Temporary drop in opioid emergency visits associated with cannabis use

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A new study out of the University of Pittsburgh has found U.S. states with legal recreational cannabis witness a short-term decline in opioid-related emergency department (ED) visits.

Data from California, Maine, Massachusetts and Nevada indicated a 7.6 per cent reduction in opioid-related ED visits for six months after legalization of adult-use marijuana compared to non-legal states, the university reports in a statement.

The reduction appeared to be primarily driven by men and those aged 25 through 44, the statement notes. That makes sense since “previous studies have shown that men and young adults account for the majority of people using cannabis.”

And though the decline was not dramatic, investigators emphasize that any reduction in opioid use should be fostered.

“This isn’t trivial — a decline in opioid-related emergency department visits, even if only for six months, is a welcome public health development,” says Coleman Drake, Ph.D., the study’s lead author and an assistant professor in the Department of Health Policy and Management.

Published this week in Health Economics, the finding follow investigators analyzing data on ED visits involving opioids in 29 states from 2011 to 2017. The aforementioned four states had legalized recreational cannabis and the others served as controls.

Even after the temporary reduction wears off, investigators found that legalizing adult-use weed is not then associated with more opioid-related ED visits. This indicates that recreational marijuana is not serving as a “gateway” to opioids, the university statement reports.

Drake cautions, however, “while cannabis liberalization may offer some help in curbing the opioid epidemic, it’s likely not a panacea.”

“Recent evidence indicates recreational cannabis laws could be a harm reduction tool to address the opioid epidemic. Individuals may use cannabis to manage pain, as well as to relieve opioid withdrawal symptoms, though it does not directly treat opioid use disorder,” the study abstract notes.

“We can’t definitively conclude from the data why these laws are associated with a temporary downturn in opioid-related emergency department visits, but, based on our findings and previous literature, we suspect that people who use opioids for pain relief are substituting with cannabis, at least temporarily,” Drake offers.

“States can fight the opioid epidemic by expanding access to opioid use disorder treatment and by decreasing opioid use with recreational cannabis laws,” he suggests. “These policies aren’t mutually exclusive; rather, they’re both a step in the right direction.”

Figures from the U.S. Centers for Disease Control and Prevention show there were 81,000-plus drug overdose deaths between June 2019 and May 2020, an unenviable record. Almost half of the country’s population currently lives in a legal state, researchers report.

Study findings differ regarding what impact consuming cannabis has on opioid use. For example, a Canadian study published last year found that using cannabis was associated with lower exposures to potentially deadly fentanyl among people undergoing opioid agonist therapy for opioid use disorder.

But study findings released last month determined that patients “who tried to smoke marijuana as a harm reduction strategy to not return to opioid use were not successful.”

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