Resumo
Da Ásia a cânabis percorreu o mundo por oferecer a humanidade possibilidades de nutrição, proteção e tratamento. Considerada um dos primeiros cultivares da revolução agrícola, a planta era utilizada para produzir redes de pesca, vestimentos e substâncias que interagem com nosso organismo e produzem diversos efeitos. Alguns efeitos são considerados terapêuticos e podem se revelar como a última alternativa para pessoas resistentes aos tratamentos convencionais adotados para uma série de enfermidades. Como todo fitoterápico, a cânabis expressa uma diversidade de moléculas. Entre estas, os canabinoides são uma grande família exclusiva da cânabis. As moléculas são produzidas pela planta em diferentes perfis de acordo com a variabilidade genética e epigenética da espécie. Quando ingeridos, estes compostos atuam em comitiva e dependendo deste perfil, do contexto de uso e do indivíduo que utiliza estão sujeitos a desencadear efeitos distintos, que podem ser considerados terapêuticos ou adversos. Discutir sobre a interação da planta com o organismo humano numa sociedade em que esta interação é proibida foi o exercício que levou à produção deste artigo
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28. Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi
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trial of cannabidiol for drug resistant seizures in the dravet syndrome. N Engl J Med.2017; 376(21):2011-2020.
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cannabis. Pain. 2017; 158(7):1373–1379.
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38. Lopez-Quintero C, Cobos JP, Hasin DS, Okuda M, Wang S, Grant BF, Blanco C. Probability and predictors of transition from first use to
dependence on nicotine, alcohol, cannabis, and co-caine: results of the National Epidemiologic Survey on Alcohol and Related
Conditions (NES-ARC). Drug Alcohol Depend. 2011; 115(1-2): 120-130.
39. Gorelick DA, Goodwin RS, Schwilke E, Schwope DM, Darwin WD, Kelly DL, McMahon RP, Liu F, Ortemann-Renon C,Bonnet D, Huestis MA.
Tolerance to effects of high-dose oral ∆9-tetrahydrocannabinol and plasma cannabinoid concentrations in male daily cannabis smokers.
J Anal Toxicol.2013; 37(1): 11-16.
40. Radhakrishnan R, Wilkinson ST, D’Souza DC. Gone to pot – a review of the association between cannabis and psychosis. Front Psychiatry.
2014; 5:art.54.
41. Fischer B, Russell C, Sabioni P, Van den Brink W, Le Foll B, Hall W & cols. Lower-risk cannabis use guidelines: a comprehensive update of
evidence and recommendations. Am J Public Health. 2017; 107(8):e1-e12.
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FIOCRUZ/ICICT; 2017. 528p.
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45. Brasil. Resolução da Diretoria Colegiada (RDC) nº 327. Dispõe sobre os procedimentos para a concessão da Autorização Sanitária para
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http://www.in.gov.br/en/web/dou/-/resolucao-da-diretoria-colegiada-rdc-n-327-de-9-de-dezembro-de-2019-232669072
46. Kalant OJ. Report of the Indian Hemp Drugs Commission, 1893-94: A Critical Review. Int J Addict. 1972;7(1):77-96.
47. Wallace GB, Cunningham EV. The marihuana problem in the City of New York; Sociologi-cal, Medical and Pharmacological Studies.
Lancaster, Pennsylvania: The Jacques Cattell Press; 1944.
48. Nahas GG, Greenwood A. The first report of the National Commission on Marihuana (1972): signal of misunderstanding or exercise in
ambiguity. Bull N Y Acad Med. 1974;50(1): 55-75.
49. Carneiro HS. Drogas: a história do proibicionismo. Editora Autonomia Literária; 2018.
50. Pacula RL, Smart R. Medical Marijuana an-d Marijuana Legalization. (2017). Annu Rev Clin Psychol.; 13: 397–419.
51. Lucas PG.Regulating Compassion: An Overview of Canada’s Federal Medical Cannabis Pol-icy and Practice.
(2008). Harm Reduct J;5:5.
52. Agarwal R, Burke SL Maddux M. Current state of evidence of cannabis utilization for treatment of autism spectrum disorders (2019).
BMC Psychiatry. 2019; 19: 328.
53.https://www.emcdda.europa.eu/topics/cannabis-policy. Acessado em 01/10/2020 às 16:20.
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Janeiro; 9 dez 2019.
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Estado do Ceará. J Manag Prim Health Ca-re. (on line). [acesso em: 20 set 2020]. Disponível em:
https://www.jmphc.com.br/jmphc/article/view/543
2. McPartland JM. Cannabis systematics at the levels of family, genus and species. Cannab Can-na Res. 2018;3(1):203-212.
3. Arno Hazekamp, Katerina Tejkalová, and Stelios Papadimitriou.Cannabis and Cannabinoid Research. 2016.202-215.
4. Lewis MA, Russo EB, Smith KM. Pharmacological foundations of cannabis chemovars. Planta Med. 2018;84(4):225-233.
5. Andre CM, Hausman JF, Guerriero G. Cannabis sativa: the plant of the thousand and one mol-ecules. Front Plant Sci.2016; 7:19.
6. US Department of Justice. Diversion Control Division.Food and drugs. (on line). [acessado em: 21 out 2020]. Disponível em: www.gpo.gov
https://www.deadiversion.usdoj.gov/21cfr/21usc/
7. Dolgin E. Genomics blazes a trail to improved cannabis cultivation. PNAS. 2019; 116(18):8638-8640.
8. ElSohly MA, Radwan MM, Gul W, Chandra S, Galal A. Phytochemistry of cannabis sativa L. Prog Chem Org Nat Prod. 2017; 103:1-36.
9. Wang M, Wang YH, Avula B, Radwan MM, Wanas AS, van Antwerp J, Parcher JF, ElSohly MA, Khan IA. Decarboxylation Study of Acidic
Cannabinoids: A Novel Approach Using Ultra-High-Performance Supercritical Fluid Chromatography/Photodiode Array-Mass
Spectrometry. Cannabis Cannabinoid Res. (2016);1(1):262-271.
10. Pacchetti CCB, Vandelli MA, Forni F, Cannazza G. Analysis of Cannabinoids in Commercial Hemp Seed Oil and Decarboxylation Kinetics
Studies of Cannabidiolic Acid (CBDA). J Pharm Biomed Anal. (2018).149:532-540.
11. Wang M, Wang YH, Avula B, Radwan MM, Wanas AS, Antwerp J. & cols. Decarboxylation study of acidic cannabinoids: a novel approach
using ultra-high-performance supercritical fluid chromatography/photodiode array-mass spectrometry. Cannab Cann Res. 201;
1(1):262271.
12. Mechoulam R, Parker LA. The endocannabinoid system and the brain. Annu Rev Psychol. 2013; 64:21-47.
13. Pertwee RG. Endocannabinoids and their pharmacological actions. Handb Exp Pharmacol. 2015; 231:1-37.
14. De Petrocellis L, Melck D, Bisogno T, Milone A, Di Marzo V. Finding of the endocanna-binoid signalling system in hydra, a very primitive
organism: possible role in the reeding response. Neuroscience. 1999; 92(1):377-87.
15. Metna-Laurent M, Mondésir M, Grel A, Vallée M, Piazza PV. Cannabinoid-induced tetrad in Mice. Curr Protoc Neurosci. 2017; 80:9.59.1-
9.59.10.
16. Cristino L, Bisogno T, Di Marzo V.Cannabinoids and the expanded endocannabinoid system in neurological disorders. Nat Rev Neurol.
2020; 16(1):9-29.
17. Pacher P, Kunos G. Modulating the endocannabinoid system in human health and disease--successes and failures. FEBS J. 2013.
280(9):1918-43.
18. Mechoulam R, Hanuš LO, Pertwee R, Howlett AC. Early phytocannabinoid chemistry to endocannabinoids and beyond. Nat Rev Neurosc.
2014. 15: 757–764.
19. Gallily R, Yekhtin Z, Hanus L. Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in
Cannabidiol. (2014) Pharmacology & Pharma-cy 06(02):75-85.
20. Pamplona FA, Silva LR, Coan AC. Potential clinical benefits of cbd-rich cannabis extracts over purified cbd in treatment-resistant epilepsy:
observational data meta-analysis. Front Neurol. 2018; 9:759.
21. Uliel-Sibony S, Hausman-Kedem M, Kramer U. Cannabidol tolerance in children and adults with treatment-resistant epilepsy. Annual
Meeting American Epil. 2018; abst 2.233.
22. Scheen AJ, Finer N, Hollander P, et al. Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a
randomised controlled study. Lancet.2006; 368:1660-72.
23. Christensen R, Kristensen PK, Bartels EM, Bliddal H, Astrup A. Efficacy and Safety of the Weight-Loss Drug Rimonabant: A meta-analysis
of randomised trials. Lancet. 2007;370(9600):1706-13.
24. Freedland CS, Sharpe AL, Samson HH, Porrino LJ. Effects of SR141716A on ethanol and sucrose Self-Administration. Alcohol Clin Exp Res.
2001; 25(2):277-82.
25. May MB, Glode AE. Dronabinol for chemotherapy-induced nausea and vomiting Unrespon-sive to Antiemetics. Cancer Manag. 2016;
res.8:49-55.
26. O’Shaughnessy WB. Case of tetanus, cured by a preparation of hemp (the cannabis indica). Transactions of the Medical and Physical
Society of Bengal. 1838–40; 8:462–469.
27. Cunha JM, Carlini EA, Pereira AE, Ramos OL, Pimentel C, Gagliardi R, Sanvito WL, Lander N, Mechoulam R. Chronic administration of
cannabidiol to healthy volunteers and epileptic patients. Pharmacology. 1980; 21(3):175-85.
28. Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi
SM; GWPCARE3 Study Group. Effect of cannabidiol on drop seizures in the lennox-gastaut syndrome. N Engl J Med. 2018; 378(20):1888-
1897.
29. Devinsky O, Cross JH, Laux L, Marsh E, Miller I, Nabbout R, Scheffer IE, Thiele EA, Wright S; Cannabidiol in dravet syndrome study group.
trial of cannabidiol for drug resistant seizures in the dravet syndrome. N Engl J Med.2017; 376(21):2011-2020.
31. Brian J Piper BJ, Beals ML, Abess AT, Nichols SD, Martin M, Cobb CM, DeKeuster RM. Chronic pain patients’ perspectives of medical
cannabis. Pain. 2017; 158(7):1373–1379.
32. National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: the current state of
evidence and recommendations for research. Washington, DC: The National Academies Press;2017.
33. Sledzinski P, Zeyland J, Słomski R, Nowak A The current state and future perspectives of cannabinoids in cancer biology Cancer Med.
2018; 7(3):765–775.
34. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27.
35. Hall W, Degenhardt L. The adverse health effects of chronic cannabis use. Drug Test Anal. 2014; 6(1-2):39-45.
36. Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J & cols. Association of cannabis use in adolescence and risk of depression, anxiety,
and suicidality in young adulthood: a system-atic review and meta-analysis. JAMA Psychiatry.2019; 76(4):426-434.
37. Scott JC, Slomiak ST, Jones JD, Rosen AF, Moore TM, Gur RC. Association of cannabis with cognitive functioning in adolescents and young adults: a systematic review and meta-analysis. JAMA Psychiatry. 2018; 75(6):585-595.
38. Lopez-Quintero C, Cobos JP, Hasin DS, Okuda M, Wang S, Grant BF, Blanco C. Probability and predictors of transition from first use to
dependence on nicotine, alcohol, cannabis, and co-caine: results of the National Epidemiologic Survey on Alcohol and Related
Conditions (NES-ARC). Drug Alcohol Depend. 2011; 115(1-2): 120-130.
39. Gorelick DA, Goodwin RS, Schwilke E, Schwope DM, Darwin WD, Kelly DL, McMahon RP, Liu F, Ortemann-Renon C,Bonnet D, Huestis MA.
Tolerance to effects of high-dose oral ∆9-tetrahydrocannabinol and plasma cannabinoid concentrations in male daily cannabis smokers.
J Anal Toxicol.2013; 37(1): 11-16.
40. Radhakrishnan R, Wilkinson ST, D’Souza DC. Gone to pot – a review of the association between cannabis and psychosis. Front Psychiatry.
2014; 5:art.54.
41. Fischer B, Russell C, Sabioni P, Van den Brink W, Le Foll B, Hall W & cols. Lower-risk cannabis use guidelines: a comprehensive update of
evidence and recommendations. Am J Public Health. 2017; 107(8):e1-e12.
42. Bastos FI, Pinkusfeld M, & cols. (orgs.). III Levantamento Nacional sobre o uso de drogas pela população brasileira. Rio de Janeiro:
FIOCRUZ/ICICT; 2017. 528p.
43. Brasil. Supremo Tribunal Federal. Arguição de Direito de Preceito Fundamental (ADPF) 187. [acesso em 21 out 2020]. Brasília; 17
jun 2014. Disponível em: http://portal.stf.jus.br/processos/detalhe.asp?incidente=2691505
44. Pratt M, Stevens A, Thuku M, Butler C, Skidmore B, Wieland LS, Clemons M, Kanji S, Hut-ton B. Benefits and harms of medical cannabis: a
scoping review of systematic reviews. (2019). Syst Rev.; 8: 320.
45. Brasil. Resolução da Diretoria Colegiada (RDC) nº 327. Dispõe sobre os procedimentos para a concessão da Autorização Sanitária para
produtos de Cannabis para fins medicinais, e dá outras providências. Brasília; 9 dez 2019.[acesso em: 21 out 2020]. Disponível em:
http://www.in.gov.br/en/web/dou/-/resolucao-da-diretoria-colegiada-rdc-n-327-de-9-de-dezembro-de-2019-232669072
46. Kalant OJ. Report of the Indian Hemp Drugs Commission, 1893-94: A Critical Review. Int J Addict. 1972;7(1):77-96.
47. Wallace GB, Cunningham EV. The marihuana problem in the City of New York; Sociologi-cal, Medical and Pharmacological Studies.
Lancaster, Pennsylvania: The Jacques Cattell Press; 1944.
48. Nahas GG, Greenwood A. The first report of the National Commission on Marihuana (1972): signal of misunderstanding or exercise in
ambiguity. Bull N Y Acad Med. 1974;50(1): 55-75.
49. Carneiro HS. Drogas: a história do proibicionismo. Editora Autonomia Literária; 2018.
50. Pacula RL, Smart R. Medical Marijuana an-d Marijuana Legalization. (2017). Annu Rev Clin Psychol.; 13: 397–419.
51. Lucas PG.Regulating Compassion: An Overview of Canada’s Federal Medical Cannabis Pol-icy and Practice.
(2008). Harm Reduct J;5:5.
52. Agarwal R, Burke SL Maddux M. Current state of evidence of cannabis utilization for treatment of autism spectrum disorders (2019).
BMC Psychiatry. 2019; 19: 328.
53.https://www.emcdda.europa.eu/topics/cannabis-policy. Acessado em 01/10/2020 às 16:20.
54. Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução de Diretoria Colegiada (RDC) nº 17. Brasília; 6
maio 2015.
55. Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução de Diretoria Colegiada(RDC) nº 66. Rio de
Janeiro;18 mar 2016.
56. Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Registro ANVISA nº 1697700030014. Brasília; 2018;
57. Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução de Diretoria Colegiada(RDC) nº 327. Rio de
Janeiro; 9 dez 2019.
58. Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução de Diretoria Colegiada(RDC) nº 335. Rio de
Janeiro; 24 dez 2020.
59. Bonfim DYG, Bandeira MAM, Gomes AB, Brasil ARL, Magalhães K do N, Sá KM. Diag-nóstico situacional das farmácias vivas existentes no
Estado do Ceará. J Manag Prim Health Ca-re. (on line). [acesso em: 20 set 2020]. Disponível em:
https://www.jmphc.com.br/jmphc/article/view/543
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Copyright (c) 2020 Renato Filev
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