Recreational or medical marijuana is available in 37 states and the District of Columbia. Researchers have found a decline in prescription medication use in states with legalized marijuana, and in some cases, the decline has been significant. People get a prescription for cannabis and use it as a substitute for drugs to treat pain, depression, anxiety, sleep, psychosis, and seizures, though there has not been an impact on drugs to treat nausea.
Using cannabis instead of expensive medicines can create cost savings for state Medicare programs, as well as reduce dangerous side effects from some prescription drugs. It is important to remember that there are risks associated with cannabis use, like the potential for users to become psychotic or anxious.
The researchers based their marijuana substitution study on data from the Centers for Medicare and Medicaid Services in 50 states from 2011 to 2019. This period saw many states legalize the recreational and medical use of cannabis.
Marijuana or its components, like CBD, are increasingly being seen by users as a potential treatment for several medical conditions, including chronic pain, spasticity, and epilepsy. People who use cannabis to treat medical problems believe it is an important strategy for harm reduction from prescription medication, particularly opioids, anti-depressives, and anti-anxiety drugs. These users actively substituted marijuana and CBD for prescription medicines.
Cannabis As a Substitution for Opioids
Cannabis can be a substitute for other medication if it replaces a medication or leads to a reduction in the use of other medicines. Substitution is a common motive among cannabis users, more common than using alcohol and/or other illicit drugs.
Substitution users are more likely to be women who use medical cannabis for the treatment of chronic pain, as antidepressants, or arthritis medication. Almost 40 percent of these substitution users report termination of prescription drug use, and 46 percent report a big decrease in medicine use. The most common form of medical cannabis use was CBD oil (65.2 percent), and 36.6 percent used cannabis. Substitute users found medical marijuana use was much more effective than prescription drugs, and 85 percent also reported that side effects from prescription medications were much worse than medical cannabis side effects.
And several states have seen sizable reductions in prescription drugs, opioids in particular. There have been fewer opioid abuse hospitalizations, lower rates of pain pill overdoses, and decreases in opioid-related healthcare costs in states with medical marijuana laws. People who support medical marijuana use feel it can become a harm reduction strategy that may reduce the use of opioids and become a qualified alternative to prescription pain pills.
States with medical marijuana laws saw opioid prescriptions decline 20 percent compared to prohibition states. This indicates that medical marijuana can become a pain management alternative that helps reduce prescriptions for pain medicine. This is increasingly important because opioid overdoses are increasing throughout the United States. In fact, a study of orthopedic surgeons, the third-highest prescribers of opioid medications, found that the legalization of medical marijuana and an increase in access to dispensaries possibly resulted in a decrease in opioid prescriptions by orthopedic surgeons. A study of these surgeons found that medical cannabis access may promote pain management options for patients. Overall opioid prescribing declined in states that increased access to cannabis medications. Researchers looked at aggregate opioid prescriptions by orthopedic surgeons. The researchers then looked at state-level prescribing data and the legal status of medical marijuana in each state.
The study found a big drop in prescriptions in states with medical cannabis laws – the aggregate rate of opioid prescriptions dropped almost 20 percent. The study also found that states with storefront dispensaries had a further 13 percent decrease in opioid prescriptions. The study also looked at the effect of states allowing cultivation and the legalization of recreational marijuana as being statistically irrelevant to a decrease in opioid prescriptions in a given state.
However, if physicians were allowed to recommend medical marijuana to patients, the rate of prescriptions for fentanyl declined significantly. The study’s results mirror other research that access to medical cannabis significantly reduces statewide opioid use — and even deaths. Large database studies have illustrated that the legalization of medical marijuana reduces opioid prescriptions and related deaths. The researchers believe that patients will voluntarily substitute marijuana for opioids.
Using Cannabis to Manage Opioid Withdrawal
A study in the Harm Reduction Journal looked at how cannabis use affected opioid withdrawal. At least four states already include opioid use disorder as a reason to become a medical marijuana user. While cannabis use can increase withdrawal symptoms and decrease them, the study found that the most profound impacts of medical marijuana use were positive. The improved symptoms were anxiety (76.2 percent of respondents), tremors (54.1 percent), trouble sleeping, bone and muscle aches, restlessness, nausea (38.5 percent), and opioid cravings (37.7 percent).
Symptoms made worse included yawning (7.4 percent), runny nose (6.6 percent), restlessness (5.7 percent), and vomiting (5.7 percent). The symptoms improved by cannabis are considerably more dramatic, and the improvements are more dramatic. Women undergoing withdrawal felt more symptom relief than men.
On days when the subjects did not use marijuana to manage withdrawal, the severity of their symptoms almost doubled. And those subjects with more experience with cannabis experienced more experienced greater symptom relief when using the marijuana to help their withdrawal.
The data in the study suggest that users who use opioids and cannabis feel that using cannabis really helped them manage their opioid withdrawal. The researchers feel their study was too limited to form firm conclusions, but their data indicates this is a field that merits more research. In the U.S., the opioid plague is vast and deadly, so any research that may help addicts tackle withdrawal with less anxiety, humiliation, and pain will surely benefit those struggling with addiction and their families.
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