Is There Less Opioid Abuse in States Where Marijuana Has Been Decriminalized, Either for Medicinal or Recreational Use? A Clin-IQ

Authors

Aaron M. Wendelboe, University of Oklahoma Health Sciences CenterFollow
Richard Mathew, University of Oklahoma Health Sciences CenterFollow
Tana Chongsuwat, University of Oklahoma Health Sciences CenterFollow
Elizabeth Rainwater, University of Oklahoma Health Sciences Center; Variety CareFollow
Mark A. Wendelboe, University of OklahomaFollow
Elizabeth Wickersham MD, University of Oklahoma Health Sciences CenterFollow
Ann F. Chou, University of Oklahoma Health Sciences CenterFollow

Publication Date

10-28-2019

Keywords

medical marijuana, cannabis, analgesic, opioid, epidemiology, ecologic analysis, decriminalization

Abstract

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship between marijuana use and decriminalization and the aforementioned opioid-related outcomes. Ten peer-reviewed studies met the inclusion criteria; 3 cross-sectional studies, 6 ecologic studies (ie, using aggregate data), and 1 retrospective cohort study. Eight studies reported associations between policies decriminalizing marijuana and reduced prescription opioid use, 1 study was inconclusive, and the retrospective cohort study reported an increase in adverse opioid-related outcomes. These results should be interpreted with caution given limitations associated with the studies’ design. Results demonstrating association between marijuana decriminalization and opioid-related outcomes are mixed. Longitudinal studies are needed, and further analysis of this policy should continue to be tracked.

Recommended Citation

Wendelboe AM, Mathew R, Chongsuwat T, Rainwater E, Wendelboe MA, Wickersham E, Chou AF. Is there less opioid abuse in states where marijuana has been decriminalized, either for medicinal or recreational use? A Clin-IQ. J Patient Cent Res Rev. 2019;6:267-73. doi: 10.17294/2330-0698.1704