Recreational cannabis legalization was associated with changes in pain prescriptions among privately insured adults, though effects varied between opioid and non-opioid medications.
health policy researchers, pain management clinicians, opioid crisis analysts
What the researchers found
Using nationally representative commercial insurance data, the study examined how two sequential recreational cannabis policies affected prescribing of opioids and other pain medications, providing evidence on whether cannabis substitutes for or complements prescription pain treatments.
Why it matters
Whether cannabis substitutes for prescription pain medications has major implications for opioid policy. This study uses insurance claims data, which captures actual prescribing behavior rather than self-report.
The numbers in context
National sample of commercially insured adults. Two sequential recreational cannabis policies examined. Outcomes: opioid and non-opioid pain prescription fills.
How the study worked
Analysis of national commercially insured adult data examining the effect of recreational cannabis legalization (through two sequential policies) on prescribing of opioids and other pain medications.
What this study cannot tell us
Commercially insured population may not represent uninsured or publicly insured individuals. Insurance claims may not capture all cannabis use. Cannot determine individual-level substitution. State-level variation in implementation.
How to read the evidence
National claims data provides real-world prescribing evidence, but ecological design and inability to confirm individual cannabis use limit to moderate.
When this study was published
Uses national commercial insurance data spanning recreational legalization periods.
The bigger picture
The substitution vs. complementarity question is central to cannabis policy debates. If cannabis replaces opioids, legalization could help address the opioid crisis. If it complements them, the benefits are less clear.
Questions still open
- Does cannabis substitution vary by type of pain condition?
- Do uninsured populations show different substitution patterns?
Common questions
Does legal cannabis reduce opioid prescriptions?
Are people replacing pain pills with cannabis?
Read the original research
Recreational Cannabis Laws and Fills of Pain Prescriptions in the Privately Insured.
Cannabis (Albuquerque, N.M.), 8(1), 121-138
Citation
Steuart, Shelby R; Lozano-Rojas, Felipe; Bethel, Victoria; Shone, Hailemichael Bekele; Abraham, Amanda J. (2025). Recreational Cannabis Laws and Fills of Pain Prescriptions in the Privately Insured.. Cannabis (Albuquerque, N.M.), 8(1), 121-138. https://doi.org/10.26828/cannabis/2024/000268
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