The Impact of Medical Cannabis Laws on Cannabis and Opioid Use Disorder Treatment and Overdose-Related Health Care Utilization Among Adults With Chronic Noncancer Pain.

IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Emma E McGinty, Pradyhumna Wagle, Christie Lee Luo, Nicholas J Seewald, Elizabeth A Stuart, Kayla N Tormohlen
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引用次数: 0

Abstract

Policy Points Among patients with chronic noncancer pain, state medical cannabis laws did not impact health care use for opioid use disorder. There were no changes in health care use for opioid overdose attributable to medical cannabis laws. Medical cannabis laws do not appear to lead to reductions in adverse opioid-related outcomes.

Context: State medical cannabis laws, currently in place in 39 states and Washington, DC, provide an avenue for therapeutic use of cannabis to manage chronic noncancer pain stemming from conditions such as arthritis and low back pain. These laws may also influence cannabis and opioid addiction and overdose, for example, if people substitute cannabis in place of opioids to manage pain. No studies, to our knowledge, have examined how state medical cannabis laws influence health care use related to addiction to or overdose from cannabis or opioids among people with chronic noncancer pain.

Methods: We used a difference-in-differences design and augmented synthetic control analyses comparing changes in cannabis use disorder (CUD) and opioid use disorder (OUD) treatment and cannabis and opioid overdose-related health care use before and after medical cannabis law implementation among Medicare beneficiaries with chronic noncancer pain in seven states (Florida, Maryland, Minnesota, New Hampshire, New York, Oklahoma, and Pennsylvania) relative to changes in outcomes over the same period in 17 comparison states (Alabama, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Mississippi, Nebraska, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Virginia, Wisconsin, and Wyoming) without medical cannabis laws.

Findings: State medical cannabis laws had an estimated average effect of less than 0.005 percentage points on the overall proportion of patients receiving any CUD or OUD treatment, less than 0.009 percentage points on the proportion of patients newly initiating CUD or OUD treatment, and less than 0.0005 percentage points on the proportion of patients receiving overdose-related health care for cannabis or opioid overdoses (p > 0.05 for all findings).

Conclusions: Our study did not identify effects of state medical cannabis laws on health care use related to CUD or OUD treatment or overdose among Medicare beneficiaries younger than age 65 years with chronic noncancer pain.

医疗大麻法律对大麻和阿片类药物使用障碍治疗以及慢性非癌性疼痛成人中过量相关医疗保健利用的影响
政策要点:在慢性非癌性疼痛患者中,州医用大麻法对阿片类药物使用障碍的医疗保健使用没有影响。由于医用大麻法律,阿片类药物过量的医疗保健使用没有变化。医用大麻法律似乎并未导致阿片类药物相关不良后果的减少。背景:目前在39个州和华盛顿特区实施的州医用大麻法为大麻的治疗性使用提供了一条途径,以控制由关节炎和腰痛等病症引起的慢性非癌症疼痛。这些法律也可能影响大麻和阿片类药物成瘾和过量使用,例如,如果人们用大麻代替阿片类药物来缓解疼痛。据我们所知,没有研究调查过州医用大麻法律如何影响慢性非癌症疼痛患者对大麻或阿片类药物成瘾或过量使用相关的医疗保健使用。方法:我们采用了差异中之差设计和增强合成对照分析,比较了七个州(佛罗里达州、马里兰州、明尼苏达州、新罕布什尔州、纽约州、俄克拉何马州、与17个没有医用大麻法律的比较州(阿拉巴马州、佐治亚州、爱达荷州、印第安纳州、爱荷华州、堪萨斯州、肯塔基州、密西西比州、内布拉斯加州、北卡罗来纳州、南卡罗来纳州、南达科他州、田纳西州、德克萨斯州、弗吉尼亚州、威斯康星州和怀俄明州)同期结果的变化相比。研究结果:各州医用大麻法律对接受任何CUD或OUD治疗的患者总体比例的平均影响估计小于0.005个百分点,对新开始CUD或OUD治疗的患者比例的影响估计小于0.009个百分点,对因大麻或阿片类药物过量而接受过量相关医疗保健的患者比例的影响估计小于0.0005个百分点(所有研究结果p < 0.05)。结论:我们的研究没有确定州医用大麻法律对65岁以下患有慢性非癌性疼痛的医疗保险受益人中与CUD或OUD治疗或过量相关的医疗保健使用的影响。
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来源期刊
Milbank Quarterly
Milbank Quarterly 医学-卫生保健
CiteScore
9.60
自引率
3.00%
发文量
37
审稿时长
>12 weeks
期刊介绍: The Milbank Quarterly is devoted to scholarly analysis of significant issues in health and health care policy. It presents original research, policy analysis, and commentary from academics, clinicians, and policymakers. The in-depth, multidisciplinary approach of the journal permits contributors to explore fully the social origins of health in our society and to examine in detail the implications of different health policies. Topics addressed in The Milbank Quarterly include the impact of social factors on health, prevention, allocation of health care resources, legal and ethical issues in health policy, health and health care administration, and the organization and financing of health care.
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