When investors think of medical cannabis stocks, names like GW Pharmaceuticals (NASDAQ:GWPH) and more recently Tilray (NASDAQ:TLRY) come to mind before Cara Therapeutics (NASDAQ:CARA) does. Indeed, if someone knew nothing about CARA and examined its website, it would be difficult to determine that CARA stock is even a play on the proliferation of medical marijuana.

Cara Therapeutics is involved in medical marijuana, though, and arguably has more credibility in the field than many other hot pot stocks. Cara’s biopharma unit is taking dead aim at the growing opioid-addiction epidemic by using cannabis to create non-addictive painkillers.

And 2019 is likely to be a big coming-out year for CARA stock.

A Small But Powerful Pipeline

Cara Therapeutics’ pipeline is relatively small. What the company lacks in depth, however, it makes up for in potency and potential. The company only has one drug –CR845 —  in clinical trials. But it’s being tested in two Phase 3 trials and three other trials in earlier stages. Moreover, CARA is due to provide updates on most of these trials sooner rather than later

Opioids are a necessary evil. They’re a far more effective means of fighting pain, and post-operation pain in particular, than more common options like acetaminophen and ibuprofen, but their mechanism of action makes them highly addictive. An average of more than 115 people die in the United States each day due to opioid addictions. Many of these addictions start with a single opioid prescription.

Their addictiveness is at least partially caused by how they work and where they attach to the central nervous system to deaden pain. Cara is testing ways to prevent pain by interrupting different areas of the nervous system than opioids.

CR845 is being tested as a way to treat Pruritus (subcutaneous itching) as well as severe pain.

The Year Ahead for Cara Therapeutics Stock

Current and prospective owners of CARA stock may want to keep their ears open and their eyes peeled for a key update even before 2018 comes to a close. CEO Derek Chalmers commented during the company’s third-quarter earnings conference call that efficacy data from a Phase 1 trial of CR845 — which is supposed to provide itch relief for mild, moderate and patients with severe liver disease — could be unveiled before the end of this year or early next year.

CARA expects to announce data from Phase 3 trials of CR845 as a Pruritus treatment sometime in 2019 as well. Data from a Phase 2 trial of an oral form of CR845 for non-dialysis patients with kidney disease-related itching should also be reported next year.

What’s missing is clarity on when investors will hear more about CR845’s potential for use as a treatment for pain. The drug’s efficacy as a post-op pain treatment is being evaluated in a Phase 3 trial. Its use as a solution for chronic pain is being evaluated in a Phase 2 trial that’s in its latter stages.

The strong potential of Cara’s most advanced cannabis-based compound, CR701, should make owners of CARA stock more optimistic about the company’s outlook. It’s only in pre-clinical development right now, leaving the door wide open to all sorts of potential good developmental news.

The Bottom Line on CARA Stock

Right or wrong, macro headlines often steer small-cap biotech stocks. CARA stock hasn’t been an exception to that norm, largely rising and falling with mania about marijuana stocks.

Yet, looking past the noise, Cara’s news due to be announced in 2019 should be considerably more meaningful than the news of 2018 was. In the coming year, the company will be taking more serious strides toward commercialization. That may well set the stage for more persistent bullishness about CARA stock.

As it stands right now, most of the company’s 2019 updates will focus on Pruritus rather than pain treatment, even though the latter offers more potential upside. Don’t let the tentative schedule fool you, though. Updates on the pain treatment front are also in the cards, even if it’s not exactly clear when they will be released.

As of this writing, James Brumley did not hold a position in any of the aforementioned securities. You can follow him on Twitter, at @jbrumley.