Medical Cannabis Dispensary Openings Were Linked to Significant Drops in Opioid Prescribing for Cancer Patients | Research

The takeaway

Among over 3 million commercially insured cancer patients, the opening of medical cannabis dispensaries was associated with fewer opioid prescriptions, shorter supply durations, and fewer prescriptions per patient.

Cancer patients managing pain, oncologists, and policymakers evaluating medical cannabis programs.

Medical dispensary openings: 41 fewer cancer patients per 10,000 with opioid prescriptions

What the researchers found

Medical cannabis dispensary openings were associated with a reduction of 41 fewer patients per 10,000 with opioid prescriptions, 2.54 fewer days of supply per prescription, and 0.099 fewer prescriptions per patient. Recreational dispensary openings showed smaller but still significant reductions. The association was consistent across age, race/ethnicity, and sex subgroups.

Why it matters

Cancer pain is a major driver of opioid prescribing, and the opioid crisis has highlighted the need for alternatives. This large-scale study from JAMA Health Forum provides some of the strongest evidence to date that cannabis access may reduce opioid reliance in this population.

The numbers in context

Mean 3.05 million patients annually. Medical dispensary effect: -41.07 per 10,000 patients with prescriptions (p<0.001), -2.54 days supply (p<0.001), -0.099 prescriptions/patient (p<0.001). Recreational dispensary effect: -20.63 per 10,000 (p=0.049), -1.09 days (p=0.04), -0.097 prescriptions/patient (p=0.01).

How the study worked

Cross-sectional study using Optum's Clinformatics Data Mart (2007-2020) with a synthetic control method to estimate the association of state-level cannabis dispensary openings with opioid dispensing among commercially insured cancer patients aged 18-64. Published in JAMA Health Forum.

What this study cannot tell us

Observational design cannot prove cannabis caused the reduction. Uses insurance claims data, which may not capture all opioid or cannabis use. Commercially insured population may differ from uninsured or Medicaid populations. Cannot determine if cannabis is actually effective for cancer pain.

How to read the evidence

Strong: very large dataset (3+ million patients annually), published in JAMA Health Forum, with synthetic control methodology and consistent results across subgroups.

When this study was published

2025 study using 2007-2020 claims data.

The bigger picture

This adds to a growing body of evidence that cannabis access may function as an opioid substitute for pain management. The finding that medical dispensaries had larger effects than recreational ones suggests that medical cannabis programs may more directly facilitate opioid reduction.

Questions still open

Are cancer patients actively choosing cannabis over opioids, or are physicians prescribing fewer opioids when alternatives exist? Is the pain management adequate with cannabis as a substitute? Would similar patterns hold for non-cancer chronic pain?

Common questions

Does this mean cannabis treats cancer pain?

The study shows an association between dispensary availability and reduced opioid prescribing, suggesting cannabis may serve as a substitute. However, it cannot determine whether cannabis is actually effective for cancer pain management.

Were medical or recreational dispensaries more impactful?

Medical dispensaries showed larger and more consistent reductions in opioid prescribing than recreational dispensaries, suggesting medical programs may more directly facilitate opioid reduction.

Read the original research

Cannabis Laws and Opioid Use Among Commercially Insured Patients With Cancer Diagnoses.

JAMA health forum, 6(10), e253512

View on PubMed ↗Publisher’s paper ↗

Citation

Lozano-Rojas, Felipe; Bethel, Victoria; Gupta, Sumedha; Steuart, Shelby R; Bradford, W David; Abraham, Amanda J. (2025). Cannabis Laws and Opioid Use Among Commercially Insured Patients With Cancer Diagnoses.. JAMA health forum, 6(10), e253512. https://doi.org/10.1001/jamahealthforum.2025.3512