The report concludes that, while CBD legalization may not reduce opioid prescribing rate itself, it has resulted in a 6.6 to 8.1 percent reduction of opioid prescriptions.
The paper states that “in general, we found that state-level legalization of CBD only led to a statistically meaningful reduction in opioid prescriptions if states also allowed for open and legally sanctioned dispensaries.” This suggests that adequate access to the supply side is needed to achieve the potential benefits from legalization.
The study also found that dispensaries that sold CBD products, both open and legal, reduced the opioid prescribing rate by nearly 3.5 per cent two years after legalization. However, strict restrictions on CBD purchases, such as ID requirements or patient registrations, weakened this impact.
The report published in the Southern Economic Journal last week by economists from Wofford College, South Carolina, and California State University Bakersfield claims to provide “first empirical evidence” that (i) state-legalized CBD does not reduce opioid use; (ii), regulations that limit purchasing, like ID laws, negate almost all of the benefits associated with demand-side legalization. (iii), supply-side access is vital to combating the opioid epidemic, whether it’s through interstate purchases or open and legal dispensaries
We found that CBD purchases made legally led to a 6.6% to an 8.1% reduction in opioid prescriptions.
The study notes that the majority of previous research on cannabis and opioids has been focused on THC. While CBD products are not the miracle cure they claim to be, they appear to be a net substitute for opioids.
Researchers analyzed state laws governing CBD-only, limited-access laws between 2010 and 2019 to draw their conclusions. These laws “allow for the prescription of certain CBD products based on certain identified medical conditions” were enacted in states such as Iowa, Tennessee, and Texas. Researchers examined state laws between 2010 and 2019 to draw their conclusions. They looked at the different CBD-only, limited-access laws, “which allow for the prescribing of certain CBD products to patients based on certain identifiable medical conditions.”
The authors have noted that the market dynamics for CBD products changed during this period.
The authors noted that “despite the fact that the OTC CBD market segment is the fastest-growing segment, the majority of states have not yet established industrial hemp programs. This means that OTC CBD was largely unavailable during our study period.” CBD products can be purchased without a prescription in the U.S.
The authors note that their findings are limited, but still valuable, given the rapidly changing legal landscape surrounding CBD and hemp-derived cannabinoids. They used county-level opioid prescribing data from the Centers for Disease Control and Prevention’s (CDC) U.S. Prescription Rate Maps. These results may not be applicable to OTC products due to the large range of quality, and the confusion surrounding the unregulated market. However, they do suggest that more research is needed on CBD’s effects.
The apparent benefit of CBD access dispensaries in reducing opioid prescriptions was lost if strict rules were imposed on CBD access. The report states that “additional regulations in the form patient registries and ID requirements are estimated to almost entirely negate opioid-reducing benefits from creating supply-side CBD accessibility in the form dispensaries.”
The study states that “many patients were unable” to obtain CBD-containing products in the early stages of CBD legalization at the state level, before the 2018 federal Farm Bill legalized hemp and its derivatives more broadly. These initial challenges encouraged some states to modify their laws in order to allow CBD products to be purchased from a variety of sources. In Tennessee, for instance, a 2016 change allowed patients to import CBD from another state.
Although the data was noisy, it appears that CBD-only legalization of marijuana reduced opioid prescription rates but not as much as comprehensive medical cannabis laws (MMLs) and recreational marijuana laws.
“Comparing states without legal marijuana use, those that have adopted MMLs and RMLs prescribed fewer opioids for every 100 people.” These areas are healthier and have a higher number of doctors. This suggests that the difference in opioid use rates may not be due to legal marijuana.
The study found that the most significant reduction in opioid use was due to the availability of CBD dispensaries.
We see that states with CBD laws have lower rates of opioid prescriptions than states without laws. However, they are still higher than those with MMLs and RMLs. When we examine states that allow CBD dispensaries we find that the opioid prescribing rate is lower than in states with MMLs and RMLs. This is true even when comparing states with CBD laws to those with MMLs.
The overall trend of opioid prescription rates decreased over the period of the study, likely due to the continuing spike in opioid overdose deaths. State with medical marijuana laws experienced a 35 percent drop in opioid prescribing between 2010 and 2018. States without any form of marijuana legalization saw a similar 33 percent decline.
Researchers found that even in states where CBD dispensaries are available, requiring ID checks or patient registrations for CBD purchases “does not lead to a statistically significant difference in opioid prescribing rate.”
They wrote: “This suggests again that regulatory burdens hinder the potential benefits of CBD in addressing opioid crisis.”
The study concluded that “further work is required to understand to what extent our results can be generalized to the over-the counter market for CBD.” “Our results suggest that policy makers should carefully balance the costs of regulations and the trade-offs between ensuring quality and restricting CBD access.”
Since the first state cannabis laws, there has been much discussion and inquiry about the impact of cannabis reforms on opioid prescription and use rates. Although the results have been mixed, research generally indicates that increasing access to cannabis led to a decline in opioid usage.
One of the more recent studies published in August linked medical marijuana to reduced pain levels, and reduced dependence on prescription opioids. One study, published in February by the American Medical Association, showed that patients with chronic pain who used medical marijuana for more than a month experienced significant reductions in opioids.
AMA released research that showed that about one third of chronic pain sufferers report using cannabis for treatment options, and that most have used cannabis to replace other pain medications including opioids.
According to a recent study, state-level marijuana legalization was also associated with a significant reduction in the prescribing opioid codeine.
According to a study released last year, giving patients legal access medical cannabis could help them reduce or stop using opioid painkillers without affecting their quality of life.
There are also many data-based analyses, observations which indicate that cannabis is used as an alternative drug to opioid-based painkillers or sleep medication.
A federally-funded study in August found that cannabis was significantly associated with decreased opioid cravings among people who use them without prescription. This suggests that increasing access to legal marijuana could provide a safer alternative for more people.
Photo by Kimzy Nanny.
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