|
 One study focused on older adults with Medicare drug benefits. In
each state, in an average year, doctors prescribed 23 million daily
doses of opioids. Compared to states where cannabis was banned,
states where medical marijuana was legal averaged 3.7 million fewer
opioid doses annually, while states that permitted only home
cultivation of marijuana had 1.8 million fewer doses.
A separate study of adults insured by Medicaid, the U.S. health
program for the poor, found medical marijuana laws associated with
an almost 6 percent decline in opioid prescriptions.
"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, coauthor of an accompanying editorial and director
of addiction psychiatry at Beth Israel Deaconess Medical Center in
Boston.
"The evidence thus far does not suggest that cannabis should be a
first-line or even a second-line treatment for pain," Hill said by
email. "But if a patient has tried to treat pain using multiple
modalities without success, a trial of medical cannabis may make
sense."
Each day, 90 Americans die from opioid overdoses, Hill notes in JAMA
Internal Medicine, where both studies were published. While some
deaths may be due to illegal narcotics like heroin, others are
caused by opioid medications like oxycodone, fentanyl, hydrocodone,
morphine, and methadone.
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.
But annual hydrocodone use declined, on average, by 2.3 million
daily doses in states with legal marijuana dispensaries and by 1.3
million daily doses in states that legalized only home growth of
marijuana.
Legal dispensaries were also associated with an average of 361,000
fewer daily doses of morphine prescriptions each year, the study
found.
"Patients and physicians seem to be responding to the introduction
of medical cannabis as if it were medicine - in many ways as they
would with the introduction of a new FDA-approved medical
treatment," said study coauthor W. David Bradford, a researcher at
the University of Georgia in Athens.
[to top of second column] |
"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.
The study of Medicaid patients examined the association between
opioid prescribing rates and state marijuana laws implemented from
2011 to 2016.
In states without medical marijuana laws, the annual opioid
prescription rate was about 670 for every 1,000 people enrolled in
Medicaid, the study found.
When states implemented medical marijuana laws, however, the annual
opioid prescription rate declined by almost 6 percent, or
approximately 39 fewer prescriptions for every 1,000 people enrolled
in Medicaid each year.
Neither study proves that legalizing marijuana causes a decline in
opioid prescriptions. Also, it’s unclear from the studies exactly
how much marijuana use was for medical versus recreational purposes
or how much people might have relied on other non-opioid
painkillers.
"Marijuana is one of the potential, non-opioid alternatives that can
relieve pain at a relatively lower risk of addiction and virtually
no risk of overdose," said Hefei Wen, co-author of the Medicaid
study and a researcher at the University of Kentucky College of
Public Health in Lexington.
"The potential of these marijuana (legalization) policies to reduce
the use and consequences of addictive opioids deserves consideration
especially in states that have been hit hard by the opioid
epidemic," Wen said by email.
SOURCE: http://bit.ly/2uIwdEI, http://bit.ly/2uGnCT1 and http://bit.ly/2uLErMo
JAMA Internal Medicine, online April 2, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
