Patients with chronic illnesses in Panama say they cannot legally obtain medical cannabis treatments nearly three years after the country passed a landmark law. Individuals with conditions like epilepsy and multiple sclerosis report facing a maze of bureaucratic obstacles that force many to seek medicine through informal channels.
The law regulating the medicinal use of cannabis and its derivatives took effect in October 2021. It established a legal framework for patient registration, medical prescriptions, and the controlled sale of products. Recent implementing regulations, however, have drawn sharp criticism from patient advocacy groups for being overly restrictive and difficult to navigate.
“It is the opportunity to improve symptoms that have not gone away in 30 years. We are also members of the technical commission on medical cannabis, which was formed after the law itself, and they have not called us even once.” [Translated from Spanish]
Emilia Martínez, a patient living with multiple sclerosis, shared that statement. She describes years of persistent pain and views regulated access to medicinal cannabis as a potential lifeline for improving her quality of life. Her experience highlights a common frustration, the perceived exclusion of patient voices from the regulatory process she helped to shape.
Burdensome Requirements Create Barriers to Care
To register legally, patients must navigate an official platform and submit a notarized copy of their ID, detailed medical certifications, and in some cases, additional documentation for a designated caregiver. Requirements become even more stringent for minors, potentially requiring a judicial sentence certifying guardianship and signed authorizations from both parents.
Enma Pinzón, president of the Federation for Critical Illnesses, argues these rules have backfired. She says they create more barriers than solutions for vulnerable people seeking relief.
“The patient who needs the medication still has to resort to illicit means to obtain it. They put so many requirements for patient registration that the only thing they did was create more obstacles to access.” [Translated from Spanish]
This situation persists despite some commercial progress. The Ministry of Health (Minsa) has granted several licenses for commercialization, and the first dedicated pharmacy opened its doors in Panama City recently. For many patients, these outlets remain out of reach due to the complex registration hurdle.
Officials Cite International Standards for Regulation
Panamanian health authorities defend the regulatory framework. They emphasize patient safety and adherence to international drug control conventions as their guiding principles.
Uriel Pérez, the Director of Pharmacies and Drugs at Minsa, explained the rationale behind the dispensing rules. He distinguished between different cannabis compounds and their legal status globally.
“Internationally, cannabidiol is not a controlled substance and that is why its dispensing has a different connotation.” [Translated from Spanish]
His reference to cannabidiol (CBD) points to a key distinction in the law. CBD, a non-psychoactive component, is used to treat conditions like epilepsy and chronic pain. Products containing tetrahydrocannabinol (THC), the psychoactive compound, face stricter controls under the Panamanian system.
Authorized treatments can come in various forms including capsules, ointments, and patches. These products are meant to be obtained with a prescription from a certified doctor following a successful patient registry application.
The ongoing conflict between patient accessibility and regulatory control shows no immediate signs of resolution. Advocacy groups continue to call for a simplified registry process. They want a system that acknowledges the urgent medical needs of chronically ill Panamanians. The government, meanwhile, maintains its commitment to a cautious and controlled rollout. For patients caught in the middle, the wait for legal relief continues, pushing some toward an unregulated market they hoped the 2021 law would eliminate. The future of Panama’s cannabis medicinal program may depend on finding a compromise between these two positions.