.”
What makes this globally significant is timing. Oregon recriminalized drugs in 2024 after overdose deaths spiked 1,500%. Amsterdam banned public cannabis smoking.
Thailand dismantled 11,000 dispensaries in 2025, three years after decriminalizing. Brazil is betting it can succeed where others stumbled. The answer depends on evidence the science has not delivered.