As a result, there are 30 percent fewer deaths related to opioids in counties that operate marijuana dispensaries than those who do not.
The Washington Post published a piece Wednesday by Harvard University student Julien Berman, who used University of Michigan data to identify dispensary locations on a county-level to compare the opioid overdose trend over the past 10 years between jurisdictions that have legalized cannabis and those with no regulated access.
“The theory is straightforward: making cannabis more available—and reducing its cost—could induce people to shift from opioids, which are super dangerous, to marijuana, a significantly safer alternative,” Berman said. Existing opioid users who are seeking relief from pain can switch to marijuana rather than heroin. This is especially true in areas where the recreational use of marijuana is allowed and easy access. New potential opioid users may never use them at all, if marijuana is available instead.
The conclusion was supported by other factors, such as a comparison of the rates of opioid-related mortality in counties that are part if a legal state and where some counties allow retail operations while others do not.
“That kind of variation helps rule out other state-level changes such as expanded access to naloxone—a drug that can reverse the effects of an overdose—as the main cause of the drop in deaths,” Berman said.
In general, opioid deaths following the establishment cannabis dispensaries fell more rapidly in the first few years than they did for dry counties. From years 5 to 10 there is a greater impact, with an overall rate of 27 per cent less opioid deaths for jurisdictions which have cannabis stores after a ten-year period.
The analysis has some limitations, such as the fact that the University of Michigan dataset contains “an enormous number of messy records of business” which could have led to the misidentification of certain businesses. Berman pointed out that it is possible that counties assessed during this time period could have implemented separate programs to combat opioid abuse.
“Still, the fact that the drop in deaths shows up right after the first dispensary opens—and not before—strongly suggests that opioid users do shift to marijuana, at least enough to stop overdosing,” he wrote.
While marijuana may not be completely harmless, he said that it is “much safer than heroin.”
“Hell, it is arguably more safe than alcohol.” If the dispensary down the street can get people off opioids, public health wins—even if overall marijuana use goes up,” he said.
Relatedly, a recently published study found that, among drug users who experience chronic pain, daily cannabis use was linked to a higher likelihood of quitting the use of opioids—especially among men.
Researchers for a separate federally funded survey recently found an association between state-level marijuana legalization and reduced prescriptions for opioid pain medications among commercially insured adults—indicating a possible substitution effect where patients are choosing to use cannabis instead of prescription drugs to treat pain.
A study published late last year found that legalizing medical cannabis appeared to significantly reduce monetary payments from opioid manufacturers to doctors who specialize in pain, with authors finding “evidence that this decrease is due to medical marijuana becoming available as a substitute” for prescription painkillers.
Recent research has also shown a drop in the number of fatal opioid overdoses among jurisdictions that have legalized marijuana for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. The authors estimated that legalizing recreational marijuana “is associated” with a reduction of approximately 3.5 fatalities per 100,000 people.
Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. The study concluded that cannabis has an important role in the management of pain and reduction of opioid usage.
Yet another study, published in 2023, linked medical marijuana use to lower pain levels and reduced dependence on opioids and other prescription medications. And another, published by the American Medical Association (AMA) last February, found that chronic pain patients who received medical marijuana for longer than a month saw significant reductions in prescribed opioids.
About one in three chronic pain patients reported using cannabis as a treatment option, according to a 2023 AMA-published report. The majority of this group reported using cannabis to replace other pain medication, such as opioids.
Other research published that year found that letting people buy CBD legally significantly reduced opioid prescription rates, leading to 6.6 percent to 8.1 percent fewer opioid prescriptions.
A 2022 research paper that analyzed Medicaid data on prescription drugs, meanwhile, found that legalizing marijuana for adult use was associated with “significant reductions” in the use of prescription drugs for the treatment of multiple conditions.
A 2023 report linked state-level medical marijuana legalization to reduced opioid payouts to doctors—another datapoint suggesting that patients use cannabis as an alternative to prescription drugs when given legal access.
Researchers in another study, published last year, looked at opioid prescription and mortality rates in Oregon, finding that nearby access to retail marijuana moderately reduced opioid prescriptions, though they observed no corresponding drop in opioid-related deaths.
Cannabis may also be an alternative for opioids to manage pain, according to other recent studies.
A report published recently in the journal BMJ Open, for instance, compared medical marijuana and opioids for chronic non-cancer pain and found that cannabis “may be similarly effective and result in fewer discontinuations than opioids,” potentially offering comparable relief with a lower likelihood of adverse effects.
Separate research published found that more than half (57 percent) of patients with chronic musculoskeletal pain said cannabis was more effective than other analgesic medications, while 40 percent reported reducing their use of other painkillers since they began using marijuana.