Medical cannabis does not reduce use of prescription meds

TOPLINE:

The availability of medical cannabis has little effect on prescription rates of opioids, nonopioid pain medicines, and other pain interventions, according to a new study published in Annals of Internal Medicine.

METHODOLOGY:

• Cannabis advocates suggest that legal medical cannabis can be a partial solution to the opioid overdose crisis in the United States, which claimed more than 80,000 lives in 2021.
• Current research on how legalized cannabis reduces dependence on prescription pain medication is inconclusive.
• Researchers examined insurance data for the period 2010-2022 from 583,820 adults with chronic noncancer pain.
• They drew from 12 states in which medical cannabis is legal and from 17 in which it is not legal to create a hypothetical randomized trial. The control group simulated prescription rates where medical cannabis was not available.
• Authors evaluated prescription rates for opioids, nonopioid painkillers, and pain interventions, such as physical therapy.

TAKEAWAY:

In a given month during the first 3 years after legalization, for states with medical cannabis, the investigators found the following:

• There was an average decrease of 1.07 percentage points in the proportion of patients who received any opioid prescription, compared to a 1.12 percentage point decrease in the control group.
• There was an average increase of 1.14 percentage points in the proportion of patients who received any nonopioid prescription painkiller, compared to a 1.19 percentage point increase in the control group.
• There was a 0.17 percentage point decrease in the proportion of patients who received any pain procedure, compared to a 0.001 percentage point decrease in the control group.

IN PRACTICE:

“This study did not identify important effects of medical cannabis laws on receipt of opioid or nonopioid pain treatment among patients with chronic noncancer pain,” according to the researchers.

SOURCE:

The study was led by Emma E. McGinty, PhD, of Weill Cornell Medicine, New York, and was funded by the National Institute on Drug Abuse.

LIMITATIONS:

The investigators used a simulated, hypothetical control group that was based on untestable assumptions. They also drew data solely from insured individuals, so the study does not necessarily represent uninsured populations.

DISCLOSURES:

Dr. McGinty reports receiving a grant from NIDA. Her coauthors reported receiving support from NIDA and the National Institutes of Health.

A version of this article first appeared on Medscape.com.