Medical marijuana dispensary laws were not associated with reduced prolonged opioid use after surgery in adolescents and young adults aged 12-25.
Pediatric surgeons, pain management specialists, and cannabis-opioid substitution researchers.
aOR 0.98 (not significant)for medical marijuana dispensary law effect on prolonged opioid use in adolescents and young adults
What the researchers found
Medical marijuana dispensary laws showed no significant association with prolonged opioid use (aOR=0.98, 95% CI 0.81-1.18). Being female, longer hospital stays, greater initial opioid supply, and rural residence predicted prolonged use.
Why it matters
While cannabis access may reduce opioid use in adults, this large study suggests the same effect does not occur in the particularly vulnerable adolescent and young adult population.
The numbers in context
195,204 patients aged 12-25 across all 50 states (2005-2014). 4.8% had prolonged opioid use. Medical marijuana law: aOR=0.98 (not significant). Female: aOR=1.27. >14 days initial supply: aOR=2.42.
How the study worked
Retrospective cohort study using 2005-2014 MarketScan Commercial claims data for patients aged 12-25 undergoing 13 surgical procedures, with logistic regression for prolonged opioid use.
Who was studied
195,204 commercially insured adolescents and young adults (12-25) who underwent 13 surgical procedures across all 50 states.
What this study cannot tell us
Commercial insurance claims may not represent uninsured populations. Medical marijuana access does not equal use. 2005-2014 data predates recreational legalization in most states.
How to read the evidence
Large retrospective cohort with nationwide coverage; strong null finding for this age group.
When this study was published
Uses 2005-2014 claims data, before most recreational cannabis laws.
The bigger picture
The assumption that cannabis can substitute for opioids across all age groups is not supported for young people, highlighting the need for age-specific approaches to post-surgical pain management.
Replication
Pre-recreational legalization data; updated analysis warranted.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Why might cannabis substitution for opioids work in adults but not young people?
- Would more recent data including recreational legalization show different results?
Read the original research
Medical marijuana access and prolonged opioid use among adolescents and young adults.
The American journal on addictions, 32(5), 479-487
Citation
Kim, Kyungha; Pacula, Rosalie L; Dick, Andrew W; Stein, Bradley D; Druss, Benjamin G; Agbese, Edeanya; Cohrs, Austin C; Leslie, Douglas L. (2023). Medical marijuana access and prolonged opioid use among adolescents and young adults.. The American journal on addictions, 32(5), 479-487. https://doi.org/10.1111/ajad.13440