Medical cannabis laws have no effect on opioid prescriptions, study finds

According to a policy analysis conducted by Weill Cornell Medicine investigators, state laws permitting the use of medical cannabis have not reduced prescriptions for opioids or other therapies for chronic noncancer pain.

Dr. Beth McGinty, head of the Division of Health Policy and Economics at Weill Cornell Medicine, used a study design that emulates a clinical trial to analyze the effects of medical cannabis laws on the treatment of people with chronic non-cancer pain. The results, published on July 4 in Annals of Internal Medicinechallenge the results of previous studies that suggested that medical cannabis laws could reduce the prescription of opioids, thereby helping to stem the current opioid crisis in the United States.

“Some research suggests that medical cannabis laws may be reducing opioid prescribing for chronic non-cancer pain because some people can substitute cannabis,” said Dr McGinty, who was recruited as a science professor. population health at Weill Cornell Medicine. “We found no effect of these laws on opioid prescribing or any type of noncancer chronic pain treatment we looked at.”

Public health authorities and policymakers hoping to stem the current opioid overdose crisis in the United States have taken a variety of approaches, including recommending more judicious prescribing of opioids. Some have suggested allowing medical cannabis to offer patients with chronic non-cancer pain an option with a lower risk of overdose. But many questions remain about this approach.

The science continues to evolve on the effectiveness of cannabis for chronic non-cancer pain.”

Dr. Beth McGinty, head of the health economics and policy division at Weill Cornell Medicine

Questions remain about the effectiveness of cannabis in treating chronic non-cancer pain compared to evidence-based therapies, including non-opioid analgesics and physical therapy.

To understand how medical cannabis laws affect the treatment of chronic noncancer pain, Dr. McGinty and colleagues used commercial insurance claims data to analyze opioid prescribing, nonopioid painkiller prescribing and the delivery of non-cancer chronic pain procedures like physical therapy in 12 states with medical cannabis laws and 17 states without such laws. The team used statistical adjustments to correct for any pre-law differences between pain treatment outcomes in the medical cannabis states and their comparison states.

“It’s an observational study, but we set it up to mimic a clinical trial as closely as possible,” she said.

The study did not find a significant impact on the number of patients with chronic noncancer pain receiving a prescription opioid, a prescription nonopioid painkiller, or the procedures used to relieve chronic pain. Dr. McGinty said the results were consistent in all states with medical cannabis laws.

“Medical cannabis laws do not appear to be associated with changes in prescription opioids or other non-cannabis, non-opioid treatments for chronic non-cancer pain,” she said.

Dr. McGinty acknowledged that the study has limited statistical power, in part because there are only 50 states, a limit in any study of the effects of state policies. Investigators could also examine the effects of medical cannabis laws on the treatment of chronic pain using a data source that captures the use of medical cannabis in addition to data on other pain treatments. chronic, for example state prescription drug monitoring programs which in some cases are beginning to include medical cannabis. as well as opioid prescriptions.

In the meantime, the study may provide valuable insights for policymakers seeking to understand how medical cannabis laws influence the prescribing of prescription opioids and the administration of other treatments for chronic noncancer pain.

“The results of our study suggest that medical cannabis laws do not significantly reduce opioid prescribing,” Dr. McGinty said. “Policymakers trying to reduce opioid overprescribing and overdoses should focus on other strategies.”