Study: Orthopedic Surgeons Issue Fewer Opioid Prescriptions Following Medical Cannabis Legalization

New York, NY: The enactment of statewide medical cannabis access laws is associated with a reduction in opioid prescribing practices by orthopedic surgeons, according to observational data published in the Journal of the American Academy of Orthopedic Surgeons.

A team of researchers affiliated with Columbia University in New York evaluated the association between the implementation of state cannabis laws and opioid prescribing patterns by orthopedic surgeons between 2013 and 2017. Orthopedic surgeons specialize in the treatment of conditions involving the musculoskeletal system. They are the third highest prescribers of opioids among physicians in the United States.

Investigators reported that that the “implementation of medical THC-grade cannabis laws and patient accessibility to in-state dispensaries are each associated with significantly reduced opioid prescribing by orthopedic surgeons.”

They concluded: “In this study, we observed an association between state-level legalization of medical cannabis and opioid prescribing by orthopedic surgeons in the Medicare Part D cohort. We found that overall opioid prescribing by orthopedic surgeons in this cohort was reduced in states permitting patient access to medical cannabis, compared with those who do not. … On examination of prescription data of different opioid classes, we found that prescriptions for hydrocodone, the most commonly prescribed opioid medication, by orthopedic surgeons had a statistically significant negative association with state MCLs. Although our study does not support a direct causal relationship, these population- level findings show that legalization of medical cannabis and patient access to dispensaries may be associated with reductions in opioid prescribing by orthopedic surgeons.”

The study’s findings are consistent with those of a number of prior observational studies as well as numerous longitudinal studies reporting that pain patients typically reduce their use of prescription opioids after enrolling in state sanctioned medical cannabis access programs. According to the findings of a 2016 study published in the journal Health Affairs, medical cannabis access laws are associated with reduced prescriptions rates for a broad range Medicare Part D-approved medications, not just opioids.

Full text of the study, “State medical cannabis laws associated with reduction in opioid prescriptions by orthopedic surgeons in Medicare Part D cohort,” appears in the Journal of the American Academy of Orthopedic Surgeons. Additional information appears in the NORML fact-sheet, “Relationship Between Marijuana and Opioids.”