Association between cannabis laws and opioid prescriptions among privately insured adults in the US

Prev Med. 2019 Aug:125:62-68. doi: 10.1016/j.ypmed.2019.05.012. Epub 2019 May 21.

Abstract

We examine the association between opioid prescription patterns in privately insured adults and changes in state cannabis laws among five age groups (18-25, 26-35 36-45, 46-55 and 56-64 years). Using the 2016 Clinformatics Data Mart, a nationwide commercial health insurance database, we performed a cross-sectional analysis of two types of opioid prescribing (>30-day and >90-day prescriptions) among all adults aged 18-64 based on the stringency of cannabis laws. We found a significant interaction between age and cannabis law on opioid prescriptions. Age-stratified multilevel multivariable analyses showed lower opioid prescription rates in the four younger age groups only in states with medical cannabis laws, when considering both >30 day and >90 day opioid use [>30 day adjusted odds ratio (aOR) = 0.56, in 18-25, aOR = 0.67 in 26-35, aOR = 0.67 in 36-45, and aOR = 0.76 in 46-54 years; >90 day aOR = 0.56, in 18-25, aOR = 0.68 in 26-35, aOR = 0.69 in 36-45, and aOR = 0.77 in 46-54 years, P < 0.0001 for all]. This association was not significant in the oldest age group of 55-64 years. There was no significant association between opioid prescriptions and other categories of cannabis laws (recreational use and decriminalization) in any of the age groups studied.

Keywords: Cannabis; Commercial insurance; Cross-sectional; Marijuana; Medical cannabis; Opioid; Prescription.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Analgesics, Opioid / therapeutic use*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Insurance, Health*
  • Legislation, Drug / trends*
  • Male
  • Medical Marijuana*
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Practice Patterns, Physicians' / trends
  • Private Sector*
  • Retrospective Studies
  • United States

Substances

  • Analgesics, Opioid
  • Medical Marijuana