
25 Jan Columbia University Documents Relationship Between Medical and Recreational Cannabis Laws and Opioid Use
MedicalResearch.com Interview with:

Dr. Martins
Silvia S. Martins, MD, PhD
Associate Dean for Faculty
Professor of Epidemiology
Director, Substance Use Epidemiology Unit
Co-Director, Substance Abuse Epidemiology T32 Program
Department of Epidemiology
Columbia University Mailman School of Public Health
New York, NY
MedicalResearch.com: What is the background for this study?
Response: Much has been speculated on whether the enactment of medical and recreational cannabis laws can have a role in decreasing prescriptions for opioid pain relievers, opioid use and misuse, opioid use disorder, and overdose in the U.S. However, findings on the associations of medical cannabis laws alone and recreational cannabis las + medical cannabis laws with opioid-related outcomes are mixed.
By the end of 2019, 32 U.S. states had adopted medical marijuana laws (MCL) alone. All states that went on to adopt recreational marijuana laws (RCL) had previously adopted an MCL.
MedicalResearch.com: What are the main findings?
Response: We used data from the National Survey on Drug Use and Health (NSDUH) data from 2015-2019, to estimate cannabis law associations with opioid (prescription opioid misuse and/or heroin use) misuse and use disorder. Overall, MCL and RCL adoption were not associated with changes in the odds of any opioid outcome. After restricting to respondents reporting past-year cannabis use, decreased odds of past year opioid misuse were observed among individuals in states with MCL compared to those in states without cannabis laws. RCLs were not associated with changes in the odds of any opioid outcome beyond MCL adoption. From 2015 to 2019, approximately 282,768 respondents participated in the NSDUH study. The prevalence of past year and past month opioid misuse was reported by 4 percent and 1.3 percent of participants, respectively. Approximately 3 percent of the participants met criteria for past-year DSM-IV opioid use disorder (OUD) — abuse and dependence. Prevalence of past year and past month opioid misuse, as well as opioid use disorder, were all higher among respondents reporting past year cannabis use (15 percent) compared to those reporting no use. Reductions in some measures of opioid misuse and opioid use disorder were reported in states with MCLs alone, but only among individuals reporting past-year cannabis use who had initiated cannabis use prior to cannabis law adoption.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings shed light on the potential beneficial effects of medical marijuana laws alone and future studies should continue to monitor changes in opioid-related harm outcomes, as the cannabis legalization landscape evolves. Our findings generally support the premise that state adoption of RCLs+MCLs has few benefits in terms of reducing substance misuse and indicates that continued monitoring of RCL+MCL-related trends is warranted.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: One important issue to consider is that compared to medical marijuana laws, relatively fewer states have adopted RCLs+MCLs, and most laws have been adopted within the past decade. Therefore, the impact of recreational marijuana laws+medical marijuana laws may become clearer as more states adopt these laws and as post-law observation time accumulates. More studies are needed to examine opioid use among individuals who receive cannabis from medical and recreational dispensaries.
No disclosures.
Citation:
Silvia S. Martins, Emilie Bruzelius, Christine M. Mauro, Julian Santaella-Tenorio, Anne E. Boustead, Katherine Wheeler-Martin, Hillary Samples, Deborah S. Hasin, David S. Fink, Kara E. Rudolph, Stephen Crystal, Corey S. Davis, Magdalena Cerdá,
The relationship of medical and recreational cannabis laws with opioid misuse and opioid use disorder in the USA: Does it depend on prior history of cannabis use?,
International Journal of Drug Policy,
Volume 136, 2025, 104687, ISSN 0955-3959,
https://doi.org/10.1016/j.drugpo.2024.104687
——————–
The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition.
Some links are sponsored. Products, services and providers are not warranted or endorsed.
Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.
Last Updated on January 25, 2025 by Marie Benz MD FAAD