Opioids/Other Addictive Drugs - Citations

Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees JAMA Internal Medicine 4/2018

"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. Nonetheless, marijuana liberalization alone cannot solve the opioid epidemic. As with other policies evaluated in the previous literature, marijuana liberalization is but one potential aspect of a comprehensive package to tackle the epidemic."

Cannabis use is associated with reduced risk of exposure to fentanyl among people on opioid agonist therapy during a community-wide overdose crisis

"Participants on on opioid agonist therapy (OAT) using cannabis had significantly lower risk of being exposed to fentanyl. Our findings reinforce the need for experimental trials to investigate the potential benefits and risks of controlled cannabinoid administration for people on OAT."

Pills to Pot: Observational Analyses of Cannabis Substitution Among Medical Cannabis Users With Chronic Pain

"This article presents results that confirm previous clinical studies suggesting that cannabis may be an effective analgesic and potential opioid substitute. Participants reported improved pain, health, and fewer side effects as rationale for substituting. This article highlights how use duration and intentions for use affect reported treatment and substitution effects."

Medical Marijuana Laws May Be Associated With A Decline In The Number Of Prescriptions For Medicaid Enrollees

"We found that the use of prescription drugs in fee-for-service Medicaid was lower in states with medical marijuana laws than in states without such laws in five of the nine broad clinical areas we studied. If all states had had a medical marijuana law in 2014, we estimated that total savings for fee-for-service Medicaid could have been $1.01 billion. These results are similar to those in a previous study we conducted, regarding the effects of medical marijuana laws on the number of prescriptions within the Medicare population. Together, the studies suggest that in states with such laws, Medicaid and Medicare beneficiaries will Lll fewer prescriptions." 

Nursing Outlook Volume 66, Issue 1, January–February 2018

"Review of the current literature suggests states that implement MCpol icies could reduce POM-associated mortality, improve pain management, and significantly reduce health care costs. However, MC research is constrained by federal policy restrictions, and more research related to MC as a potential alternative to POM for pain management, MC harms, and its impact on POM-related harms and health care costs should be a priority of public health, medical, and nursing research."

Dept of Human Resources Overdose ER Visits

In 2019 12,130 persons went to ERs for overdoses. None for cannabis.

 Journal of Health Economics 12/2019

"The results of this study suggest that passing cannabis access laws reduces the use of prescription opioids across several different measures of opioid prescriptions. These empirical effects are net impacts on each of these measures of usage, including both increases and decreases that may have occurred for any individual patient. While cannabis may be a gateway drug that encourages use of opioids in some patients, on balance for the population generally both recreational and medical cannabis access laws decrease opioid use. Thus, the passage of an RCL or MCL may be a valid policy option for combating the ongoing opioid epidemic, even if these laws were not originally conceived for that purpose. While the results here do not suggest that cannabis access laws are the only tool to address prescription opioid use, they do suggest that cannabis access laws could play a meaningful role in addressing the opioid epidemic." 

Journal of the American Medical Directors Association Volume 20, Issue 1, January 2019

"Studies examining older adults that are utilizing medical cannabis legally have demonstrated significant decreases in prescription medication use, most notably a reduction in opioid analgesic usage. As such, medical cannabis should be viewed as an additional option in the clinician's toolbox of therapeutic interventions for symptom relief.

Medical Cannabis: Effects on Opioid and Benzodiazepine Requirements for Pain Control Annals of Pharmacotherapy

Over the course of this 6-month retrospective study, patients using medical cannabis for intractable pain experienced a significant reduction in the number of MMEs available to use for pain control. No significant difference was noted in DE from baseline. Further prospective studies are warranted to confirm or deny the opioid-sparing effects of medical cannabis when used to treat intractable pain.

Opioid Reduce Can Legalizing Cannabis Curb Deaths from Opioids? Yale Insight February 11, 2021

For two decades, the opioid crisis has been accelerating. Between 1999 and 2010, overdose deaths related to opioids grew by 9.1% per year, and between 2010 and 2018, by about 12% per year. Between June of 2019 and May of 2020, the rate of overdose deaths grew by 18%.

Physician Guide to Cannabis-Assisted Opioid Reduction

The Effect of Medical Cannabis Dispensaries on Opioid- and Heroin-Overdose Mortality Cato Institute June 19, 2019 

These estimates imply that 10 per 100,000 (8.5 percent) fewer opioid-related deaths would have occurred between 1999 and 2015 if states that legalized medical cannabis during this period had introduced dispensaries in all counties as soon as the MCL came into effect. Our results have direct policy implications, since we find that MCLs lead to a reduction in opioid-related deaths that is limited to counties where access to medical cannabis is facilitated through the presence of dispensaries.

The use of cannabis in response to the opioid crisis

How cannabis is a safe alternative for those using prescription opioid medications (POMs).

Can Legalizing Cannabis Curb Deaths from Opioids?

"Looking at medical and recreational dispensaries in 812 counties across 23 states and Washington D.C., they found that an increase from one available dispensary to two is associated with a 17% reduction in opioid-related overdose deaths; an increase from two to three is associated with a further 8.5% reduction."

The Effect of Medical Cannabis Dispensaries on Opioid- and Heroin-Overdose Mortality

"With more than 47,000 deaths caused by opioid overdoses in 2017, the ongoing opioid epidemic is arguably the most pressing public health crisis in the United States."

Matched pilot study examining cannabis-based dronabinol for acute pain following traumatic injury

Dronabinol is a licensed form of delta-9-tetrahydrocannabinol (THC)

Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees

"In this population-based, cross-sectional study using the all-capture Medicaid prescription data for 2011 to 2016, medical marijuana laws and adult-use marijuana laws were associated with lower opioid prescribing rates (5.88% and 6.38% lower, respectively)."

The impact of cannabis access laws on opioid prescribing

"While recent research has shown that cannabis access laws can reduce the use of prescription opioids, the effect of these laws on opioid use is not well understood for all dimensions of use and for the general United States population."

NC Emergency Department Visits for Overdose Involving Medication or Drugs w/ Dependency Potential

"Report is restricted to N.C. residents between the ages 15 to 65 years."

Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population: JAMA Internal Medicine - 2018;178(5)

Medical cannabis laws are associated with significant reductions in opioid prescribing in the Medicare Part D population. This finding was particularly strong in states that permit dispensaries, and for reductions in hydrocodone and morphine prescriptions. 

Our results are intriguing in that we find fairly strong evidence using both difference-in-differences and synthetic control group methods that states providing legal access to marijuana through dispensaries experience lower treatment admissions for addiction to pain medications. We provide complementary evidence that dispensary provisions also reduced deaths due to opioid overdoses. Our estimates are robust to advanced methods that account for differential trends across adopting and non- adopting states. We estimate even larger effects in states that have both legally protected and active dispensaries, further supportive evidence that legal access to medical marijuana substitute for opioid use.
Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. Further investigation is required to determine how medical cannabis laws may interact with policies aimed at preventing opioid analgesic overdose.
"While the results here do not suggest that cannabis access laws are the only tool to address prescription opioid use, they do suggest that cannabis access laws could play a meaningful role in addressing the opioid epidemic."