Can Medical Marijuana Laws Curb Opioid Use?

Studies suggest a drop in opioid use in states with medical marijuana laws.

Medically reviewed in August 2021

Trading one drug for another is a risky proposition, but sometimes it works—swapping heroin for methadone, for example. What about medical marijuana and opioids? Two studies—one from 2014 and another from 2016—suggest that states with medical marijuana laws may have fewer opioid-related deaths than states with no medical marijuana laws.

Medical marijuana may be an effective painkiller. A 2015 review of 28 studies published in JAMA found evidence that marijuana works to treat chronic pain, neuropathic pain and muscle spasms due to multiple sclerosis. Opioids, on the other hand, are suitable for short-term pain, but often used much longer than directed, leading to addiction and dependence.

Opioid overdoses drop
A 2014 study published in JAMA Internal Medicine looked at death certificates in all 50 states between 1999 and 2010. Researchers were looking for death certificates that indicated an opioid painkiller overdose. The study found, on average, 25 percent fewer opioid overdose deaths in states with medical marijuana laws than those without.

What’s more, the longer the laws were in effect, the larger the decline in opioid use. In the first year after medical marijuana became legal, opioid overdose deaths were 20 percent lower than in states without legal medical marijuana. In the second, the disparity rose to 25 percent. It dropped slightly in years three and four, but states with five- and six-year-old medical marijuana laws had one-third fewer opioid overdose deaths than states without medical marijuana laws.

Less using and driving
Another study published in the American Journal of Public Health in 2016, looked at data on more than 68,000 drivers who died in car crashes in 18 states between 1999 and 2013. It found 50 percent fewer drivers between ages 21 and 40 who had opiates in their system in states with medical marijuana laws.

Breathless headlines about the study announced that medical marijuana curbs opioid usage, but it’s important to temper enthusiasm about this study. For one, the researchers saw no changes in drivers over 40. And, while fatal car crashes may be a useful proxy for estimating the effects on medical marijuana laws on opioid use, it is a fairly narrow view of the opioid epidemic and doesn’t tell the whole story. 

The bottom line on medical marijuana
The science on medical marijuana is not settled yet. Marijuana derivatives have been used to combat nausea from chemotherapy since 1985, and the American Academy of Neurology endorses the drug to ease some symptoms of multiple sclerosis. It may also help with chronic pain and spasticity.

However, while the federal Drug Enforcement Agency made it easier for marijuana to be studied, in August 2016, it is still a Schedule I drug, which limits research options. Research on using marijuana (medical or otherwise) to treat opioid addiction is limited. Get your healthcare provider’s take on medical marijuana, and seek help if you or someone close to you is addicted to opioids.

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