Knowledge translation and evidence use in medicinal cannabis policy: An evidence brief on regulation, effectiveness, safety and stakeholder support in Colombia

In Colombia, formulating and implementing regulatory frameworks for safe access to medicinal cannabis (MC) is significantly challenging. The objective of this study is to mobilize available scientific evidence, public opinions and stakeholders’ perspectives to support policy formulation regulating the use of medicinal cannabis. We conducted a knowledge translation process based on a strategy composed of four components: (1) identifying the best available scientific evidence regarding three elements previously defined in collaboration with decision-makers from Colombia’s Ministry of Health and synthesizing it into an evidence brief, (2) organizing citizens panels ( n = 20 citizens) to deliberate on the findings from the evidence brief, (3) developing a policy dialogue with key stakeholders ( n = 32 stakeholders) from relevant organization to the issue and (4) conducting semistructured interviews with decision-makers ( n = 4 decision-makers) to document their perceptions of the process and any policy developments they associated with it. Evidence was organized and deliberated across three policy elements: (1) regulation limits, where evidence shows that permissible tetrahydrocannabinol (THC) thresholds in MC products vary across jurisdictions, commonly ranging between 0.2 and 1%; (2) effectiveness and safety, where evidence supports MC use for chronic pain, adjunctive treatment for refractory epilepsy and alleviation of chemotherapy-induced nausea and vomiting, with uncertainty persisting due to low- to moderate-quality evidence; and (3) training and communication, where educational strategies were shown to be effective at increasing clinical confidence, yet healthcare personnel perceived their current training as insufficient. Deliberation with citizens and stakeholders was conducted around these three elements. Participants identified the lack of clear and accessible information as the primary barrier to informed decision-making, emphasizing the need for professional training, evidence-based guidelines and monitoring mechanisms. Findings derived from evidence and citizen dialogues highlight key aspects informing public policies on MC. Despite regulatory advancements in cannabis, uncertainties remain regarding considerations for establishing regulatory limits and their potential consequences. The dearth of high-quality studies obfuscates the efficacy and safety of medicinal cannabis. Lastly, education of healthcare professionals and the community is imperative for the successful implementation of regulatory frameworks and informed decision-making.