Two new studies find opioid use lower in US states with legal cannabis

  • Two new studies found opioid use is lower when patients have access to cannabis
  • Legalisation of medical cannabis led to a 6% drop in opioid prescriptions to Medicaid patients
  • Legal recreational use led to additional 6% decrease: more access to cannabis = less chance of opioid addiction
  • 64,000 people died due to opioid overdose in the US in 2016
  • The UK has seen nearly a 100% increase in opioid-related death from 2012 – 2016

Legalising medical cannabis may be the answer to America and the UK’s growing opioid crisis, according to data from two new studies.

Evidence from the studies supports the increasingly popular argument that medical cannabis should replace dangerous opioid-based pharmaceuticals, as there are no known fatalities, or any serious side-effects, to the ancient herbal medication.

The studies compared opioid prescription patterns in states where patients have access to legal cannabis with those that have not. The first study, from the University of Georgia, investigated opioid prescriptions covered by Medicare Part D, which covers people 65 years or older and those with disabilities, between 2010 and 2015, to see if legalising cannabis would impact the prevalence of opioid prescription.

The study also investigated whether specific laws related to cannabis affected prescriptions.

Researchers found that associations between legalising cannabis and any opioid prescribing were “statistically significant”.

Medicare patients in states which allowed cannabis to be grown at home had 7% fewer (1.792 million) daily doses of opioid prescriptions filled compared to those with no legal access to cannabis.

Interestingly, the figured doubled to 14% (3.742 million) in states which had active cannabis dispensaries, indicating that the greater access people have to cannabis, the less likely they are to develop a dangerous opioid addiction.

Discussing the results of the study, W. David Bradford, a professor of public policy at the University of Georgia, said:

“…we found that the use of prescription drugs for which marijuana could serve as a clinical alternative fell significantly, once a medical marijuana law was implemented.

“National overall reductions in Medicare program and enrollee spending when states implemented medical marijuana laws were estimated to be $165.2 million per year in 2013.

“The availability of medical marijuana has a significant effect on prescribing patterns and spending in Medicare Part D.

Physicians cannot prescribe cannabis; it is still a Schedule I drug.

“We’re not observing that prescriptions for cannabis go up and prescriptions for opioids go down.

“We’re just observing what changes when medical cannabis laws are enacted, and we see big reductions in opiate use.”[

Marijuana is one of the potential, non-opioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose.
– Hefei Wen, lead author on the Kentucky Medicaid study

The second study, from the University of Kentucky, also investigated the relationship between legalising medical and recreational cannabis and lower rates of opioid prescribing for Medicaid enrollees.

The study compared states with legal access to cannabis against those without.

Researchers found that laws which allowed people to use cannabis to treat specific medical conditions were associated with about a 6% lower rate of opioid prescribing for pain; about 39 fewer prescriptions per 1,000 people using Medicaid.

As with the study from Georgia, the Kentucky study found that states with the most access to cannabis, i.e. legal recreational use, had a further 6% drop in opioid prescriptions, indicating that to truly tackle opioid addiction, recreational use may need to be legalised.

Discussing the results, Hefei Wen, lead author on the Kentucky Medicaid study, said:

“We saw a 9% or 10% reduction (in opioid prescriptions) in Colorado and Oregon.

“In Alaska and Washington, the magnitude was a little bit smaller but still significant.

“Marijuana is one of the potential, non-opioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose.

“Our study provides some of the first empirical evidence that the implementation of medical and adult-use marijuana laws was associated with lower opioid prescribing rates and spending among Medicaid enrollees.” Both research teams conclude that while there is significant evidence to support the argument that legalising cannabis in its entirety is the best solution to tackling the opioid epidemic, in both the US and the UK, further research is needed before any concrete conclusions can be drawn.

While some states in the US are taking an active step to prevent the rise of an opioid epidemic, the UK remains solidified in its refusal to legalise cannabis, even for medical use.

The number of opioid overdose in the UK increased by nearly 100% in 4 years, from 1,290 in 2012 to 2,038 in 2016.

If the British Government are serious about their pledge to tackle this rising epidemic, they may need to consider legalising cannabis, not only for medical use, but across the board.

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References and further Reading

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2677000?alert=article&redirect=true

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2676999?redirect=true