Legalizing Recreational Cannabis May Reduce Some Opioid Distribution

Recreational cannabis availability through state-level legalization may contribute to reduced rates of opioid distribution, opioid use disorder (OUD), and overdose. As the opioid epidemic has evolved over the past few decades, healthcare professionals have had immense difficulty reducing the number of opioids prescribed and misused.

According to the CDC, in 2020, the opioid prescription rate was 43.3 prescriptions per 100 individuals, accounting for nearly 1.5 million opioid prescriptions. While this rate is significantly lower than the 81.3 prescriptions per 100 people observed in 2012, it is still considerably high, considering the available pain management options. These prescription rates have contributed to opioid-involved deaths, which make up 75% of all drug overdoses in the United States.

A recent study published in Health Economics found that the legalization of cannabis has contributed to lower demand for opioids. Over 20 states have enacted laws allowing the sale of recreational cannabis.

According to an article in the Cornell Chronicle, pharmacy-based distribution of codeine has decreased by 26% in states where recreational cannabis is legalized. Furthermore, rates are an additional 11% lower four years after the laws have been in effect. However, hospital-distributed codeine rates were not impacted by codeine laws.

Despite lower rates of codeine distribution, cannabis laws did not impact the distribution of oxycodone, hydrocodone, and morphine in any care setting.

“This finding is particularly meaningful,” said senior author Coleman Drake of the University of Pittsburgh’s School of Public Health in an interview with the Cornell Chronicle. “Where previous studies have focused on more potent opioids, codeine is a weaker drug with a higher potential for addiction. It indicates people may be obtaining codeine from pharmacies for misuse and that recreational cannabis laws reduce this illicit demand.”

Considering the pain-relieving effects of cannabis and its multiple other healthcare implications, legalized cannabis may continue to impact the healthcare landscape. As many states continue to contemplate their stance on cannabis use, studies such as this may help inform regulatory decisions.