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Cannabis and the Opioid Epidemic: 2019 update

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This is now the second literature review I've seen published stating findings that were opposite of initial studies carried out in states that had at the time recently legalized either medical or recreational marijuana. At first, studies saw an association of the easing of cannabis laws with a decrease in rates of opioid related mortality and abuse.

 

While I don't have the link handy to the first, recent review that made headlines, here's a new one supporting the findings of that other one (and I even think the one I'm thinking about was posted on the board, but I can't find it in the obvious subforums). 

 

Contribution of Marijuana Legalization to the U.S. Opioid Mortality Epidemic: Individual and Combined Experience of 27 States and District of Columbia

 View ORCID ProfileArchie Bleyer, Brian Barnes
 

Abstract

Background: Prior studies of U.S. states as of 2013 and one state as of 2015 suggested that marijuana availability reduces opioid mortality (marijuana protection hypothesis). This investigation tested the hypothesis with opioid mortality trends updated to 2017 and by evaluating all states and the District of Columbia (D.C.). Methods: Opioid mortality data obtained from the U.S. Centers for Disease Control and Prevention were used to compare opioid death rate trends in each marijuana-legalizing state and D.C. before and after medicinal and recreational legalization implementation and their individual and cumulative aggregate trends with concomitant trends in non-legalizing states. The Joinpoint Regression Program identified statistically-significant mortality trends and when they occurred. Results: Of 23 individually evaluable legalizing jurisdictions, 78% had evidence for a statistically-significant acceleration of opioid death rates after medicinal or recreational legalization implementation at greater rates than their pre-legalization rate or the concurrent composite rate in non-legalizing states. All four jurisdictions evaluable for recreational legalization had evidence (p <0.05) for subsequent opioid death rate increases, one had a distinct acceleration, and one a reversal of prior decline. Since 2009-2012, when the cumulative-aggregate opioid death rate in the legalizing jurisdictions was the same as in the non-legalizing group, the legalizing group′s rate accelerated increasingly faster (p=0.009). By 2017 it was 67% greater than in the non-legalizing group (p<0.05). Conclusions: The marijuana protection hypothesis is not supported by recent U.S. data on opioid mortality trends. Instead, legalizing marijuana appears to have contributed to the nation′s opioid mortality epidemic.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Protocols

http://comedsoc.org/images/OpioidDeathRate&MarijuanaLegalization2010-2016.pdf

Funding Statement

Neither author received external funding for the conduct and reporting of this investigation.

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2 minutes ago, STENDEC said:

I don't know much about cannabis but I never thought it was really fungible with opiates.

Because we do not know, there's an idea out there that there could be some cross-sensitization between cannabinoids and opioids. While 3/4ths of the population report overall euphoric effects following opioid administration, 1/4 report net dysphoric effects (overwhelming nausea or constipation, perhaps not so much a high and relaxation as much as dizziness/disorientation, etc). Perhaps following exogenous cannabinoid administration,  a person who ordinarily would be fine on as-needed prescription opioids and never become addicted might start liking opioids and become susceptible to opioid use disorders.

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On 10/2/2019 at 8:41 PM, Something Anonymous said:

Count me as part of the 25% that don’t enjoy opioid use. But, I also don’t care for the effects of cannabis. 

Ditto on both counts. Hate both.

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8 minutes ago, Something Anonymous said:

 

You are the only other person I know that reacts poorly to both. We must have some specific neurochemistry. 

My condolences. 😂 I get cannabis psychosis even in ultra low thc, cbd high strains. And even codeine feels disgusting to me...not a sensation I like at all.

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Interesting...I prefer codeine over the heavier shit. Vicodin always makes me teary. That's honestly as heavy as I've ever gone with opiates. 

 

Weed tends to make me anxious, but relaxed, somehow. 

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