Access to legal cannabis sources is associated with a reduction in opioid-related deaths in the United States, particularly those related to synthetic opioids such as fentanyl, a study published by Am BMJ today.
Opioids are ‘morphine type’ drugs that relieve short-term (hungry) pain and end-of-life pain. There is little evidence that they are helpful for long-term (chronic) pain, but they are often prescribed for this purpose.
This has led to widespread abuse and a sharp rise in overweight deaths, especially in the United States. In 2018, there were more than 46,000 fentanyl-related deaths, representing more than two-thirds of U.S. opioid-related deaths that year.
Some studies have suggested that increased access to cannabis sources – with the legal authority to sell medical and recreational cannabis – could help reduce opioid-related deaths, but the evidence so far is mixed.
To further explore this, researchers examined relationships between medical and recreational cannabis sources (referred to as medications) and opioid-related deaths from 2014 to 2018.
Their findings are based on data for 812 counties within 23 U.S. states that allowed legal cannabis treatments to work by the end of 2017.
Information on state-level cannabis legislation was combined with county-level data on approved treatments and opioid-related mortality rates.
After controlling population characteristics and other potentially influencing factors, the researchers found that counties with a higher number of active cannabis plants were associated with higher mortality rates. lower opioid.
According to this estimate, an increase from one to two treatment centers in a county was associated with a 17% reduction in opioid-related mortality rates.
This association held for both medical and recreational therapies and was particularly strong for deaths related to synthetic opioids rather than metadone, with a 21% reduction in mortality rates associated with increased from one to two treatment centers.
An increase from two to three treatments was associated with another 8.5% decrease in opioid-related mortality rates.
This study is the first to examine the association between active cannabis cannabis activity and opioid-related mortality rates at a more refined county level.
However, the results are speculative, so they cannot establish a cause, and the researchers confirm that while cannabis is generally thought to be as addictive as opioids, it still carries harm potential and public safety hazards should not be overlooked.
But they say their findings suggest “a possible link between increased frequency of medical and recreational cannabis treatments and lower opioid-related mortality rates.”
And they want “a better understanding of the impact of cannabis legislation on opioid misuse and public health outcomes before policymakers can highlight the potential benefits of the harms to its use. legal promotion of cannabis. “
In a linked edition, researchers argue that liberal cannabis cannot be considered a cure for the opioid crisis until a strong evidence base is available. “
While some might interpret these decisions as evidence in support of cannabis liberalism to address the opioid crisis, they point out that “such decisions are too premature now without evidence of cause. “
Further experimental studies incorporating individual level data of those with the use of prescription opioids and illicit opioids would provide “a more developed understanding of the substitution between opioids and cannabis,” they conclude.
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Peer review? Yes (research); Not (linked editor)
Type of evidence: Observation; Opinion
Subjects: Legal cannabis shops
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