By Emily Ledger
The findings of a recent study suggest that the prevalence of legal cannabis dispensaries in the US could be linked to a reduction in opioid-related deaths. These findings add to evidence that cannabis may be useful as an alternative treatment option to prescription opioids and as a harm reduction strategy in tackling the use of illicit opioids, such as heroin.
Opioid has been linked to an astonishing number of drug-related deaths in North America in recent years, with figures sharply increasing since 1999. In 2018, a total of 67,367 drug overdose deaths were reported in the US – opioids were implicated in 46,802 (69.5%) of these fatalities.
A number of research studies in recent years have aimed to establish whether cannabis legalisation could be linked to a reduction in opioid use. Now, new research has shown that counties with increased access to legal cannabis dispensaries are likely to have lower rates of opioid-related deaths, particularly deaths related to fentanyl. Fentanyl is a synthetic opioid drug that is 50-100 times more potent than morphine.
What are Opioids?
Opioids are a class of drugs that can be both synthetic or derived from natural sources. A number of opioids, such as morphine, codeine, and fentanyl, are commonly prescribed in the US and the rest of the world. While the efficacy of these drugs – particularly over long periods of time – remains questionable, they are commonly prescribed for pain management and other conditions. 7
There have been growing calls for the development of alternative therapies in recent years, as opioid medications are known to be extremely addictive and have a high risk of overdose.
While many opioids are available through the healthcare system, prescription opioids, as well as heroin, are also widely sourced through the illicit black market.
Recently published in the journal, BMJ, the study used US mortality data from the Centers for Disease Control and Prevention combined with US census data to determine opioid-related mortalities between 2014 and 2018. Researchers also used secondary sources to determine cannabis dispensary storefront locations across the country.
Only counties in states that have legalised either the medical and/or recreational use of cannabis were included in this study. At the time of data collection, eight states and the District of Columbia allowed adult-use recreational cannabis, with a further 15 states allowing for medical use only. Data from a total of 812 counties within the 22 legal states (and D.C.) were included in the study.
The Results of the Study
After making adjustments for potentially influential factors such as population characteristics, the researchers found that there was a connection between the number of cannabis dispensaries and rates of opioid-related deaths.
There was seen to be a 17% decrease in opioid-related mortalities in counties with 1-2 more storefront cannabis dispensaries. This trend was observed for both medical and recreational dispensaries and had a particularly strong effect on methadone-related deaths (a synthetic opioid).
Furthermore, an increase from two to three cannabis dispensaries was associated with a further 8.5% decrease in opioid-related mortalities.
The Implications of these Findings
These findings paint a promising picture of the potential benefits of cannabis legalisation in relation to the US opioid pandemic. However, while the researchers own that there does seem to be a link between access to cannabis and opioid mortality rates, they stress that the possible health implications of cannabis use should not be ignored.
Moreover, it is clear that more studies are needed to understand the link between access to cannabis and opioid use and related deaths. In an editorial, the researchers conclude that the legalisation of cannabis “cannot be regarded as a remedy to the opioid crisis until a robust evidence base is available.”
Since 2018 (the last year for which data was used in this study) more states have opted to legalise medical and/or recreational cannabis. This means that a total of 15 states, plus D.C., have now passed legislation to legalise recreational cannabis and 35 states now permit the medical use of the drug.