The Grapevine

Fewer Opioid Prescriptions In States That Provide Easier Access To Marijuana

Many people have advocated medical marijuana as a tool to fight against the on-going opioid epidemic in the nation. According to the Centers for Disease Control and Prevention (CDC), 115 Americans die each day from an opioid overdose. Newly published findings from two studies now suggest that states with easier access to marijuana have seen fewer opioid prescriptions.

One study examined opioid prescriptions that were covered by Medicare Part D between 2010 and 2015. The other study examined opioid prescriptions covered by Medicaid between 2011 and 2016. The two papers were published in the Journal of the American Medical Association (JAMA) on 02 April 2018.

The first study conducted a multiple regression analysis using data from Medicare and found that patients filled fewer daily doses of any opioid in states that approved medical cannabis. Overall, a 14% reduction in opioid use was observed over the period of the study.

"We do know that cannabis is much less risky than opiates, as far as likelihood of dependency," says W. David Bradford, lead author and a professor of public policy at the University of Georgia. Bradford links the "substantial reductions in opiate use" to states that have initiated dispensaries to obtain marijuana, adding that there is no risk of death caused by the drug itself.

Some of the uses of medical marijuana include pain control, reducing PTSD symptoms, relieving insomnia/anxiety, and treating severe conditions such as epilepsy and multiple sclerosis. It is "impossible to overdose on and far less addictive" than opioids, explains Dr. Peter Grinspoon, who teaches medicine at Harvard Medical School.

In the second study, Medicaid prescription data revealed 5.88% lower opioid prescribing rates in states that implemented medical marijuana laws. In the states with existing medical marijuana laws, the implementation of adult-use marijuana laws was associated with a 6.38% lower rate of opioid prescribing.

"The potential of marijuana liberalization to reduce the use and consequences of prescription opioids among Medicaid enrollees deserves consideration during the policy discussions about marijuana reform and the opioid epidemic," the authors write.

While these results certainly provide a strong case for marijuana legalization, Bradford acknowledges that there are still complications involved. "Like any drug in our FDA-approved pharmacopeia, it can be misused. There's no question about it," he says. The Medicaid study also mentions that opponents have viewed marijuana as a "gateway" or "stepping stone" to opioids or other dangerous drugs.

For instance, one study from 2017 linked illicit cannabis use with non-medical prescription opioid use. Dr. Kevin Hill suggests that further research needs to be conducted to understand the differences between illicit use and legalized use. Dr. Hill is an addiction psychiatrist at Beth Israel Deaconess Medical Center and an assistant professor of psychiatry at Harvard Medical School.

"As we have all of these states implementing these policies, it's imperative that we do more research," he said. "We need to study the effects of these policies, and we really haven't done it to the degree that we should."