Legal Marijuana Reduces Opioid Prescription Rates

Grant Boone
April 4, 2018

In an essay accompanying the study, Kevin P. Hill, MD, MHS, of the Division of Addiction Psychiatry at Harvard Medical School, noted distinct disparities between the results of studies such as Wen's, and those of studies that viewed the association between illicit marijuana and opioid use.

So while neither study includes all of the people who now use opioids or those who are at risk of using them, both show promising possibilities for marijuana laws.

"These findings suggest that medical and adult-use marijuana laws have the potential to reduce opioid prescribing for Medicaid enrollees, a segment of population with disproportionately high risk for chronic pain, opioid use disorder, and opioid overdose". "Combined with previously published studies suggesting cannabis laws are associated with lower opioid mortality, these findings further strengthen arguments in favor of considering medical applications of cannabis as one tool in the policy arsenal that can be used to diminish the harm of prescription opioids".

Among the eight states that began implementing medical marijuana laws between 2011 and 2016, four had significantly lower opioid prescribing rates: Delaware, Massachusetts, Minnesota and New Hampshire.

According to the Centers for Disease Control and Prevention, opioids were involved in more than 42,000 deaths in 2016. Also, it's unclear from the studies exactly how much marijuana use was for medical versus recreational purposes or how much people might have relied on other non-opioid painkillers. So that doesn't count people using illegal opioids or folks who don't use Medicare or large parts of the population that are under 65.

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They compared opioid prescribing patterns between states with medical or recreational pot and those that have taken a hard line against weed. In that time, Gov. Charlie Baker signed a bill that made MA the first state to limit an opioid prescription to a 7-day supply for a first time adult, and limit a 7-day limit on every opiate prescription for minors, with certain exceptions. Specifically, states with dispensaries cut the number of opioids dispensed cut by 3.742 million doses on average.

Results did vary based on the type of opioid, however.

Opioids are a class of strong pain medications, including drugs such as OxyContin (oxycodone) and Vicodin (a combination of hydrocodone and acetaminophen). Instead, they find evidence that legalization may reduce the prescribing of opioids.

"And now, with these two papers, plus a handful of previous studies, we've got pretty compelling evidence that shows that we need to really to think about cannabis as a potential way to curb the opioid crisis", said Hill, who co-authored an editorial that was published alongside the two studies in the same journal. "Medical cannabis wouldn't be an effective treatment for flu or for anemia, so we feel pretty confident that the changes we see in opioids are because of cannabis because there is a legitimate medical use".

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