Pubdate: Mon, 10 Jun 2019
Source: Minneapolis Star-Tribune (MN)
Copyright: 2019 Star Tribune
Author: Carla K. Johnson, Associated Press


A new study shoots down the notion that medical marijuana laws can
prevent opioid overdose deaths, challenging a favorite talking point
of legal pot advocates.

Researchers repeated an analysis that sparked excitement years ago.
The previous work linked medical marijuana laws to slower than
expected increases in state prescription opioid death rates from 1999
to 2010. The original authors speculated patients might be
substituting marijuana for painkillers, but they warned against
drawing conclusions.

Still, states ravaged by painkiller overdose deaths began to rethink
marijuana, leading several to legalize pot for medical use.

When the new researchers included data through 2017, they found the
reverse: States passing medical marijuana laws saw a 23% higher than
expected rate of deaths involving prescription opioids.

Legalizing medical marijuana "is not going to be a solution to the
opioid overdose crisis," said Chelsea Shover of Stanford University
School of Medicine. "It would be wonderful if that were true, but the
evidence doesn't suggest that it is."

Shover and colleagues reported the findings Monday in Proceedings of
the National Academy of Sciences. It's unlikely, they said, that
medical marijuana laws caused first one big effect and then the
opposite. Any beneficial link was likely coincidental all along.

"We don't think it's reasonable to say it was saving lives before but
it's killing people now," Shover said.

In the opioid crisis, dozens of forces are playing out across the
nation in different ways. How widely available is the overdose
antidote naloxone? Who has insurance? How broadly does insurance cover
addiction treatment?

What's more, prescription pills once were involved in the largest
share of overdose deaths, but that changed as heroin and then fentanyl
surged. The studies on marijuana laws and opioid deaths don't account
for that.

The new study undermines recent policy changes in some states. Last
week, New Mexico joined New York, New Jersey and Pennsylvania in
approving marijuana for patients with opioid addiction.

"I was told my paper helped change the law in New York. I was
appalled," said Rosalie Liccardo Pacula of the Rand Drug Policy
Research Center. She co-authored a 2018 study on marijuana laws and
overdose deaths.

Experts agree evidence doesn't support marijuana as a treatment for
opioid addiction. Drugs like buprenorphine, morphine and naltrexone
should be used instead, Pacula said.

Authors of the original research welcomed the new analysis.

"We weren't happy when a billboard went up saying marijuana laws
reduce overdose deaths," said Brendan Saloner of Johns Hopkins
Bloomberg School of Public Health. "That was very hard for us to rein

Marijuana has been shown to help ease chronic pain, and other studies
have suggested medical marijuana laws may reduce opioid prescribing.
So there's still reason to believe that for some people, marijuana can
substitute for opioids as a pain reliever.

As for addiction and the overdose crisis, "we should focus our
research and policies on other questions that might make a
difference," Shover said.
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