FDA Will Foster Development Of Non-Addictive Alternatives To Opioids For Pain: Should Cannabis Be On The List?

The U.S. Food and Drug Administration (FDA) announced Wednesday that it is taking steps aimed to foster the development of non-addictive alternatives to opioids to manage acute pain and prevent new addiction.

The agency issued draft guidance to provide recommendations to companies developing non-opioid analgesics for acute pain.

“This guidance supports the HHS Overdose Prevention Strategy, which focuses on four priority areas — primary prevention, harm reduction, evidence-based treatment, and recovery support,” stated the agency in a press release.

“Opioid misuse and abuse remain a serious public health crisis facing the country. Preventing new addiction through the development of novel non-opioid analgesics is an important priority for the FDA,” said Patrizia Cavazzoni, M.D., director of the FDA’s Center for Drug Evaluation and Research. “The guidance reinforces the agency’s commitment to confront opioid misuse, abuse, and addiction by taking steps to help those with acute pain get access to improved non-opioid treatment alternatives.”

The agency noted that “even at prescribed doses” opioids pose a risk for addiction, abuse, overdose, death. A non-opioid could have a major public health impact by alleviating suffering and the risks associated with opioids.

While the FDA does not mention cannabis as an alternative, there is a growing body of research that looks at its therapeutic properties that can help people recover from addiction as well as alleviate pain. 
"Generally people can use cannabis instead of opioids for chronic pain. By combining opioids and cannabis the doses can stay low (since most of the problems you have with opioids are dose-related) and cannabis can help with opioid withdrawal symptoms,” Dr. Peter Greenspoon from Harvard University explained to El Planteo.
According to researchers conducting a study on osteoarthritis at the Thomas Jefferson University in Philadelphia, population studies show that medical marijuana legalization has been associated with reduced mortality due to opioid overdose, opioid-related hospitalizations and decreased opioid prescription. However, there is still insufficient evidence to show that medical marijuana can be an effective replacement for opioids.
A study published in 2021, in BMC Public Health, titled “Opioid use in medical cannabis authorization for adult patients from 2013 to 2018: Alberta, Canada” has shown that permission to use medical cannabis to treat chronic pain led to a reduction in opioid use. 
The FDA approved in January an investigational new drug (IND) application for the clinical trial evaluating ANANDA Scientific Inc’s investigational drug - Nantheia ATL5 - using CBD as an adjunctive treatment for opioid use disorder. The National Institute on Drug Abuse (NIDA) agreed to provide funds for the research.

Photo by Danilo Alvesd on Unsplash.