Access to legal cannabis stores is associated with a reduction in opioid-related deaths in the United States, particularly those linked to synthetic opioids such as fentanyl, reveals a study published by The BMJ today.
Opioids are morphine-type drugs that relieve short-term (acute) pain and pain at the end of life. There is little evidence that they are useful for long-term (chronic) pain, but they are usually prescribed for this reason.
This has led to widespread misuse and a sharp increase in overdose deaths, especially in the United States. In 2018, there were more than 46,000 fentanyl-related deaths, representing more than two-thirds of all opioid-related deaths in the United States that year.
Some studies have suggested that increased access to cannabis stores – legally authorized to sell medical and recreational cannabis – may help to reduce opioid-related deaths, but the evidence so far is mixed.
To explore this further, the researchers examined the relationships between medical and recreational marijuana stores (called dispensaries) and opioid-related deaths from 2014 to 2018.
Their findings are based on data from 812 counties within the 23 U.S. states that allowed legal marijuana dispensaries to operate until the end of 2017.
Information about state cannabis legislation has been combined with county data on licensed dispensaries and opioid-related mortality rates.
After controlling for population characteristics and other potentially influential factors, the researchers found that counties with a greater number of active cannabis dispensaries were associated with reduced opioid-related mortality rates.
According to this estimate, an increase from one to two dispensaries in a county was associated with an estimated 17% reduction in all opioid-related mortality rates.
This association holds true for medical and recreational dispensaries and appears particularly strong for deaths associated with synthetic opioids other than methadone, with an estimated 21% reduction in mortality rates associated with an increase from one to two dispensaries.
An increase from two to three dispensaries was associated with an additional 8.5% reduction in all opioid-related mortality rates.
This study is the first to examine the association between active cannabis dispensary operations and opioid-related mortality rates at the county’s finest level.
However, the results are observational, so it is not possible to establish the cause, and the researchers emphasize that although cannabis is generally considered less addictive than opioids, it still carries potential damage and risks to public safety should not be ignored.
But they say their findings suggest “a potential association between an increased prevalence of cannabis dispensaries for medical and recreational purposes and a reduction in opioid-related mortality rates.”
And they call for “a greater understanding of the impact of cannabis legalization on opioid misuse and public health outcomes before lawmakers can weigh the potential benefits against the harm of promoting cannabis legalization.”
In a linked editorial, the researchers argue that cannabis liberalization “cannot be seen as a remedy for the opioid crisis until a robust evidence base is available”.
While some may interpret these findings as evidence that supports cannabis liberalization to deal with the opioid crisis, they point out that “such conclusions are currently premature with no evidence of causality.”
Other experimental studies, including individual-level data from those using prescription opioids and illicit opioids, “inform a more subtle understanding of the substitution between opioids and cannabis,” they conclude.
###
Peer-reviewed? Yes (research); No (linked editorial)
Type of evidence: Observational; Opinion
Subjects: Legal Cannabis Stores
Legal Notice: AAAS and EurekAlert! are not responsible for the accuracy of the press releases posted on EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.