Study Finds Lower Opioid Prescription Rates in Areas with Cannabis Dispensaries Nearby

The results of a recent study found that closer proximity to cannabis dispensaries in a community leads to a lower rate of opioid prescription. The study entitled “Recreational cannabis dispensary access effects on prescription opioid use and mortality,” was made available online in June but will be published in Regional Science and Urban Economics in its September 2024 issue.

Steven J. Dundas of Oregon State University and Jason W. Beasley of Western Michigan University (a former student of Dundas’) used Oregon as an example to examine opioid prescriptions and mortality rates and how they changed based on the number of cannabis dispensaries nearby. The data they used stemmed from the Oregon Health Authority’s Public Health Division from January 2014-December 2017, which researchers explained “captures nearly two years of data pre- and post-RCL [recreational cannabis legalization] in Oregon.”

“This paper addresses the question of whether access to recreational cannabis is a relevant factor impacting demand for prescription opioids within a community,” researchers explained. “We combine neighborhood-scale opioid prescription data and recreational cannabis dispensary locations in the U.S. state of Oregon (OR) to investigate the impact of changes to cannabis access on opioid prescriptions.”

Dundas and Beasley reviewed Oregon-based communities that are within one mile of a licensed cannabis dispensary and found that prescription opioid rates were lower compared to areas without dispensaries close by. “Using distance bins to identify the non-linear effect of recreational dispensary access, our empirical results suggest mean prescription opioids per capita fell by 1.0–3.9% after recreational legalization in communities near cannabis dispensaries,” the study stated. “Our results show that the further individuals must travel to a recreational dispensary, the higher the rates of prescription opioids per capita.”

In contrast, communities that had a dispensary located within one to four miles had higher prescription opioid rates. As the radius distance increased to a range of a dispensary being located four to 10 miles away from a community, or 10 to miles away, the prescription rates continued to increase.

This evidence suggests that if there are close alternatives to cannabis products from dispensaries that can be used to opioid prescriptions, residents are more likely to consider switching to cannabis for treatment. However, they also noted that while opioid-related mortality rates have quadrupled between 2005-2022, these results don’t have much of an effect on opioid-related mortality. “Despite the reduction, we find no evidence that reducing barriers to cannabis access and subsequent declines in prescription opioids are associated with meaningful changes in opioid mortality,” the researchers wrote.

Other studies have previously examined the opioid mortality rates associated with exposure to medical and/or recreational cannabis. A study published on June 5 in JAMA Network Open examined the case of 175,734 patients and why they consumed cannabis within the past three months. “While most patients (76.1%) reported using cannabis to manage a health symptom, very few patients identified as medical cannabis users.” Those consumers still used cannabis for common conditions such as pain, stress, and as a sleep aid. “Less than half the patients who used cannabis reported using it for medical reasons, even though the majority of patients reported cannabis use to manage a health-related symptom,” that report stated.

Another study published at the start of the year in BJM Open found evidence that cannabis has potential in acting as a substitute for opioids, specifically when helping patients manage pain. A total of 22,028 patient’s profiles were reviewed across 84 randomized controlled trials, which showed that cannabis offered similar relief that opioids provided without any negative side effects. “Our findings suggest that both opioids and cannabis for medical use may provide benefits for a minority of chronic pain patients,” researchers wrote. “Furthermore, cannabis does not cause respiratory depression which can result from opioids consumption and lead to non-fatal or fatal overdose.”

In February, another study published in the Harm Reduction Journal developed a clinical framework to help patients use cannabis to treat chronic pain if they are opioid-dependent. “Based on a comprehensive review of the literature and epidemiological evidence to date, cannabinoids stand to be one of the most interesting, safe, and accessible tools available to attenuate the devastation resulting from the misuse and abuse of opioid narcotics,” researchers explained. 

Research published earlier in May in the journal Pain also shared that injecting terpenes is more effective than injecting morphine-based chemo medications, and there are far fewer adverse effects. “What we found is that terpenes are really good at relieving a specific type of chronic pain with side effects that are low and manageable,” said researcher John Streicher. The study used five terpenes (alpha-humulene, beta-caryophyllene, beta-pinene, geraniol, and linalool) and tested on mice with a focus on neuropathic pain (a common condition that is developed by chemotherapy medications). All of the terpenes showed signs of pain reduction, especially when combined. “We looked at other aspects of the terpenes, such as does this cause reward? Is this going to be addictive? Is it going to make you feel awful?” Streicher said. “What we found was yes, terpenes do relieve pain, and they also have a pretty good side effect profile.”