Panamanian patients continue waiting for legal medical cannabis access nearly four years after legislation passed. The Ministry of Health recently announced regulatory changes that could soon place cannabis products on pharmacy shelves, but the absence of an active patient registry prevents actual distribution. Patient advocates acknowledge progress while expressing cautious skepticism about the timeline for meaningful access.
Chronic pain patient Enma Pinzon leads the National Federation of Associations of Chronic, Critical and Degenerative Diseases. She emphasizes that medical cannabis represents more than policy discussion for people living with conditions that often respond poorly to conventional treatments. Scientific evidence increasingly supports cannabis as a therapeutic alternative for various conditions, she notes, particularly when traditional medications cause damaging side effects.
“Medical cannabis already has scientific evidence of its benefits for several diseases,” Pinzon stated. [Translated from Spanish] “For patients with rheumatic and musculoskeletal diseases like myself, it provides relief from chronic pain without the organ damage that Nonsteroidal Anti-Inflammatory Drugs can cause to kidneys.”
Pinzon speaks from personal experience managing her conditions while advocating for broader therapeutic options. Her federation represents thousands of Panamanians who could potentially benefit from regulated Medical Cannabis programs already established in numerous countries worldwide.
Regulatory Progress Meets Practical Hurdles
Uriel Perez, Director of Pharmacies and Drugs at the Ministry of Health, recently indicated that regulatory adjustments move the country closer to seeing initial cannabis products in authorized pharmacies. These modifications to the decree implementing Law 242 of October 2021 include provisions for pharmacy distribution and eliminate previous restrictions that patient groups found problematic.
Pinzon acknowledges these regulatory improvements but identifies critical missing components. The patient registry system required to track prescriptions and prevent diversion remains inactive despite being legally mandated. This creates a fundamental barrier between available products and the patients who need them.
“The decree helps with the opening of pharmacies and product distribution within them,” Pinzon explained. [Translated from Spanish] “However, we still have not received news that the patient registry has been enabled.”
Without this operational registry, pharmacies cannot legally dispense cannabis products regardless of their physical presence in the country. Physicians lack the formal mechanism to authorize treatments even if they believe cannabis represents the best therapeutic option for specific patients. The General Health Directorate within the Ministry holds responsibility for activating this essential component.
Physician Training Shifts From Mandatory to Voluntary
Another significant regulatory change eliminates mandatory training courses previously required for physicians to prescribe medical cannabis. Health authorities now permit any licensed doctor to recommend cannabis treatments without completing specialized certification. Some stakeholders view this modification as streamlining access while others question its implications for treatment quality.
Pinzon approaches this change with measured concern. She recognizes that removing bureaucratic barriers could increase the number of participating physicians. The practical reality, however, means patients must become more discerning about selecting providers knowledgeable about cannabis therapeutics.
“The fact that they eliminate the requirement for doctors to train does not mean that those doctors who are interested in properly managing the medication will not opt for training,” Pinzon said. [Translated from Spanish] “It is up to us patients to know how to choose our doctors.”
Effective cannabis medicinal treatment requires understanding proper dosing, potential drug interactions, mechanisms of action, and side effect management. The voluntary nature of training could create disparities between patients who access educated physicians and those who do not. Pinzon believes the ultimate responsibility for ensuring proper use should not fall entirely on patients navigating complex medical decisions.
Open Conditions List Represents Significant Advancement
Regulators eliminated the previously established closed list of qualifying conditions for medical cannabis access. This development received strong endorsement from patient advocacy groups who argued that restrictive lists quickly become outdated as research evolves. Pinzon characterizes this modification as aligning Panama’s approach with dynamic scientific understanding.
Medical literature continues documenting potential applications for cannabis beyond initially recognized conditions. Maintaining a fixed list would have inevitably excluded patients who might benefit from treatment options supported by emerging evidence. The new framework permits physicians to evaluate patients based on clinical presentation rather than bureaucratic categorization.
“Eliminating the list helps because research always continues,” Pinzon noted. [Translated from Spanish] “It may be that over time other diseases are found where the product will work, and having a closed list hinders patient access to scientific advances.”
For Panamanian patients, this means that any individual with a clinically supported condition can discuss cannabis as a potential treatment option with their physician. This patient-centered approach reflects evolving international standards that prioritize therapeutic relationships over restrictive regulations.
Private Sector Participation Advances Amid Oversight Questions
The Ministry of Health reports five companies currently hold operational licenses with three additional businesses approved for controlled substances handling. These developments indicate progressing infrastructure for eventual product importation and distribution. Licensed entities must still secure necessary permissions from source countries before initiating imports.
Pinzon recognizes private sector involvement as essential for creating a functional supply chain. She simultaneously emphasizes that ultimate responsibility for product quality and safety rests with the Government of Panama through its regulatory agencies. Established frameworks exist for monitoring cannabis quality, but their consistent enforcement remains untested.
The Director of Pharmacies and Drugs already possesses regulatory authority to ensure compliance with quality standards. Patient advocates stress the importance of rigorous oversight as products approach market. Many individuals considering cannabis treatments have compromised immune systems or existing organ damage from years of conventional medications. They represent a particularly vulnerable population requiring assurance about product safety and consistency.
Affordability Concerns Loom for Import-Only Initial Phase
Initial market availability will feature exclusively imported cannabis products, creating inevitable cost barriers for many patients. Local production remains years from implementation despite legislative provisions allowing domestic cultivation and manufacturing. This import-dependent phase will test the affordability of treatments for chronic conditions often requiring continuous medication.
Patients currently using conventional pharmaceuticals like Nonsteroidal Anti-Inflammatory Drugs face known risks of gastrointestinal bleeding, kidney damage, and cardiovascular complications. Many seek cannabis alternatives specifically to avoid these documented hazards. The economic accessibility of safer alternatives remains uncertain as regulators finalize distribution protocols.
Panama’s medical cannabis implementation continues evolving through sequential regulatory adjustments. Patient advocates monitor these developments while emphasizing that legal frameworks only translate into actual access when all components function together. The operational patient registry represents the final missing piece preventing thousands from obtaining treatments already legalized years earlier.