Overdose death rates from prescription opioid painkillers and illicit drugs such as heroin have declined significantly in states with medical marijuana laws, according to controversial new study published in the Journal of the American Medical Association (JAMA).
Critics immediately attacked the study as flawed, while supporters of medical marijuana say it adds to the growing body of evidence that cannabis is a safer and more effective analgesic than opioids.
Researchers studied death certificate data from13 states where medical marijuana was legal between 1999 and 2010. They found those states had nearly a 25% lower death rate from opiates than states without such laws.
In 2010, that translated to about 1,729 fewer deaths than expected.
The association with lower overdose death rates grew stronger over time, with states reporting an average of 33% fewer deaths by the 6th year that medical marijuana was legal.
“Although evidence for the analgesic properties of cannabis is limited, it may provide analgesia for some individuals. In addition, patients already receiving opioid analgesics who start medical cannabis treatment may experience improved analgesia and decrease their opioid dose, thus potentially decreasing their dose-dependent risk of overdose,” said lead author Marcus A. Bachhuber, MD, of the Philadelphia Veterans Affairs Medical Center.
“If the relationship between medical cannabis laws and opioid analgesic overdose mortality is substantiated in further work, enactment of laws to allow for use of medical cannabis may be advocated as part of a comprehensive package of policies to reduce the population risk of opioid analgesics.”
Overdose death rates from prescription opioids have risen dramatically in the U.S. to nearly 17,000 deaths annually or 46 people per day, according to government estimates. Overdose deaths are often cited by health officials, government regulators and politicians as a reason to restrict access to opioid pain medicines.
“The potential protective role of medical marijuana in opioid analgesic-associated mortality and its implication for public policy is a fruitful area for future work,” wrote Marie Hayes, PhD, of the University of Maine and Mark Brown, MD, of the Eastern Maine Medical Center in a commentary also published in JAMA.
“If the decline in opioid analgesic-related overdose deaths is explained, as claimed by the authors, by increased access to medical marijuana as an adjuvant medication for patients taking prescription opioids, does this mean that marijuana provides improved pain control that decreases opioid dosing to safer levels?”
But critics said the study doesn’t prove that marijuana is safer or more effective than opioids, and relies on faulty data.
“Much more research must be done before making the sweeping conclusion that MMLs (medical marijuana laws) reduce opiate overdose deaths. Though that connection may be intrinsically appealing – some could view the idea that people might use a milder drug versus an opiate as an improvement – too many uncertainties lie in this JAMA analysis,” said Kevin Sabet, PhD, director of the University of Florida Drug Policy Institute.
Sabet points out that while opiate death rates did decline in states with medical marijuana laws, their death rates were still higher than in states where marijuana is illegal.
“As the study authors conceded, the raw data showed that medical marijuana states had higher rates of opiate deaths. When the authors introduced four possible reasons for this, the rate completely flipped. This is a major red-flag, signifying that possibly one of those four reasons alone may have influenced the death rate, and could be a sign of what researchers call a ‘spurious relationship’ between MMLs and death rates,” Sabet wrote in an email to National Pain Report..
A recent online survey of readers by National Pain Report found that medical marijuana worked better than prescription drugs such as Lyrica and Cymbalta in relieving pain and other symptoms caused by fibromyalgia.
Sixty-two percent who have tried cannabis said it was very effective at treating their fibromyalgia symptoms. Another 33% said it helped a little and only 5% said it did not help at all.