If we look back, drugs like oxycodone and alprazolam were widely prescribed with medical backing, a strong safety narrative, and significant market influence. The result? Expanded use, dependence in some patients, and a system that, for a time, underestimated the risks.
Now, with medical cannabis, the scenario is different — but not entirely new.
It has a better safety profile, especially because it does not cause fatal respiratory depression like opioids. That significantly changes the severity of outcomes. At the same time, however, it carries a factor that may be even more powerful from a market perspective: the perception that it is “natural” and therefore almost harmless.
And that’s where my reflection comes in.
Cannabis is not risk-free. There is Cannabis Use Disorder, there are cognitive impacts with chronic use, and possible psychiatric effects in susceptible patients. But compared to other historically problematic drug classes, these risks are lower — and that completely changes how it is positioned.
In practice, what I see is an “upgrade” of the old model:
a product with lower objective risk, greater social acceptance, growing medical endorsement, and a highly profitable market around it.
This does not invalidate its legitimate use — which exists and is important in several indications. But it does raise a warning: when perceived risk is very low, the threshold for indication tends to relax.
And the history of medicine has already shown more than once what can happen when that occurs.