Summary: New research shows that legalizing recreational marijuana is associated with a noticeable decline in the use of certain prescription drugs. The study found significant reductions in prescriptions for conditions such as pain, sleep disorders, anxiety, depression, psychosis and seizures after states legalized adult personal use of cannabis.
Source: Cornell University
Legal recreational cannabis laws are linked to lower demand for expensive prescription medications covered by state Medicaid programs, according to an analysis by researchers at Cornell and Indiana University.
The researchers observed that when states permitted recreational marijuana for adult use, the volume of Medicaid prescriptions fell within drug categories commonly prescribed for pain management, mood disorders, sleep problems, anxiety, psychosis and seizure control. These reductions suggest that some patients may be substituting cannabis for certain prescription therapies.
The paper was authored by Shyam Raman, a doctoral student in the Jeb E. Brooks School of Public Policy at Cornell University, together with Ashley Bradford, a doctoral student at Indiana University.
Their study, titled “Recreational Cannabis Legalizations Associated with Reductions in Prescription Drug Utilizations Among Medicaid Enrollees,” was published April 15 in the journal Health Economics.
Most existing research has concentrated on medical cannabis laws and their effects on prescription drug use, or on how recreational legalization affects opioid prescriptions. This study expands the evidence base by examining how legal personal-use cannabis correlates with prescription volumes across a broader set of medication classes.
“These findings have meaningful policy implications,” Raman said. “Lower utilization of certain prescription drugs could generate notable cost savings for state Medicaid programs, and may also reduce exposure to some medications’ harmful side effects. At the same time, it is important to weigh potential harms associated with cannabis use and to ensure continuity of primary care for patients.”
Raman and Bradford based their analysis on quarterly Medicaid prescription data from the Centers for Medicare and Medicaid Services, covering all 50 U.S. states from 2011 through 2019. That period includes the wave of state-level changes in cannabis law where many states adopted policies allowing adult personal use.
Roughly 40 states now permit medical marijuana under physician oversight, while around 20 states have legalized cannabis for adult personal use; that latter figure has continued to grow over time. In states that legalized recreational cannabis during the study period, the authors detected meaningful declines in prescriptions for sleep and anxiety disorders and for several other therapeutic areas, but they did not observe a clear effect on medications prescribed for nausea.
The authors caution that substituting cannabis for prescription medications is not universally risk-free. A number of studies have linked cannabis use to increased risk of anxiety symptoms and in some cases to psychotic episodes. Additionally, patients may be less likely to engage with primary care providers if they rely on cannabis in place of prescribed treatments, potentially creating gaps in overall healthcare management.
About this marijuana legalization and medicine research news
Author: Becka Bowyer
Source: Cornell University
Contact: Becka Bowyer – Cornell University
Image: The image is in the public domain
Original Research: Closed access. “Recreational cannabis legalizations associated with reductions in prescription drug utilization among Medicaid enrollees” by Shyam Raman et al., published in Health Economics.
Abstract
Recreational cannabis legalizations associated with reductions in prescription drug utilization among Medicaid enrollees
Previous work has highlighted the potential for medical cannabis laws to reduce demand for certain prescription medications, but less is known about how recreational cannabis laws affect prescription drug use. Given evidence that medical cannabis access can substitute for some prescriptions, the authors investigate whether legalizing adult personal use produces similar patterns.
Using quarterly Medicaid prescription data from 2011 to 2019 across all states, the researchers employ two-way fixed effects event study models to estimate the relationship between state-level recreational cannabis laws and prescription volumes. They identify statistically significant declines in prescriptions for drug classes that correspond to treatments for pain, depression, anxiety, sleep disorders, psychosis, and seizures.
The results are consistent with substitution away from prescription medications in these therapeutic areas, which could translate into cost savings for state Medicaid programs. The authors note, however, that any policy discussion must balance potential cost reductions with concerns about cannabis-related harms and the need to preserve access to comprehensive medical care.