Monday, 18 Jun 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

Blacks Suffer When Pain is Poorly Defined

Racial discrimination was a key feature at a 2-day summit on pain management and the opioid crisis, hosted by the National Institutes of Health on Thursday and Friday.

Asheley Cockrell Skinner, PhD, of the Duke Clinical Research Institute in Durham, North Carolina, provided a broad overview of racial bias in opioid prescribing.

Prescription Drug Monitoring Programs Fail to Deter Opiate Abuse

A systematic review of prescription drug monitoring programs (PDMPs), advocated in the president's Prescription Drug Abuse Prevention Plan, fails to show evidence of efficacy in preventing nonfatal and fatal overdoses.

Measures of Opioid Misuse Predict Future Opioid Overdose and Death

The current issue of Annals of Internal Medicine examines patterns of potential opioid misuse that are associated with subsequent adverse outcomes nationally.

Researchers analyzed a 5% sample of Medicare beneficiaries who had an opioid prescription, without a cancer diagnosis.  Specifically the sought to correlate a diagnosis of opioid overdose with other measures of opioid misuse including:

Opioid Marketing & Meals Tied to Opioid Prescribing

A current study in JAMA Internal Medicine showed that while US physicians who received no opioid-related marketing payments had fewer opioid prescriptions in 2015 compared with 2014, those receiving such payments wrote for more opioid in 2015.

New EULAR Pain Guidelines

The European League Against Rheumatism (EULAR) convened a multidisciplinary task force including health professionals and patient representatives to develop evidence-based recommendations for pain management in patients with inflammatory arthritis (IA) and osteoarthritis (OA).