February 14, 2023

More Research Indicates Marijuana Use May Reduce Opioid Use

At this time, medical marijuana is currently legal in 36 states and recreationally legal in 21 states, and many states have introduced bills or launched other regulatory initiatives to legalize marijuana for the 2023 legislative session.

Among them are Ohio, Oklahoma, Minnesota, Kentucky, and Hawaii, and it is possible more states will continue introducing proposals. As marijuana legalization continues to spread across the country, the workers’ comp industry must prepare for the day that marijuana use becomes commonplace, as the clinical considerations of marijuana cannot be ignored.

Of note, recent medical literature has discussed how medical marijuana use among patients with chronic pain can reduce opioid use.

The Journal of the American Medical Association (JAMA) published a new study that analyzed opioid use amongst patients in the New York medical cannabis program.

The study focused on 8,165 patients who received medical cannabis for chronic pain while also receiving opioid treatment from 2017-2019. Prior to the study period, all patients had received long-term opioid therapy – 120 days of opioid prescriptions or 10 or more opioid prescriptions in the past 12 months.

These patients were studied for eight months following the start of medical cannabis use. All patients fell into one of two groups; the non-exposure group who received marijuana for 30 days or less and did not receive marijuana for the remaining study period, and the exposure group who received marijuana for 30 days or more.

The exposure group had 4,041 patients, while the non-exposure group had 4,124 patients. Both groups had similar baseline MMEs.

At the eight months mark, the exposure group had significantly greater reductions in opioid dosage, averaging in MME decreases from 47-51%, while the non-exposure group only saw 4-14% reductions in MME.

Meanwhile, Health Economics published a new study examining the impact of legal recreational marijuana on prescription opioid dispensing. This study differed from previous studies that have looked at recreational marijuana laws and how they affect opioid prescriptions financed by private and public payers or dispensed to unique endpoints.

Instead, this study analyzed opioid shipments from 11 states across all payers and endpoints, including pharmacies, hospitals, and specialists.

This study found that states with legal recreational cannabis laws saw a 26% reduction in the amount of codeine dispensed at retail pharmacies. Among opioid prescriptions, codeine is particularly likely to be used non-medically.

Last month, Healthe reported on additional JAMA research which found that among adults enrolled in state medical marijuana programs who used marijuana, more than half found that cannabis led them to decrease their use of prescription opioids, prescription nonopioid drugs, and over-the-counter pain medications.

There are many clinical marijuana considerations to be discussed in workers’ comp, including those of workplace safety. Healthesystems will continue to monitor growing clinical research and legislative activity surrounding marijuana.

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