Cannabis legalization linked to lower prescription drug use among Medicaid patients

As the US ponders the prospect of legalizing cannabis at the federal level, new research highlights the impact state reforms have had on prescription drug use. After analyzing all Medicaid prescriptions over an eight-year period, researchers found that legalizing recreational cannabis is associated with significant reductions in prescriptions for treating pain, depression, anxiety, sleep disorders, psychosis and seizures.

To date, 38 states and the District of Columbia (DC) have passed medical cannabis laws, while recreational consumption is legal in 18 states and DC. Several previous studies have indicated that access to medical cannabis may be linked to lower rates of prescription opioid use, although little is known about the influence of fully legal marijuana on pharmaceutical absorption.

Writing in the journal Health Economics, the study authors explain that “as long as RCLs [recreational cannabis laws] impact the entire adult population within a state, as opposed to just those with active medical cannabis cards, it seems plausible that the effect of RCLs on pharmaceutical drug utilization could be even greater than that of medical laws.” To investigate, they collected data on Medicaid prescriptions from all 50 states for each quarter between 2011 and 2019. Prior to that period, no US state had legalized the recreational use of cannabis.

The results indicated that states that joined the so-called green wave in this period experienced major changes in prescription drug use. On average, recreational legalization was associated with a 12.2% reduction in Medicaid prescriptions for anxiety medications, while scripts for antidepressants and pain relievers dropped 11.1% and 8%, respectively.

Prescriptions for seizure medications were also reduced by 9.5%, with antipsychotic use down 10.7% and use of sleep medication down 10.8%. However, no changes were observed in the use of medications for nausea, spasticity or glaucoma after legalization.

“These results have important implications,” the researchers write, adding that “the reductions in drug use we found provide insight into potential cost savings for state Medicaid programs.”

“The results also indicate a potential harm reduction opportunity, as pharmaceutical drugs often have dangerous side effects or – like opioids – potential for misuse,” they say.

However, while these numbers indicate a move away from pharmaceutical drugs, the data does not reveal whether patients are actually replacing these drugs with cannabis, making it difficult to draw firm conclusions about the power of marijuana to replace other drugs. Furthermore, the researchers point out that these results do not provide information about patient well-being and therefore cannot be used to determine whether this trend away from pharmaceuticals is actually beneficial to people’s health.

Still, numbers like these are sure to add weight to the argument for federal cannabis legalization and could help ensure this 4/20 is one of the last of the prohibition era.

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