Abstract
Twenty-one U.S. states have passed recreational cannabis laws as of November 2022. Cannabis may be a substitute for prescription opioids in the treatment of chronic pain. Previous studies have assessed recreational cannabis laws’ effects on opioid prescriptions financed by specific private or public payers or dispensed to a unique endpoint. Our study adds to the literature in three important ways: by (1) examining these laws’ impacts on prescription opioid dispensing across all payers and endpoints, (2) adjusting for important opioid-related policies such as opioid prescribing limits, and (3) modeling opioids separately by type. We implement two-way fixed-effects regressions and leverage variation from eleven U.S. states that adopted a recreational cannabis law (RCL) between 2010 and 2019. We find that RCLs lead to a reduction in codeine dispensed at retail pharmacies. Among prescription opioids, codeine is particularly likely to be used non-medically. Thus, the finding that RCLs appear to reduce codeine dispensing is potentially promising from a public health perspective.
Keywords: cannabis, codeine, difference-in-differences, opioids, substance use
© 2023 John Wiley & Sons Ltd.
Similar articles
-
Prescription of Controlled Substances: Benefits and Risks.2022 Sep 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.PMID: 30726003 Free Books & Documents.
-
Florida Controlled Substance Prescribing.2022 Oct 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.PMID: 33428370 Free Books & Documents.
-
NP Safe Prescribing Of Controlled Substances While Avoiding Drug Diversion.2022 Oct 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.PMID: 33232099 Free Books & Documents.
-
Early evidence of the impact of cannabis legalization on cannabis use, cannabis use disorder, and the use of other substances: Findings from state policy evaluations.Am J Drug Alcohol Abuse. 2019;45(6):644-663. doi: 10.1080/00952990.2019.1669626. Epub 2019 Oct 11.PMID: 31603710 Free PMC article. Review.
-
State marijuana laws and opioid overdose mortality.Inj Epidemiol. 2019 Sep 2;6:38. doi: 10.1186/s40621-019-0213-z. eCollection 2019.PMID: 31497489 Free PMC article. Review.
References
REFERENCES
-
- Abouk, R., Ghimire, K. M., Maclean, J. C., & Powell, D. (2021). Does marijuana legalization affect work capacity? Evidence from workers’ compensation benefits. Working Paper 28471. National Bureau of Economic Research.
- Ahmad, F., Cisewski, J., Rossen, L., & Sutton, P. (2022). Provisional drug overdose death counts. Technical report. National Center for Health Statistics.
- Ali, M., McClellan, C., Mutter, R., & Rees, D. (2021). Recreational marijuana laws and the use of opioids: Evidence from NSDUH microdata. Technical Report w29087. National Bureau of Economic Research.
- Boehnke, K. F., Gangopadhyay, S., Clauw, D. J., & Haffajee, R. L. (2019). Qualifying conditions of medical cannabis license holders in the United States. Health Affairs, 38(2), 295-302.
- Bradford, A. C., & Bradford, W. D. (2016). Medical marijuana laws reduce prescription medication use in Medicare Part D. Health Affairs, 35(7), 1230-1236.