Wednesday, 17 Oct 2018

You are here

Cannabis Laws Lessen the Opioid Crisis

Three reports from JAMA Internal Medicine demonstrate favorable trends with less opioid use when cannabis became legal.

Opioid-related mortality increased nearly 320% between 2000 - 2015 and by 15.6% between 2014 and 2015 alone. There is research showing that opioid and nonopioid pain prescriptions decreased in Medicare Part D and Medicaid populations with the introduction of medical cannabis. Researchers sought to assess any magnitude of opioid prescribing change with the introduction of medical cannibis laws (MCLs).

Researchers looked at the total number of daily opioid doses prescribed (in millions) in each US state for all opioids according to the establishement of laws and public consumption. 

Under Medicare Part D there were 23.08 million daily doses of any opioid dispensed per year in the average state between 2010 to 2015. Multiple regression analysis results found that patients filled fewer daily doses of any opioid in states with MCLs.

States with active dispensaries had 3.742 million fewer daily doses filled; states with home-cultivation-only MCLs saw 1.792 million fewer filled daily doses of opioids, especially for hydrocodone and morphine.

When looking only at Medicaid enrollees, MCLs were again associated with a 5.88% lower rate of opioid prescribing.

The cause and effect here are inferred and not directly relateable. Moreover, these data from Medicare Part D or Medicaid are limited and may not be generalizable to all demographic groups, since the data was derived in the disabled and elderly and low income levels individuals. 

Nonetheless, medical cannabis laws may be associated with significant reductions in opioid prescribing, especially for hydrocodone and morphine, and may add to strategies aimed at curtailing opioid use or abuse.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Rheumatologists' Comments

Please resist the temptation to misuse headlines to attract readers! The headline "Cannabis Laws Lessen the Opioid Crisis" is misleading & possibly incorrect - the study referenced found an association found lower opioid prescribing in places where marijuana use had been legalized - that does NOT mean that the laws lessened the crisis. Association is not causation!

More Like This

Complex Pain Syndromes in the Emergency Room

Emergency physician Chris Hahn, MD, doesn't have any trouble conjuring a simple definition of fibromyalgia. "Just think about the most annoying chief complaints you can imagine. That's the diagnostic criteria."

Carpal Tunnel Syndrome - a Leading Cause of Work Related Disability

MMWR reports that workers’ compensation claims for carpal tunnel syndrome (CTS) in California during 2007–2014 were 6.3 per 10,000 full-time equivalent workers, with female workers and workers in industries that manufacture apparel, process food, and perform administrative work being at highest risk for CTS.

Anxiety and Depression are Common in Arthritis Patients

The high prevalence of symptoms of anxiety and depression among adults with arthritis warrants awareness, screening, and subsequent treatment of these conditions. Health care providers can refer patients to mental health professionals and self-management education programs, and encourage physical activity to reduce anxiety and depression symptoms and improve quality of life.

FDA's Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS) Finalized

In response to the growing opioid crisis, the US Food and Drug Administration has approved the final Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS), designed to reduce the risk of abuse, misuse, addiction, overdose, and deaths due to prescription opioid analgesics.

Lower Income Elderly are More Likely to Use Opioids

The Journal of Gerontology reports that the poorest of the elderly are the most likely to receive prescription opioids.