A study examined whether state medical cannabis laws affected prescribing of opioids and other pain medications for chronic non-cancer pain.
Pain medicine specialists, health policy researchers, state legislators, and chronic pain patients.
Prescription impactStudy assessed whether medical cannabis laws changed opioid and nonopioid pain medication prescribing
What the researchers found
The study assessed whether state medical cannabis laws led to substitution of cannabis for prescription opioids or guideline-concordant nonopioid pain medications, examining actual prescribing patterns rather than self-report.
Why it matters
If medical cannabis laws lead patients to substitute cannabis for opioids, this could help address the opioid crisis. But if they substitute cannabis for evidence-based nonopioid treatments, the net effect may be negative.
The numbers in context
The study assessed effects of state medical cannabis laws on receipt of prescription opioids, nonopioid prescription pain medications, and clinical procedures for chronic noncancer pain.
How the study worked
Policy analysis examining prescription patterns for chronic noncancer pain before and after implementation of state medical cannabis laws.
Who was studied
Patients with chronic noncancer pain in states before and after medical cannabis law implementation.
What this study cannot tell us
State-level policy analysis may miss individual variation; concurrent policy changes could confound results; substitution patterns may differ between medical and recreational cannabis access.
How to read the evidence
Policy analysis with prescription data; provides population-level evidence but cannot capture individual decision-making.
When this study was published
Recent policy analysis reflecting the evolving US medical cannabis landscape.
The bigger picture
This study helps distinguish whether medical cannabis laws are achieving their intended public health goal of reducing opioid dependence or are simply changing the mix of treatments without necessarily improving outcomes.
Replication
Adds prescription data analysis to the cannabis-opioid substitution literature; builds on prior ecological studies.
Funding
Not specified
Conflicts of interest
Not specified
Questions still open
- Do patients substitute cannabis for opioids or for all medications?
- Is cannabis substitution associated with better pain outcomes?
- Do dispensary proximity and product availability affect substitution patterns?
Read the original research
Effects of U.S. State Medical Cannabis Laws on Treatment of Chronic Noncancer Pain.
Annals of internal medicine, 176(7), 904-912
Citation
McGinty, Emma E; Tormohlen, Kayla N; Seewald, Nicholas J; Bicket, Mark C; McCourt, Alexander D; Rutkow, Lainie; White, Sarah A; Stuart, Elizabeth A. (2023). Effects of U.S. State Medical Cannabis Laws on Treatment of Chronic Noncancer Pain.. Annals of internal medicine, 176(7), 904-912. https://doi.org/10.7326/M23-0053