Am I You Tomorrow? How the lessons learned from the opioid crisis and the tobacco epidemic can be useful in regulating the use of medical Cannabis

André Luiz Oliveira da Silva
OrcID

    André Luiz Oliveira da Silva

    Agência Nacional de Vigilância Sanitária-Anvisa

    OrcID https://orcid.org/0000-0003-4768-959X

    Possui graduação em Ciências Biológicas, com ênfase em Genética, pela Universidade Federal do Rio de Janeiro (UFRJ), mestrado em Toxicologia Ambiental e Ocupacional e doutorado em Saúde Pública, ambos pela Fundação Oswaldo Cruz (FIOCRUZ). Possui ainda um pós-doutorado em controle do tabaco na Universidade da Califórnia, em São Francisco (UCSF). Atualmente, é Especialista em Regulação e Vigilância Sanitária na Agência Nacional de Vigilância Sanitária (ANVISA), onde se dedica à área de Controle do Tabaco. Anteriormente, atuou como Biólogo e Assessor da Vice-presidência na FIOCRUZ, instituição na qual também leciona como Professor convidado nos cursos de pós-graduação da Escola Nacional de Saúde Pública (ENSP) e do Instituto Nacional de Controle de Qualidade em Saúde (INCQS). Sua trajetória docente abrangeu também a Universidade Estácio de Sá e a educação básica no Instituto de Educação do Rio de Janeiro. No cenário internacional, colabora ativamente com a Organização Mundial da Saúde (OMS) como expert pro bono da Convenção-Quadro para o Controle do Tabaco (CQCT/OMS) para os artigos 9 e 10, e como coordenador do grupo de aditivos de produtos de tabaco do Fórum Global dos Reguladores de Tabaco (GTRF/WHO).

Keywords

Tobacco
Opiods
Regulation
Medicial Cannabis
Tobacco Industry
Pharmaceutical Industry

Abstract

The regulation of medicines becomes especially challenging when it involves substances with both therapeutic potential and risk of abuse, as is the case with medicinal Cannabis. This article reflects on the lessons learned from the opioid and tobacco crises for the regulation of medicinal Cannabis. Both epidemics reveal regulatory failures and corporate strategies that have contributed to serious public health harms. Based on these experiences, concrete recommendations are proposed, ranging from harmonized international regulatory frameworks to strict measures for marketing control and management of conflicts of interest, aiming to harness the therapeutic benefits of Cannabis without repeating past mistakes. Thus, the goal is to ensure that the introduction of medicinal Cannabis occurs in a safe and effective manner, protected against misuse or undue influence from commercial interests.

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Am I You Tomorrow? How the lessons learned from the opioid crisis and the tobacco epidemic can be useful in regulating the use of medical Cannabis. Rev Fitos [Internet]. 2025 Dec. 3 [cited 2026 Apr. 3];19:e1820. Available from: https://revistafitos.far.fiocruz.br/index.php/revista-fitos/article/view/1820
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