Recreational cannabis and opioid distribution

Raman, Shyam; Maclean, Johanna Catherine; Bradford, W. David; Drake, Coleman

doi:10.1002/hec.4652

Health Economics

2023

DOI: 10.1002/hec.4652

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Recreational cannabis and opioid distribution

Shyam Raman

Johanna Catherine Maclean

W. David Bradford

et al.

Abstract: One in three U.S. residents now live in a state that has legalized adult-use recreational cannabis (ProCon, 2022b). Recreational cannabis legalization (RCL) increases adult cannabis use. Estimates of these increases range from 13% to 38% (Abouk

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Cited by 5 publications

References 34 publications

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The addition of cannabis to prescription drug monitoring programs and medication fills in Medicaid

Steuart

2024

Health Economics

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To date, there is considerable evidence of the medical applications of cannabis, however concerns regarding the safety of cannabis are also mounting. To improve the safety of cannabis, nine states have added medical cannabis to their state PDMPs, helping providers to take patient cannabis use into consideration when making prescribing decisions. Across a variety of models using Medicaid State Drug Utilization claims data, I find statistically significant reductions in severely and moderately contraindicated medication fills across two outcomes. In my main specification, adding cannabis to a state PDMP is associated with a 14.4% (p < 0.01) and 7.74% (p < 0.001) decrease in the units per prescription, for severely and moderately contraindicated medications, respectively, as compared to states with legal medical cannabis dispensaries open. An interesting spillover effect of adding cannabis to PDMPs is an apparent decrease in the prescribing of scheduled narcotics, with Schedule II medications seeing a moderately significant decrease and Schedule IV medications seeing a 11.4% decrease (p < 0.01) in the prescribing rate and a 16.2% decrease (p < 0.001) in the units per prescription. The main analysis was conducted using the Borusyak et al. (2023) Imputation Estimator with a robustness check using the Callaway and Sant’Anna (2021) difference‐in‐difference. This work presents evidence that adding cannabis to a state PDMP impacts provider prescribing decisions involving medications that are contraindicated for use with cannabis as well as controlled substances. This paper demonstrates that adding cannabis to PDMPs influences prescribing and thus has the potential to make medical cannabis use safer. Conversely, this work indicates providers may have bias against patients who use cannabis and deny them life‐improving medications (like controlled ADHD medication or opioids) on the basis of medical cannabis use. This paper also contributes to the literature comparing DD outcomes estimated using Borusyak, Jaravel, and Spiess' (2023) Imputation Estimator and Callaway and Sant’Anna's (2021) DD Estimator.

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The addition of cannabis to prescription drug monitoring programs and medication fills in Medicaid

Steuart

2024

Health Economics

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Pain Management and Work Capacity: Evidence From Workers’ Compensation and Marijuana Legalization

Maclean¹,

Ghimire²,

Powell³

2023

J Policy Anal Manage

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We study whether the work capacity of the older working population responds to improved pain management therapy access. We use the adoption of state recreational marijuana laws (RMLs) as a large policy shock to access to a non‐pharmaceutical pain management option. We focus on workers’ compensation cash benefit receipt as a measure of work capacity, finding that receipt declines in response to RML adoption. Workers’ compensation cash benefits are awarded to workers who require time away from work to recover from an injury, which arguably captures a policy‐relevant aspect of work capacity. We observe similar shifts in complementary proxies for work capacity, including work‐limiting disability rates. After considering a range of alternative mechanisms, the evidence suggests that the primary driver of the reductions in workers’ compensation benefits is improvements in work capacity.

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Recreational cannabis dispensary access effects on prescription opioid use and mortality

Beasley,

Dundas

2024

Regional Science and Urban Economics

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Recreational cannabis and opioid distribution

Abstract: One in three U.S. residents now live in a state that has legalized adult-use recreational cannabis (ProCon, 2022b). Recreational cannabis legalization (RCL) increases adult cannabis use. Estimates of these increases range from 13% to 38% (Abouk

Cited by 5 publications

References 34 publications

The addition of cannabis to prescription drug monitoring programs and medication fills in Medicaid

The addition of cannabis to prescription drug monitoring programs and medication fills in Medicaid

Pain Management and Work Capacity: Evidence From Workers’ Compensation and Marijuana Legalization

Recreational cannabis dispensary access effects on prescription opioid use and mortality

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