TY - JOUR
T1 - Association Between Legal Access to Medical Cannabis and Frequency of Non-Medical Prescription Opioid Use Among U.S. Adults
AU - Samples, Hillary
AU - Levy, Natalie S.
AU - Bruzelius, Emilie
AU - Segura, Luis E.
AU - Mauro, Pia M.
AU - Boustead, Anne E.
AU - Mauro, Christine M.
AU - Martins, Silvia S.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023
Y1 - 2023
N2 - The impact of state-level medical cannabis laws (MCL) on individual-level opioid outcomes is inconclusive. We analyzed representative samples of U.S. adults ≥ 21 years reporting past-year non-medical prescription opioid (NMPO) use in the 2004–2014 National Surveys on Drug Use and Health. Multi-level mixed effects models estimated associations of state-level MCL with individual-level NMPO use frequency, categorized as occasional (1–12 days), regular (13–52 days), or frequent (53–365 days). Further analyses stratified by past-year cannabis use and disorder (no use, use only, DSM-IV cannabis use disorder). MCL was associated with increases in occasional NMPO use (2.1% points, 95% CI: 0.5, 3.8) alongside reductions in regular (-0.6% points, 95% CI: -1.1, -0.1) and frequent NMPO use (-1.5% points, 95% CI: -2.7, -0.4). In stratified analyses, significant changes were observed only for adults with cannabis use disorder, including increases in occasional NMPO use (5.6% points, 95% CI: 1.5, 9.6) and decreases in frequent NMPO use (-4.9% points, 95% CI: -8.1, -1.8). The association of MCL with lower frequency of NMPO use was driven by individuals with cannabis use disorder, highlighting the importance of identifying tradeoffs of cannabis legalization as an intervention to reduce opioid-related harms.
AB - The impact of state-level medical cannabis laws (MCL) on individual-level opioid outcomes is inconclusive. We analyzed representative samples of U.S. adults ≥ 21 years reporting past-year non-medical prescription opioid (NMPO) use in the 2004–2014 National Surveys on Drug Use and Health. Multi-level mixed effects models estimated associations of state-level MCL with individual-level NMPO use frequency, categorized as occasional (1–12 days), regular (13–52 days), or frequent (53–365 days). Further analyses stratified by past-year cannabis use and disorder (no use, use only, DSM-IV cannabis use disorder). MCL was associated with increases in occasional NMPO use (2.1% points, 95% CI: 0.5, 3.8) alongside reductions in regular (-0.6% points, 95% CI: -1.1, -0.1) and frequent NMPO use (-1.5% points, 95% CI: -2.7, -0.4). In stratified analyses, significant changes were observed only for adults with cannabis use disorder, including increases in occasional NMPO use (5.6% points, 95% CI: 1.5, 9.6) and decreases in frequent NMPO use (-4.9% points, 95% CI: -8.1, -1.8). The association of MCL with lower frequency of NMPO use was driven by individuals with cannabis use disorder, highlighting the importance of identifying tradeoffs of cannabis legalization as an intervention to reduce opioid-related harms.
KW - cannabis legalization
KW - Medical cannabis
KW - Medical marijuana
KW - Non-medical opioid use
KW - Opioid abuse
KW - Opioid misuse
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U2 - 10.1007/s11469-023-01191-y
DO - 10.1007/s11469-023-01191-y
M3 - Article
AN - SCOPUS:85175250904
SN - 1557-1874
JO - International Journal of Mental Health and Addiction
JF - International Journal of Mental Health and Addiction
ER -