Getting a medical cannabis license did not reduce opioid prescription use in Rhode Island

In a population-based study linking medical cannabis registry and prescription monitoring data, obtaining a medical cannabis license was not associated with any change in opioid prescription use.

Goedel, William C et al.·The International journal on drug policy·2022·Moderate EvidenceRetrospective Cohort
RTHC-03876Retrospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Among 5,296 medical cannabis license holders in Rhode Island, licensure was not associated with changes in odds of filling any opioid prescription (OR 0.99), filling prescriptions at 50+ morphine equivalent dose (OR 0.93), or at 90+ MED (OR 0.99). None of these associations were statistically significant.

Key Numbers

5,296 medical cannabis license holders. Any opioid prescription OR 0.99 (CI 0.94-1.05). 50+ MED OR 0.93 (CI 0.84-1.04). 90+ MED OR 0.99 (CI 0.86-1.15). All non-significant.

How They Did This

Population-based retrospective cohort linking Rhode Island medical cannabis registry with prescription drug monitoring program data (April 2016-March 2019). Within-person analysis examined changes in opioid prescriptions before and after cannabis licensure.

Why This Research Matters

Many states authorize medical cannabis as an alternative to opioids for pain. This study finds no evidence that obtaining a medical cannabis license actually reduces opioid prescription use.

The Bigger Picture

The null finding challenges the narrative that medical cannabis licenses naturally lead to opioid reduction and highlights the need for randomized trials to test cannabis as an opioid alternative.

What This Study Doesn't Tell Us

Cannot confirm whether license holders actually used cannabis. Prescription monitoring captures filled prescriptions, not consumption. Rhode Island-specific findings may not generalize.

Questions This Raises

  • ?Do medical cannabis patients who actually use cannabis regularly reduce opioid use?
  • ?Would results differ with cannabis consumption data rather than licensure alone?

Trust & Context

Key Stat:
No change in opioid prescriptions after medical cannabis licensure (OR 0.99)
Evidence Grade:
Strong population-based design with within-person analysis, but licensure is an imperfect proxy for actual cannabis use.
Study Age:
Published in 2022 with data from 2016-2019.
Original Title:
Association of medical cannabis licensure with prescription opioid receipt: A population-based, individual-level retrospective cohort study.
Published In:
The International journal on drug policy, 100, 103502 (2022)
Database ID:
RTHC-03876

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Doesn't medical cannabis reduce opioid use?

This study found no evidence for that. Having a medical cannabis license was not associated with any change in opioid prescription patterns, including at high doses.

Why might the results be null?

Having a license doesn't mean using cannabis, and using cannabis doesn't necessarily mean substituting it for opioids. The study measured licensure, not actual cannabis consumption or pain management behavior.

Read More on RethinkTHC

Cite This Study

RTHC-03876·https://rethinkthc.com/research/RTHC-03876

APA

Goedel, William C; Macmadu, Alexandria; Shihipar, Abdullah; Moyo, Patience; Cerdá, Magdalena; Marshall, Brandon D L. (2022). Association of medical cannabis licensure with prescription opioid receipt: A population-based, individual-level retrospective cohort study.. The International journal on drug policy, 100, 103502. https://doi.org/10.1016/j.drugpo.2021.103502

MLA

Goedel, William C, et al. "Association of medical cannabis licensure with prescription opioid receipt: A population-based, individual-level retrospective cohort study.." The International journal on drug policy, 2022. https://doi.org/10.1016/j.drugpo.2021.103502

RethinkTHC

RethinkTHC Research Database. "Association of medical cannabis licensure with prescription ..." RTHC-03876. Retrieved from https://rethinkthc.com/research/goedel-2022-association-of-medical-cannabis

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.