Association of medical cannabis licensure with prescription opioid receipt: A population-based, individual-level retrospective cohort study

William C. Goedel, Alexandria Macmadu, Abdullah Shihipar, Patience Moyo, Magdalena Cerdá, Brandon D.L. Marshall

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The endocannabinoid system has been implicated in physiological processes fundamental to pain, giving plausibility to the hypothesis that cannabis may be used as a substitute or complement to prescription opioids in the management of chronic pain. We examined the association of medical cannabis licensure with likelihood of prescription opioid receipt using administrative records. METHODS: This study linked registry information for medical cannabis licensure with records from the prescription drug monitoring program from April 1, 2016 to March 31, 2019 to create a population-based, retrospective cohort in Rhode Island. We examined within-person changes in receipt of any opioid prescription and receipt of an opioid prescription with a morphine equivalent dose of 50 mg or more, and of 90 mg or more. RESULTS: The sample included 5,296 participants with medical cannabis license. Medical cannabis licensure was not associated with the odds of filling any opioid prescription (OR: 0.99; 95% CI: 0.94-0.1.05) or the odds of filling a prescription with a morphine equivalent dose of 50 mg or more (OR: 0.93; 95% CI: 0.84-1.04) and 90 mg or more (OR: 0.99; 95% CI: 0.86-1.15). CONCLUSION: Medical cannabis licensure was not associated with subsequent cessation and reduction in prescription opioid use. Re-scheduling of cannabis will allow for the conduct of randomized controlled trials to determine the efficacy of medical cannabis as an alternative to prescription opioid use or a complement to the use of lower doses of prescription opioids in patients with chronic pain.

Original languageEnglish (US)
Pages (from-to)103502
Number of pages1
JournalInternational Journal of Drug Policy
Volume100
DOIs
StatePublished - Feb 1 2022
Externally publishedYes

Keywords

  • Chronic pain
  • Medical cannabis
  • Opioids
  • Prescription drug monitoring program

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Policy

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