Medical marijuana legalization in Oklahoma increased neonatal THC exposure but did not change opioid exposure rates
After Oklahoma legalized medical marijuana, positive neonatal THC tests rose significantly from 16.2 to 22.2 per 1,000 births, but neonatal opioid exposure showed no significant change.
Quick Facts
What This Study Found
Comparing 19 months before and after Oklahoma's medical marijuana law, positive THC tests in newborns increased significantly from 16.2 to 22.2 per 1,000 liveborn infants (p=0.004). Opioid exposure showed a nonsignificant decrease from 7.6 to 6.8 per 1,000 (p=0.542). The more rural site had significantly higher rates of amphetamines, benzodiazepines, and THC.
Key Numbers
16,804 live births. THC positives: 16.2 to 22.2 per 1,000 (p=0.004). Opioid positives: 7.6 to 6.8 per 1,000 (p=0.542). THC-opioid co-positives doubled from 4 to 9 cases (too few for statistical analysis). Rural site had higher rates across multiple substances.
How They Did This
Retrospective analysis of cord blood, urine, and meconium drug screens at two Oklahoma hospital sites (Oklahoma City and Lawton). 16,804 live births across 38 months (19 pre-law, 19 post-law).
Why This Research Matters
This study tests the specific hypothesis that medical marijuana legalization could reduce opioid use during pregnancy. While neonatal cannabis exposure increased as expected, the hoped-for reduction in opioid exposure did not materialize in a statistically significant way.
The Bigger Picture
The increase in neonatal cannabis exposure without a corresponding decrease in opioid exposure suggests that, at least in the prenatal population, legalization may add cannabis use without substituting for opioids.
What This Study Doesn't Tell Us
Only two hospital sites in one state. Short 19-month comparison periods. Cannot determine whether mothers held medical marijuana cards. Small numbers for co-use analysis. No clinical outcome data for exposed neonates.
Questions This Raises
- ?Do the cannabis-exposed neonates experience withdrawal or developmental effects?
- ?Would a longer post-legalization window show different opioid trends?
Trust & Context
- Key Stat:
- Neonatal THC positives rose 37% after medical marijuana legalization
- Evidence Grade:
- Pre-post comparison at two sites with objective drug screening data, though limited geographic scope and short time frame.
- Study Age:
- 2024 study
- Original Title:
- Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates.
- Published In:
- American journal of perinatology, 41(S 01), e1069-e1074 (2024)
- Authors:
- DeShea, Lise, Rolfs, Shanna, McCoy, Mike, Beasley, William H, Szyld, Edgardo, Makkar, Abhishek
- Database ID:
- RTHC-05265
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
How were neonates tested for drug exposure?
Through cord blood, urine, and meconium (first stool) screening, which can detect substance exposure during pregnancy.
Why did rural areas have higher drug exposure rates?
The study did not explain this but notes it as a finding. Rural areas may have different patterns of substance use, access to treatment, or prescribing practices.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05265APA
DeShea, Lise; Rolfs, Shanna; McCoy, Mike; Beasley, William H; Szyld, Edgardo; Makkar, Abhishek. (2024). Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates.. American journal of perinatology, 41(S 01), e1069-e1074. https://doi.org/10.1055/a-1990-8311
MLA
DeShea, Lise, et al. "Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates.." American journal of perinatology, 2024. https://doi.org/10.1055/a-1990-8311
RethinkTHC
RethinkTHC Research Database. "Medical Marijuana Legalization in Oklahoma: Effects on Neona..." RTHC-05265. Retrieved from https://rethinkthc.com/research/deshea-2024-medical-marijuana-legalization-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.