Medical marijuana reduces opioid prescribing rate

Medical marijuana reduces opioid prescribing rate

Can Cannabis solve the opioid crisis? Short answer, to us, is it CAN be a part of the solution to the crisis.

Marijuana is hailed for its high capability to cure plenty of untreatable diseases and illnesses such as cancer. With the opioid epidemic on the rise, is it possible for medical marijuana to also cure this problem?

To answer this, let’s dive into the article as we compare the prescribing rate of opioid 1 year before and after medical marijuana is legalized.

Medical Marijuana as A Painkiller

Marijuana contains many Cannabinoids including CBD or Cannabidiol and THC or Tetrahydrocannabinol. But contrary to the latter, topical CBD, particularly CBD oil, manages and reduces pain, inflammation, discomfort, and a variety of other health conditions.

As of 2020, medical marijuana is legal in over 20 states in the USA since it was first decriminalized in Nevada in 2001. But in 2017, it was found that chronic pain was the most common qualification condition among patients who are licensed to use marijuana medically, accounting for almost 62% of nearly 1 million medical cannabis patients (representing an average of 33% to 73% each year from 1999 to 2016).

Opioid Crisis

Opioid is a group of chemically similar drugs containing prescription pain relievers and heroin. A good example of these includes  hydrocodone (Vicodin®), oxycodone (OxyContin®), and morphine. This is what makes it one of the main contributing factors to the opioid crisis. According to SAMHSA, approximately over in 2018, 10 million people aged 12 or older in 2018 have misused opioids. About 9.4 million of those have misused pain relievers exclusively while the remaining 506,000 have misused pain relievers and heroin use in the previous year. On a similar note, a little over 300,000 people have also misused heroin exclusively out of the 800,000 people who misused heroin in 2017
From 1999 to 2017, it was found that there were about 400,000 people who died from overdoses of any, prescription, and illicit opioids. 

Medical Marijuana: A Potential Opioid Crisis Solution

So how exactly is medical marijuana a potential solution to the opioid crisis?

Here’s where things get really interesting…

Our Study

We’ve selected 19 states where medical marijuana is legal then compared the opioid prescribing rate 1 year before and after medical marijuana was legalized in the state. Here is what we found:

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Out of the 19 states, 15 have shown a fall of opioid prescribing rate 1 year after legalization of medical marijuana, and only 4 have increased in usage, namely: New Jersey, New Mexico, Michigan, and Arizona.

Interestingly, the state with the highest fall of opioid prescribing rate among the 19 states was Ohio, from an average opioid prescribing rate of 82.7 down to 63.5, totaling 19.2 decreased prescribing rate after marijuana legalization.

The state with the second-highest fall of opioid prescribing rate was Pennsylvania, from an average opioid prescribing rate of 75.5 down to 57.7, a total of 17.8 decreased prescribing rate after marijuana legalization.

New Mexico and New Jersey had the least number of increase in opioid prescribing rate of the 4 mentioned states, with only 2.4 and 1.6 increase in usage after marijuana legalization, respectively.

Here is the full data of our study:

State Legalization year Opioid prescribing rate - 1 year prior to legalization Opioid prescribing rate - 1 year after legalization Change
District of Columbia 2015 40,1 32,5 -7,6
Illinois 2013 66,1 62,3 -3,8
Massachusetts 2012 65,9 63 -2,9
Michigan 2008 85,6 91,6 9
Arizona 2010 84,2 88,6 4,4
Arkansas 2016 117,2 105,4 -11,8
Connecticut 2012 69,1 67,4 -1,7
Delaware 2011 101,1 94 -7,1
Florida 2016 67,1 60,9 -6,2
Hawaii 2015 47,7 41,9 -5,8
Maryland 2014 69 63 -6
Minnesota 2014 58,3 52,1 -6,2
New Hampshire 2013 83,7 79,6 -4,1
New Jersey 2010 59,9 61,5 1,6
New Mexico 2007 69 71,4 2,4
New York 2014 46,7 45,1 -1,6
North Dakota 2016 53 41,5 -11,5
Ohio 2016 82,7 63,5 -19,2
Pennsylvania 2016 75,5 57,7 -17,8
Data source: 

https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

National Drug Use & Health Subtance Abuse; Mental Health Administration

To support our point of view, let’s compare this to similar studies:

Other studies

In an article published on Harvard Health Publishing, M.D Peter Grinspoon has shown “access to medical marijuana can reduce opioid consumption”.

A study conducted by Hefei Wen, Ph.D and Jason M. Hockenberry, Ph.D as of May 2018 showed that from 2011 to 2016, adult-use marijuana laws and medical marijuana laws were associated with lower opioid prescribing rates for Medicaid enrollees: 6.38% and 5.88% lower, respectively, compared with states without medical cannabis laws.

In October 2014, Marcus A. Bachhuber, Brendan Saloner, Ph.D, Chinazo O. Cunningham, MD, MS, and Colleen L. Barry, Ph.D, MPP also conducted a study to determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. The report concluded: Between 1999 to 2010, states with medical cannabis laws (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws. Although they still claim “further investigation is required to determine how medical cannabis laws may interact with policies aimed at preventing opioid analgesic overdose.

It has to be noted that fewer annual drug doses were also being prescribed per physician in the U.S from 2010-2013:

medical marijuana opioid

In the given period, there were 1,826 fewer doses of drugs per year per physician treating pain than in states without medical marijuana laws. Moreover, there were 562 and 541 fewer annual doses of drugs per year per physician to treat anxiety and nausea, respectively.

In summary, 78% of the states (where medical marijuana is legal) have shown an average reduction rate of opioid consumption by 5.21.

But what about licensed medical professionals such as physicians? What’s their take on this matter? This is where things start to make sense…

Opinions of Patients and Physicians

To back our theory further, we’ve also gathered information from licensed medical cannabis patients and physicians. Surprisingly enough, in 2017, a survey interviewing 828 California patients revealed 74% of opioids and cannabis patients strongly agreed that the use of cannabis as a substitute with or in conjunction with opioids for select opioid-related issues can decrease opiate dose. They strongly agreed to this that 69% even prefers using cannabis to opiates and 72% would even use this more as substitute if available. 70% of the respondents also said cannabis side effects are more tolerable than opiates and that they handle pain more effectively than opiates. For 1684 surveyed medical cannabis and nonopioid using patients in California, 56% of them agreed that cannabis is more effective than their non opioid pain medication while 67%would even prefer using cannabis to non opioid pain medication. Even more surprising, 68% would even use cannabis as a substitute if available.

The effectiveness of cannabis vs opioid is so convincing that even physicians are starting to prescribe medical marijuana for their patients before opioids. Even though 23% are not prescribing it, 37% would consider prescribing it to their patients in 2017 while a surprising 40% are not yet sure as they need more research on medical marijuana.

medical marijuana opioid

Methodology

To conduct this study, we selected 21 states in the U.S. where medical marijuana is legal. Specifically, we compared the data of the average opioid prescribing rate of 1 year before and after the legalization of medical marijuana.

States mentioned in this study and their legalization year:

  • District of Columbia (2014)
  • Illinois (2013)
  • Massachusetts (2008)
  • Michigan (2008)
  • Arizona (2010)
  • Arkansas (2016)
  • Connecticut (2012)
  • Delaware (2011)
  • Florida (2016)
  • Hawaii (2000)
  • Maryland (2003)
  • Minnesota (2014)
  • New Hampshire (2013)
  • New Jersey (2010)
  • New Mexico (2007)
  • New York (2014)
  • North Dakota (2016)
  • Ohio (2016)
  • Pennsylvania (2016)

Limitation

The data collected for this study relied on self-report. Some limitations that come with this include but are not limited to the following: selective memory, telescoping, and exaggeration. We can not be certain as to how close these data match up with reality. 

Fair Use Statement

Feel free to share our project with them, so long as it’s for noncommercial purposes. Just make sure that you include a link back to this page so that your readers can take in the full breadth of our research.

Read more on American Marijuana:

Dwight K. Blake Written by: Dwight K. Blake

Dwight was a Mental Health counselor at Long Island Psychotherapy & Counseling in Westbury, New York for more than 15 years. He believes that CBD is the prime solution to this mental illness and more-- with proper research, medical acknowledgment, and application.
Through his work at AmericanMarijuana, together with the rest of the team, he wishes to provide everyone with genuine results and high-quality product reviews for everyone to enjoy for free.

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