Bottom Line:
Author: Marcus A. Bachhuber, M.D., of the Philadelphia Veterans Affairs Medical Center, and colleagues.
Background:
How the Study Was Conducted:
Results: States with medical marijuana laws had a 24.8 percent lower average annual opioid overdose death rate compared to states without such laws. In 2010, that translated to about 1,729 fewer deaths than expected. The years after implementation of medical marijuana laws also were associated with lower overdose death rates that generally got stronger over time: year 1 (-19.9 percent), year 2 (-25.2 percent), year 3 (-23.6 percent), year 4 (-20.2 percent), year 5 (-33.7 percent) and year 6 (-33.3 percent).
Discussion: "In summary, although we found a lower mean annual rate of opioid analgesic mortality in states with medical cannabis laws, a direct causal link cannot be established. … If the relationship between medical cannabis laws and opioid analgesic overdose mortality is substantiated in further work, enactment of laws to allow for use of medical cannabis may be advocated as part of a comprehensive package of policies to reduce the population risk of opioid analgesics."
( JAMA Intern Med . Published online August 25, 2014. doi:10.1001/jamainternmed.2014.4005. Available pre-embargo to the media at http://media.jamanetwork.com .)
Editor's Note:
Commentary: Legalization of Medical Marijuana and Incidence of Opioid Mortality
In a related commentary, Marie J. Hayes, Ph.D., of the University of Maine, Orno, and Mark S. Brown, M.D., of the Eastern Maine Medical Center, Bangor, write: "If medical marijuana laws afford a protective effect, it is not clear why. If the decline in opioid analgesic-related overdose deaths is explained, as claimed by the authors, by increased access to medical marijuana as an adjuvant medication for patients taking prescription opioids, does this mean that marijuana provides improved pain control that decreases opioid dosing to safer levels?"
"The potential protective role of medical marijuana in opioid analgesic-associated mortality and its implication for public policy is a fruitful area for future work," they conclude.
( JAMA Intern Med . Published online August 18, 2014. doi:10.1001/jamainternmed.2014.2716. Available pre-embargo to the media at http://media.jamanetwork.com .)
Media Advisory:
To contact author Marcus A. Bachhuber, M.D., call Katie Delach at 215-349-5964 or email katie.delach@uphs.upenn.edu . To contact commentary author Marie J. Hayes, Ph.D., call Margaret Nagle at 207-581-3745 or email nagle@maine.edu .
To place an electronic embedded link to this study in your story: Links for this study and commentary will be live at the embargo time: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.4005 and http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.2716 .
JAMA Internal Medicine