Cannabis and Opioid Use
A new study was recently published looking at the impact of cannabis laws on opioid use:
Previous studies have looked at the impact of cannabis laws on opioid overdose and deaths. There has been some controversy, but several have shown that cannabis laws may have an impact on opioid-related deaths.
How is this Study Different?
This study included a data set of over 1.5 billion US opioid prescriptions, which account for approximately 90% of all prescriptions dispensed in outpatient pharmacies during the period of the study. This study looked at the morphine equivalent doses (MED) as well as other factors of the opioid prescriptions.
What was fascinating, is that their model of this large patient population found that:
- Recreational cannabis laws reduced the MED by 11.08%, while medical cannabis laws reduced the MED by 4.2%
- These laws also reduced the:
- Total days supply of opioid prescribed
- Total number of people receiving opioids
- Probability a provider prescribes any opioids (net of any offsetting effects)
What Does this Mean for Practice?
- Recreational cannabis laws had a greater impact on opioid prescriptions. This is thought to be due to easier access than medical cannabis
- Pharmacy dispensing of medical cannabis and easier prescribing may help to improve access to patients and more information to patients than recreational cannabis
- There is more data that cannabis may help to reduce pain in patients taking opioids
- Clinicians should ask about cannabis use in patients taking opioids. If they start cannabis, increase monitoring and discuss the potential reduction in morphine equivalent dose as pain improves
- I personally don’t think that cannabis will replace other options to reduce opioid-related harm (e.g. naloxone access, opioid agonist therapy, safe injection sites) but may help to reduce harm and improve pain outcomes
- It is encouraging to see the decrease versus an increase in opioid dose with the change in cannabis laws