Medical cannabis states had lower opioid prescription rates in adults under 55
States with medical cannabis laws had significantly lower opioid prescription rates among privately insured adults under 55, but not among those 55-64, and recreational cannabis or decriminalization laws showed no association.
Quick Facts
What This Study Found
In states with medical cannabis laws, opioid prescription rates (>30-day and >90-day) were significantly lower for adults aged 18-54 (aORs ranging from 0.56 to 0.77). The association was not significant for ages 55-64. Recreational use and decriminalization laws showed no significant association with opioid prescriptions in any age group.
Key Numbers
Medical cannabis states: >30-day opioid aOR = 0.56 (ages 18-25), 0.67 (26-35), 0.67 (36-45), 0.76 (46-54). All p < 0.0001. Not significant for ages 55-64. No association with recreational or decriminalization laws.
How They Did This
Cross-sectional analysis of the 2016 Clinformatics Data Mart, a nationwide commercial insurance database. Multilevel multivariable analysis compared opioid prescribing patterns across states with different cannabis law stringencies, stratified by five age groups.
Why This Research Matters
The opioid crisis has driven interest in whether cannabis access could reduce opioid dependence. This study provides evidence that medical cannabis laws specifically (not recreational or decriminalization) are associated with lower opioid prescribing in younger adults.
The Bigger Picture
The finding that only medical cannabis laws (not recreational or decriminalization) showed an association suggests something specific about the medical framework matters, possibly clinical involvement or insurance coverage.
What This Study Doesn't Tell Us
Cross-sectional design; cannot establish causation. Only privately insured adults included. State-level confounders (pain management culture, prescribing policies) could explain differences. Cannabis use itself was not measured.
Questions This Raises
- ?Why did the association disappear in adults 55-64?
- ?Are older adults less likely to substitute cannabis for opioids?
- ?Would similar patterns emerge in Medicaid or Medicare populations?
Trust & Context
- Key Stat:
- 44% lower opioid prescriptions in 18-25 year-olds in medical cannabis states
- Evidence Grade:
- Moderate: large nationwide insurance database with multilevel analysis, but cross-sectional and ecological design.
- Study Age:
- Published in 2019.
- Original Title:
- Association between cannabis laws and opioid prescriptions among privately insured adults in the US.
- Published In:
- Preventive medicine, 125, 62-68 (2019)
- Database ID:
- RTHC-02248
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does this mean cannabis replaces opioids?
The study found an association between medical cannabis laws and lower opioid prescribing, but it did not measure individual-level substitution. Other factors in states that adopt medical cannabis laws could contribute.
Why only medical cannabis and not recreational?
The authors did not definitively explain this, but it may relate to the medical framework encouraging physician involvement, or the types of patients who seek medical cannabis being the same ones who might otherwise receive opioid prescriptions.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-02248APA
Raji, Mukaila A; Abara, N Ogechi; Salameh, Habeeb; Westra, Jordan R; Kuo, Yong-Fang. (2019). Association between cannabis laws and opioid prescriptions among privately insured adults in the US.. Preventive medicine, 125, 62-68. https://doi.org/10.1016/j.ypmed.2019.05.012
MLA
Raji, Mukaila A, et al. "Association between cannabis laws and opioid prescriptions among privately insured adults in the US.." Preventive medicine, 2019. https://doi.org/10.1016/j.ypmed.2019.05.012
RethinkTHC
RethinkTHC Research Database. "Association between cannabis laws and opioid prescriptions a..." RTHC-02248. Retrieved from https://rethinkthc.com/research/raji-2019-association-between-cannabis-laws
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.