At the 2018 WCRI Annual Issues & Research Conference, Dr. David Bradford from the Department of Public Administration and Policy at the University of Georgia discussed the impact state marijuana laws have on prescription drug spending. The question is, what has been the effect of legalizing medical marijuana on the use of FDA approved pain medications?
The study author cautioned on the limitations of the data they had available. Their conclusions are inferred from the information rather than having information showing particular patients are shifting from prescription pain medications to medical marijuana.
Currently 48 states and DC allow for medical marijuana in some form. Some state laws are very restrictive allowing for only TCH free extracts. 29 states and DC allow for the use of medical marijuana in the whole plant form.
The National Academies of Science, Engineering and Medicine published a study in 2017 indicating there is “conclusive evidence” of medical benefit for cannabis for chronic pain, nausea associated with chemotherapy, and spacticity symptoms in MS. This study is an important element in getting medical marijuana reclassified as a Schedule II drug because it demonstrates there is verifiable evidence that marijuana does provide a medical benefit for certain conditions.
Using data for prescriptions filed by Medicare Part D enrollees from 2010 to 2013 they found the use of prescription drugs dropped when the state fully implemented medical marijuana legislation. For pain medications in particular, they saw a decrease of over 10% in prescribing patterns. They did compare the changes in non-medical marijuana states as a control factor to make sure what they were seeing was not part of a trend that had nothing to do with the availability of marijuana. The difference was greater in states that had medical marijuana dispensaries vs just allowing home cultivation.
They have a forthcoming study set to be published on April 02 which is showing around a 9% reduction in opioid prescriptions in states that fully allow medical marijuana.
Savings to Medicare because of the shift to medical marijuana from prescriptions were over $1.4 billion. Since medical marijuana is not legal, the costs for this are shifted to the patient.
Finally, they looked at opioid deaths and whether medical marijuana laws had any impact on them. They did find statistically significant reductions in opioid deaths in medical marijuana states. One interesting component is that the impact in terms of prescription spending and deaths is only seen in urban areas. No impact was noted in rural areas.