The Impact of Medical Marijuana Legalization on Opioid Prescriptions

Hayoung Cheon, Tong Guo, Puneet Manchanda, S. Sriram
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引用次数: 1

Abstract

Since the late 1990s, opioids have been increasingly prescribed for pain treatment in the U.S as a result of aggressive marketing by pharmaceutical companies. This has resulted in more than 450,000 opioid overdose deaths since then. In the same time period, several U.S. states have legalized medical marijuana, a drug that can also be used for pain relief. As a result, medical marijuana can be used as a substitute for opioids, leading to a reduction in opioid prescriptions. On the other hand, marijuana use can lead to increased substance abuse, leading to a potential increase in opioid prescriptions. The lack of scientific and medical knowledge along with the uncertain regulatory environment vis-a-vis medical marijuana use also makes it possible that its legalization has no impact on opioid prescriptions. With claims data from a large health insurance company in the U.S. between 2006 and 2016, we study the effect of medical marijuana legalization on opioid prescriptions, leveraging the temporal variation in state-wise legalization. We find that, on average, opioid prescriptions decreased after medical marijuana legalization for all three outcome metrics that we consider (number of prescriptions, total days of supply, and total dosage in MME). We also find that the role of physicians in reducing opioid prescriptions after legalization is more prominent than their corresponding role in increasing opioid prescriptions.
医用大麻合法化对阿片类药物处方的影响
自20世纪90年代末以来,由于制药公司的积极营销,阿片类药物在美国越来越多地被用于治疗疼痛。自那时以来,这已导致超过45万例阿片类药物过量死亡。在同一时期,美国几个州已经将医用大麻合法化,这种药物也可以用于缓解疼痛。因此,医用大麻可以作为阿片类药物的替代品,导致阿片类药物处方减少。另一方面,大麻的使用会导致药物滥用的增加,导致阿片类药物处方的潜在增加。由于缺乏科学和医学知识,加上医用大麻使用的监管环境不确定,也有可能使其合法化对阿片类药物处方没有影响。利用2006年至2016年美国一家大型健康保险公司的索赔数据,我们研究了医用大麻合法化对阿片类药物处方的影响,利用各州合法化的时间变化。我们发现,在我们考虑的所有三个结果指标(处方数量、总供应天数和MME总剂量)中,平均而言,医用大麻合法化后阿片类药物处方减少了。我们还发现,合法化后医生在减少阿片类药物处方方面的作用比他们在增加阿片类药物处方方面的作用更为突出。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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