A study published in JAMA Internal Medicine finds that state laws legalizing marijuana reduce opioid prescribing by approximately 6 percent — with the finding applying to both medical and adult-use (”recreational”) laws. To measure prescribing trends, the study looked at data on Medicaid enrollees, who are disproportionately at-risk for chronic pain, opioid-use disorder and opioid overdoses.
National Institute on Drug Abuse Director Nora Volkow says the agency wants to assess the use of cannabis ingredients for opioid-use disorder but warns there is little evidence that marijuana helps wean those who are already addicted to opioids — especially compared to approved drugs, such as buprenorphine, methadone and naltrexone.
The JAMA study is the first to link recreational laws with changes in opioid prescribing. Previous studies have linked medical legalization to reductions in opioid-related hospitalizations, overdose deaths and opioid-related traffic fatalities.
Critics of adult-use marijuana laws have argued that full legalization could encourage risky behavior by normalizing drug use. According to NIDA, there is some evidence that marijuana could be a “gateway drug” that primes the brain for other forms of substance use — but similar effects have also been found for alcohol and nicotine use.
The study’s authors say their results are consistent with the idea that adult-use laws enable more patients to substitute marijuana for opioid-based pain relief, including some who would otherwise not have access to marijuana under a purely medical law.
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