Recreational Cannabis Laws Affected Opioid and Non-Opioid Pain Prescriptions Differently

Recreational cannabis legalization was associated with changes in pain prescriptions among privately insured adults, though effects varied between opioid and non-opioid medications.

Steuart, Shelby R et al.·Cannabis (Albuquerque·2025·Moderate EvidenceObservational
RTHC-07726ObservationalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
Not reported

What This Study 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.

Key Numbers

National sample of commercially insured adults. Two sequential recreational cannabis policies examined. Outcomes: opioid and non-opioid pain prescription fills.

How They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?Does cannabis substitution vary by type of pain condition?
  • ?Do uninsured populations show different substitution patterns?

Trust & Context

Key Stat:
Evidence Grade:
National claims data provides real-world prescribing evidence, but ecological design and inability to confirm individual cannabis use limit to moderate.
Study Age:
Uses national commercial insurance data spanning recreational legalization periods.
Original Title:
Recreational Cannabis Laws and Fills of Pain Prescriptions in the Privately Insured.
Published In:
Cannabis (Albuquerque, N.M.), 8(1), 121-138 (2025)
Database ID:
RTHC-07726

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Does legal cannabis reduce opioid prescriptions?

This study examined this question using insurance claims data, finding differential effects on opioid vs. non-opioid pain medications following recreational legalization.

Are people replacing pain pills with cannabis?

The study cannot determine individual-level substitution but examined population-level prescription changes following legalization.

Read More on RethinkTHC

Cite This Study

RTHC-07726·https://rethinkthc.com/research/RTHC-07726

APA

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

MLA

Steuart, Shelby R, et al. "Recreational Cannabis Laws and Fills of Pain Prescriptions in the Privately Insured.." Cannabis (Albuquerque, 2025. https://doi.org/10.26828/cannabis/2024/000268

RethinkTHC

RethinkTHC Research Database. "Recreational Cannabis Laws and Fills of Pain Prescriptions i..." RTHC-07726. Retrieved from https://rethinkthc.com/research/steuart-2025-recreational-cannabis-laws-and

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.