According To Study In The BMJ, Legal Cannabis Stores Linked To Fewer U.S. Opioid Deaths: Balázs Kovács, Yale University Lead Researcher and Associate Professor

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AUTHOR: Heather Allman

PUBLISHER: CANNABIS LAW REPORT

 

Legal Cannabis Stores Linked To Fewer U.S. Opioid Deaths According To Study In The BMJ: Yale University Lead Researcher, Balázs Kovács

 

Balázs Kovács, Yale University Lead Researcher and Associate Professor

 

Since the start of the COVID-19 pandemic, the number of individuals who have died from drug overdoses has significantly increased. CDC data shares that Synthetic opioids appear to be the primary driver of the increases in overdose deaths in 2020, increasing 38.4 percent from the 12-month period leading up to June 2019 compared with the 12-month period leading up to May 2020.

 

In Where Doctors Can Recommend Marijuana to Replace Opioids, Sophie Quinton reported on the use of cannabis, or marijuana, to manage both acute and chronic pain —excerpt:

Policymakers in Colorado, Illinois and New York now allow health professionals to recommend marijuana instead of addictive, potentially deadly pain pills such as OxyContin, Percocet and Vicodin. Forty-six people in the United States die every day from overdoses involving prescription opioids, according to the Centers for Disease Control and Prevention. 

New Mexico, New Jersey, New York and Pennsylvania allow people with an opioid addiction to qualify for a medical marijuana card.

Severe or chronic pain are qualifying conditions for a marijuana card in almost all states with a medical marijuana program, according to the Marijuana Policy Project, a Washington, D.C.-based organization that advocates for marijuana legalization. Colorado’s new laws allow doctors and other health professionals with prescribing power to recommend marijuana instead of opioids in all cases, including after a minor surgery.

 

Colorado State Representative: Edie Hooten (D)

“We’re talking about an alternative to managing symptoms to a narcotic, or to a pharmaceutical with severe side effects,” said Colorado Democratic state Rep. Edie Hooton. Her bipartisan bill allowing doctors to recommend pot instead of opioids easily passed the legislature and was signed by Democratic Gov. Jared Polis in May, despite some opposition from the medical establishment….

Nearly 3.1 million medical marijuana patients are registered in the United States and its territories, according to the Marijuana Policy Project. Many have turned to marijuana because they’re in pain. Over 93% of Colorado’s more than 87,000 medical marijuana patients suffer from severe pain, according to the state Department of Public Health and Environment. 

Other people are seeking to ease their pain with recreational pot. Almost two-thirds of a thousand Colorado retail marijuana customers said they used marijuana to relieve pain, according to a survey published in the peer-reviewed Journal of Psychoactive Drugs this year.

Some studies have shown a link between marijuana and pain relief. Many of the about 40 randomized controlled trials that have tested whether cannabis and its chemical compounds, called cannabinoids, reduce chronic pain have found that they work as a pain reliever, said Ziva Cooper, research director of the UCLA Cannabis Research Initiative.”

 

Research from The BMJ suggests opioid related deaths may be reduced through increased access to cannabis stores that are legally authorized to sell medical and recreational cannabis.

Although the results are observational, the researchers stress that their findings suggest that there’s a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates. 

Yale University Associate Professor Balázs Kovács, Lead Researcher of the study published in The BMJ found the following details in his observational study: 

  • After studying opioid related deaths from 2014 to 2018 in 23 US states that allowed legal cannabis dispensaries, researchers found an increase from one to two dispensaries in a county was associated with an estimated 17% reduction in all opioid related mortality rates.
  • This association held for both medical and recreational dispensaries and appeared particularly strong for deaths associated with synthetic opioids other than methadone, with an estimated 21% reduction in mortality rates associated with an increase from one to two dispensaries.  
  • An increase from two to three dispensaries was associated with a further 8.5% reduction in all opioid related mortality rate.

 

Observational Study Excerpt From The BMJ

Legal Cannabis Stores Linked To Fewer Opioid Deaths In The United States: Findings May Have Implications for Tackling Opioid Misuse:

[“”Access to legal cannabis stores is associated with a reduction in opioid related deaths in the United States, particularly those linked to synthetic opioids such as fentanyl, finds a study published by The BMJ today. Opioids are ‘morphine-type’ drugs that relieve short-term (acute) pain and pain at the end of life. There is little evidence that they are helpful for long-term (chronic) pain, but they are often prescribed for this reason. 

This has led to widespread misuse and a sharp rise in overdose deaths, particularly in the United States. In 2018, there were more than 46,000 fentanyl related deaths, representing over two thirds of all US opioid related deaths that year.

Some studies have suggested that increased access to cannabis stores – legally authorised to sell medical and recreational cannabis – may help to reduce opioid related deaths, but the evidence so far is mixed.

To explore this further, researchers examined relationships between medical and recreational cannabis stores (referred to as dispensaries) and opioid related deaths from 2014 to 2018. Their findings are based on data for 812 counties within the 23 US states that allowed legal cannabis dispensaries to operate by the end of 2017.

Information on state level cannabis legislation was combined with county level data on licensed dispensaries and opioid related mortality rates. After controlling for population characteristics and other potentially influential factors, the researchers found that counties with a higher number of active cannabis dispensaries were associated with reduced opioid related mortality rates.

However, the results are observational, so can’t establish cause, and the researchers stress that while cannabis is generally thought to be less addictive than opioids, it still carries potential harms and public safety risks should not be ignored. But they say their findings suggest “a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates.” 

Additionally, they call for “a greater understanding of the impact of cannabis legalization on opioid misuse and public health outcomes before policy makers can weigh the potential benefits against the harms of promoting cannabis.” In a linked editorial, researchers argue that cannabis liberalization “cannot be regarded as a remedy to the opioid crisis until a robust evidence base is available.” Although some may interpret these findings as evidence supporting cannabis liberalization to address the opioid crisis, they point out that “such conclusions are currently premature without evidence of causality.” 

Further experimental studies including individual level data of those with use of prescription opioids and illicit opioids “would inform a more nuanced understanding of the substitution between opioids and cannabis,” they conclude.””]

 

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