Cannabis and psychosis, PRV for addiction, vaping, and endpoints
Addiction news and updates
📞 PSA for Reporters: if you want to be connected to doctors or programs that are prescribing GLP-1RAs like Ozempic for addiction, be in touch.
⚕️ Joe Lonsdale’s FDA reform proposal includes this recommendation, “As Congress does so it should consider expanding the PRV program to include other areas of unmet need where insufficient drug development is occurring, such as treatments for substance use disorders.” Hopefully there will still be an FDA left after all the reckless slashing. This recommendation was inspired by the Innovation Agenda for Addiction that I wrote with Willy Chertman. A PRV for addiction medicine would dramatically increase biotech investment in new addiction medicines, expanding the pipeline substantially.
💉 FDA updates Sublocade label to include rapid initiation. Lengthy initiation steps are a major obstacle to getting opioid patients onto medication. This can help. Part of our excitement about GLP-1RAs for OUD is that they can be initiated without detox and can even serve as a bridge to layered medication treatment that includes OAT.
🥦 Too much broccoli? Cannabis use disorder is rising and so are the dangers. “The rate of psychosis (without a diagnosis of schizophrenia) nearly doubled after [cannabis] legalization.” Does this mean we should go back to the drug war on cannabis? No. We can balance freedom and safety if we have effective medications to end addictions along with reasonable regulations on potency and marketing. Also, some of the claims in the research reported by the Times seem like a stretch, and likely correlations rather than causations. As Geoff Cooper points out in the comments below, the claim that cannabis use disorder is half as dangerous as OUD seems laughable.
🫁 Economics paper finds that the deregulation of vaping saved lives by getting people off of burned tobacco, “…they estimate that prohibiting the FDA from regulating e-cigarettes reduced smoking attributable mortality by nearly 10% on average each year from 2011-2019 for a total savings of some 677,000 life-years.” De-regulation can be a double-edged sword however. Horror stories from a few low-quality cannabis vapes that contained vitamin E acetate have led many smokers to the false conclusion that vaping and cigarette smoking are equally dangerous.
🎯 Great NIDA blog post from Nora Volkow on updating FDA endpoints for addiction trials and moving away from abstinence based approaches. This is another core recommendation in the Innovation Agenda for Addiction and we are organizing a letter from members of Congress to the FDA on this topic. It may sound boring, but having clarity on endpoints is essential for biotechs and pharma companies that are considering making addiction medicine. We need to remove counter-productive obstacles if we want better treatments.
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And I’m very excited about two programs that CASPR is supporting for GLP-1 access in addiction treatment are launching this month and next. We’ll have exciting updates from them shortly.
"Those numbers suggest that cannabis use disorder is about half as dangerous as opioid addiction and slightly less dangerous than alcohol use disorder, the researchers said." Coming from someone who has been addicted to opiods and lost a lot of friends and family to alcohol abuse this is one of the more ridiculous reefer madness assertions I've ever read. Where are the bodies? You're telling me that for every 2 people that die from opiod abuse there's one who dies from cannabis abuse? This type of stuff is a big reason why there is less and less trust in "experts" and "scientists" these days. Young people read something like this and rightly question what other "expert" opinions are also bullshit.