Published: Wed, April 04, 2018
Medical | By Jackie Banks

Studies examine relationship between legal cannabis use, opioid prescriptions

Studies examine relationship between legal cannabis use, opioid prescriptions

Yet no study to date has focused on the effect of medical and adult-use marijuana laws on opioid prescribing in particular.

Medicare Part D, also called Medicare prescription drug benefit subsidizes the costs of prescription drugs and prescription drug insurance premiums for more than 42 million Americans.

"These findings suggest that cannabis may play a role in fighting the opioid crisis by reducing some patients' need for opioids", said Dr Kevin Hill, co-author of an accompanying editorial and director of addiction psychiatry at Beth Israel Deaconess Medical Center in Boston.

In the first study, Hefei Wen of the University of Kentucky and Jason Hockenberry of Emory University found that the passage of medical and recreational marijuana laws were followed by reductions in Medicaid opiate prescription rates of 5.88 percent and 6.38 percent, respectively.

In the Medicare study, conducted from 2010 to 2015, researchers didn't find cannabis legalization associated with a meaningful reduction in prescriptions for fentanyl or oxycodone.

"We had about a 14.5 percent reduction in opiate use when states turned on dispensaries, and about a 7 percent reduction in opiate use when states turned on home cultivation-based cannabis laws", said researcher David Bradford, chairman of public policy at the University of Georgia School of Public and International Affairs.

There is widespread agreement among doctors and public health experts that marijuana is effective at treating chronic pain.

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The National Safety Council reported that employers are taking the biggest toll in the crisis- losing eligible workers to addiction, reporting that "certain industries like construction and manufacturing, report increasing difficulties in filling open positions".

"Of course, there may be diversion from medical cannabis sources to recreational purposes - our research can't really speak to that", Bradford said by email.

North Carolina's largest health insurer is clamping down on coverage of opioid prescriptions.

The article The Impact of Medical and Adult-Use Marijuana Laws on Opioid Prescribing for Medicaid Enrollees can be accessed on JAMA's website here. Opioid prescriptions fell by 2.21 million daily doses per year, on average, in states that legalized medical marijuana - an 8.5-percent decrease - compared with opioid prescriptions in states that didn't legalize the drug.

Bottom Line: Two studies examine the relationship between legal cannabis use and opioid prescriptions. The fast-growing opioid crisis is more relevant than HIV/AIDS today and needs more funding to educate people and provide more treatment facilities.

The Trump administration's decision to increase spending to address the opioid crisis is a step in the right direction, but this epidemic needs more attention.

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