State medical cannabis laws not associated with reduced use of opioid or nonopioid pain treatments

A study of commercially insured adults with chronic noncancer pain found that state medical cannabis laws did not affect receipt of opioid or nonopioid pain treatment. These findings suggest that cannabis use has not led to large shifts in pain treatment patterns at the population level. The study is published in Annals of Internal Medicine.

In the 37 states and the District of Columbia (D.C.) with medical cannabis laws, people with chronic noncancer pain are eligible to use cannabis for pain management. The concern is that state medical cannabis laws may lead patients with chronic noncancer pain to substitute cannabis in place of prescription opioid or recommended nonopioid prescription pain medications or procedures. However, the research is not clear.

Researchers from Weill Cornell Medicine studied insurance claims data from 12 states that implemented medical cannabis laws and 17 comparison states to assess the effects of such laws on receipt of prescription opioids, nonopioid prescription pain medications, and procedures for chronic noncancer pain. The researchers found that in any given month during the 3 years of law implementation, medical cannabis laws led to a negligible difference in the proportion of patients receiving any pain medication or chronic pain procedure. According to the researchers, slow implementation could contribute to the study findings. Results also may be explained by reluctance among health system leaders and individual clinicians to recommend cannabis for pain.