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Analysis: Marijuana Access Associated With “Striking” Decline in Daily Opioid Use by IV Drug Consumers
Boston, MA: Adult-use marijuana legalization markets are associated with significant declines in non-medical opioid use among people who inject drugs (PWID), according to data published in the journal Drug and Alcohol Dependence.
Researchers affiliated with Boston University’s School of Public Health and Emory University evaluated trends in non-prescription opioid use among PWIDs in 13 states following marijuana legalization.
Investigators identified “striking” declines in the prevalence of daily opioid use post-legalization. “Notably, the magnitude of this decline was equivalent across all racial and ethnic groups and for males and females,” investigators reported.
The study’s authors concluded, “Our findings suggest that ongoing efforts to reduce regulatory barriers and legal and criminal consequences of cannabis use via RCL+MCLs [recreational cannabis legalization and medical cannabis legalization] may have the potential to help reduce overdoses and other opioid-related harms among PWID.”
Previous studies have reported that cannabis can reduce cravings and mitigate withdrawal symptoms in opioid-dependent subjects. Data from Canada finds that people who inject opioids are more likely to cease their behavior if they regularly consume cannabis.
Full text of the study, “Cannabis legalization and cannabis and opioid use in a large, multistate sample of people who inject drugs: A staggered adoption difference-in-differences analysis,” appears in Drug and Alcohol Dependence.
Study: Cannabis Formulations Associated With Reduced Pain, Improved Quality of Life in Endometriosis Patients
Wellington, New Zealand: Endometriosis patients experience decreased pain and improvements to their health-related quality of life following the medically authorized use of standardized cannabis formulations, according to observational data published in the journal BMJ Complementary Medicine and Therapies.
New Zealand investigators assessed the safety and efficacy of cannabis products in a cohort of 28 patients with endometriosis. (Medically authorized access to cannabis products is legal in New Zealand.) Study participants consumed either CBD-dominant oil extracts or CBD in combination with herbal cannabis for three months as an adjunct to their standard medications. Study subjects possessed no history of recent cannabis use before enrolling in the study.
Consistent with prior studies, cannabis therapy was associated with less pain and improved health-related quality of life.
“There was a difference between pain scores for week 1 compared to week 12 with a decrease in ‘overall’ pain from 5.46 to 3.77 and ‘worst’ pain from 7.62 to 5.38,” researchers reported. “Across the whole cohort, there was a substantial decrease in mean total EHP-30 [the Endometriosis Health Profile 30 standardized questionnaire] score from 68.77 at baseline to 37.40 after 3 months which indicates improved quality of life.”
The study’s authors concluded, “Our findings suggest that usage of medicinal cannabis had limited adverse events and resulted in a decrease in pain and improved quality of life over a 12-week period.”
Endometriosis patients enrolled in the United Kingdom’s Medical Cannabis Registry similarly report that the long-term use of cannabis preparations provides sustained symptomatic relief. In surveys, patients with endometriosis frequently acknowledge cannabis to be more effective at treating their symptoms than traditional pharmaceuticals.
Full text of the study, “Perceived impact of medicinal cannabis on pelvic pain and endometriosis related symptoms in Aotearoa New Zealand: An observational cohort study,” appears in BMJ Complementary Medicine and Therapies.
Analysis: Aggregate Harms Associated With Use of Alcohol, Tobacco Far Outweigh Cannabis-Related Risks
Toronto, Canada: The use of alcohol and tobacco causes far greater overall harms to both individual consumers and to society than does cannabis, according to a scientific analysis published in the Journal of Psychopharmacology.
An international working group of experts assessed the aggregate harms associated with the use of sixteen psychoactive substances, including alcohol, tobacco, cannabis, opioids, benzodiazepines, and methamphetamine. Substances were scored based upon the likelihood that their use causes specific harms to the user (e.g., mortality risk, physical or mental health damage, dependence, etc.) and/or to others (e.g., environmental damage, economic loss, motor vehicle injuries, etc.).
Experts ranked alcohol as the substance associated with the greatest overall harm, followed by tobacco, non-prescription opioids, cocaine, and methamphetamine.
The finding is consistent with those of other international expert panels, including those conducted in Australia, the European Union, New Zealand, and the United Kingdom, which all rank alcohol as the drug responsible for the greatest amount of overall harm. Similarly, a 2024 US study published in the Journal of Studies on Alcohol and Drugs determined that “secondhand harms from others’ alcohol use were substantially more prevalent than those from others’ use of any other drug.” A more recent evaluation in the United States ranked only fentanyl, methamphetamine, crack, and heroin above alcohol in terms of potential harm.
Full text of the study, “Drug harms in Canada: A multi-criteria decision analysis,” appears in the Journal of Psychopharmacology.
Massachusetts: Commissioners Reject Claims That Petitioners Fraudulently Obtained Signatures for Marijuana Repeal Effort
Boston, MA: Representatives of the State Ballot Law Commission are allowing an anti-marijuana initiative effort to move forward despite claims that signature gatherers misled some voters into signing the petition.
Last week, commissioners dismissed the complaint, finding that there was insufficient evidence to substantiate widespread fraud. To prevail in the case, proponents needed to establish that nearly 4,000 voters had been misled to sign the petition.
The initiative, entitled ‘An Act to Restore a Sensible Marijuana Policy,’ seeks to repeal Massachusetts laws permitting adults to home-cultivate marijuana and regulating the adult-use retail cannabis market. Those laws were enacted by voters in 2016. Prohibition groups are funding ballot efforts in three states – Arizona, Maine, and Massachusetts – to repeal voter-initiated adult-use legalization laws.
The commission’s decision came despite polling data indicating that a large percentage of Massachusetts’ voters say they would have refused to sign the initiative petition had they better understood its intentions. Voters in Maine have made similar allegations. However, state officials there have responded that canvassers’ misrepresentation of their efforts is First Amendment-protected speech.
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