Cornell University study shows a decline in prescription medicines in US states with legal adult-use cannabis

April 2022

A Cornell University research program, reviewing Medicaid patient data over the past decade in 10 states and Washington DC where recreational marijuana has been legalized, has found that drug prescriptions for anxiety, sleep, pain and seizures have fallen as a result of cannabis legalization, going beyond the findings of similar studies about the impact of cannabis on prescription medicine usage.

The research, published in Health Economics, found that states that have legalized cannabis for adult use have seen a reduction in prescriptions specifically related to drugs for anxiety, sleep, pain and seizures.

Shyam Raman, part of the Cornell University team, said the findings show adult cannabis legalization was associated with significant reductions in the volume of prescriptions drugs used for depression (down 11% from peak to current usage), anxiety (down 12%), pain (down 8%), seizures (down 10%), psychosis (down 11%) and sleep disorders (down 11%).

This is the first study of its kind to look at the associations between adult use legal states and prescription drug use. Previous studies looked at the association between drug prescription use and states with legal medical marijuana programs.

Shyam says these prior studies signaled that medical cannabis legalization on its own seems to correlate with less use of certain prescription drugs. ‘However, our paper shows the scope of potential substitution is broader with adult-use legalization compared to medical marijuana alone, as patients in adult-use legal states may access marijuana for their needs without medical diagnoses or physician recommendations.’

What Comes Next

Shyam says cannabis laws appear to change consumer behavior to reduce use of some prescription medicines, although ‘As researchers we do not have a grasp on what a therapeutic dose of cannabis really is. Our study suggests there could be substitution to cannabis away from some prescription drugs, and potential cost savings for state Medicaid programs. We also see a potential harm reduction opportunity, as pharmaceutical drugs often come with dangerous side effects or, as with opioids, potential for misuse.’

The published report is part of a larger study by Cornell University on the impact of adult legalization in 10 states and Washington, D.C. The first step towards considering cannabis for opioid or other additions and harm reduction is determining what that therapeutic dose looks like and that requires federal funding be made more widely available to pursue those questions.

A meta-study published in 2020 signaled that marijuana shows promise as a treatment option for chronic pain with an increase in quality of life, and could serve as an alternative to opioid-based painkillers.

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