JAMA: Medical Cannabis States Possess Lower Rates Of Opiate-Induced Fatalities

  • by Paul Armentano, NORML Deputy Director August 25, 2014

    The enactment of medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates, according to data published online today in the Journal of the American Medical Association (JAMA) Internal Medicine.

    A team of investigators from the University of Pennsylvania, the Albert Einstein College of Medicine in New York City, and the Johns Hopkins Bloomberg School of Public Health in Baltimore conducted a time-series analysis of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010 — a period during which 13 states instituted laws allowing for cannabis therapy.

    Researchers reported, “States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.” Specifically, overdose deaths from opioids decreased by an average of 20 percent one year after the law’s implementation, 25 percent by two years, and up to 33 percent by years five and six.

    They concluded, “In an analysis of death certificate data from 1999 to 2010, we found that states with medical cannabis laws had lower mean opioid analgesic overdose mortality rates compared with states without such laws. This finding persisted when excluding intentional overdose deaths (ie, suicide), suggesting that medical cannabis laws are associated with lower opioid analgesic overdose mortality among individuals using opioid analgesics for medical indications. Similarly, the association between medical cannabis laws and lower opioid analgesic overdose mortality rates persisted when including all deaths related to heroin, even if no opioid analgesic was present, indicating that lower rates of opioid analgesic overdose mortality were not offset by higher rates of heroin overdose mortality. Although the exact mechanism is unclear, our results suggest a link between medical cannabis laws and lower opioid analgesic overdose mortality.”

    In a written statement to Reuters Health, lead author Dr. Marcus Bachhuber said: “Most of the discussion on medical marijuana has been about its effect on individuals in terms of reducing pain or other symptoms. The unique contribution of our study is the finding that medical marijuana laws and policies may have a broader impact on public health.”

    Added co-author Colleen L. Barry in USA Today: “[The study’s findings] suggest the potential for many lives to be saved. … We can speculate … that people are completely switching or perhaps supplementing, which allows them to lower the dosage of their prescription opioid.”

    Nationwide, overdose deaths involving opioid analgesics have increased dramatically over the past decade. While fewer than 4,100 opiate-induced fatalities were reported for the year 1999, by 2010 this figure rose to over 16,600 according to an analysis by the US Centers for Disease Control.

    An abstract of the JAMA study, “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010,” appears online here.

    21 Responses to “JAMA: Medical Cannabis States Possess Lower Rates Of Opiate-Induced Fatalities”

    1. Galileo Galilei says:

      “In a written statement to Reuters Health, lead author Dr. Marcus Bachhuber said: ‘Most of the discussion on medical marijuana has been about its effect on individuals in terms of reducing pain or other symptoms. The unique contribution of our study is the finding that medical marijuana laws and policies may have a broader impact on public health.'”

      A knife in the black heart of prohibition.

    2. Don B. says:

      The benefits of cannabis will continue to be revealed as legalization spreads and matures. These benefits will become so numerous, on so many levels, and be so obvious that history will view cannabis prohibition as among the stupidest policies ever concocted and inflicted on the people.

    3. Patricia says:

      The DEA needs to choose between fighting medical marijuana and fighting prescription painkiller abuse. They need to get with the real world and get their priorities straight.

    4. Mark Mitcham says:

      This is a remarkable study! There is a line by Rage Against The Machine which goes something like “there is no other pill to take, so swallow the one that makes you ill” (or something close to that). This describes life during marijuana prohibition: people taking dangerous drugs for pain relief because the safer medicine is prohibited, loosely speaking. But is seems that the flip side of the coin is, given the legalization of cannabis, people will VOLUNTARILY reduce or stop taking the dangerous drugs when a safer alternative is available! And why not? That’s perfectly rational behavior.

    5. fireweed says:

      right on Don B. I think we’re seeing the beginnings of how beneficial cannabis actually is to society as a whole. I can’t wait for a similar report to come out on traffic fatalities, as Colorado apparently is enjoying a significant drop in traffic fatalities since legalization of cannabis. I think long term the studies will also come out on pot’s contribution to individual health, both in lowering incidence of the big 3 and of improving functioning. I intend to be smoking for the rest of my life and wouldn’t be surprised to still be skateboarding at 80 if I can keep getting my hands on good weed.

    6. Galileo Galilei says:

      1.) We have kids overdosing on this damn ‘spice’ (synthetic marijuana) crap,
      2.) We have fewer people overdoing on opiates in medical marijuana states using the ‘real’ marijuana.

      I’m sure the Dr. Andy Harris (R, Maryland) and the prohibitionists will find some reason we still need keep prohibition using these 2 facts.

    7. California MMJ Patient says:

      The first thing I did after getting ahold of a steady supply of Rick Simpson Oil (full extract cannabis oil), was to withdraw and detox from a 17-year-morphine prescription.

      I’m opiate free thanks to cannabis.

      I found you don’t need methadone, or buprenorphine or even clonidine for opiate withdrawal and detox because the Rick Simpson Oil eliminates nausea and diarrhea the two main symptoms of eliminating opiates.

      Just ONE very cool thing in a very long list thanks to the role of cannabinoids on the endocannabinoid system and HOMEOSTASIS

    8. Donna says:

      Pretty sure you can sum up this ground breaking,utterly profouned, shocking, and mind bending information with one word…. DUH !

    9. Dave Evans says:

      No shit, really? Sound rather like what I have been saying all along: “Marijuana is not dangerous, it is helpful”. What exactly is outrageous about my statement here???

      Drugs are dangerous. Marijuana is not dangerous. Why doesn’t this disqualify it from being called a drug???

    10. Steve says:

      I heard about this report this morning. Our local WKYC (Cleveland) news did a very short piece on this. I would like to see it circulated more and have more media outlets run it. Particularly since this is not a “crackerjack” study but published by well respected institutions. Personally, I think it carries a tremendous amount of weight in favor of the legalization cause.

    11. mexweed says:

      Thanks JAMA, and thanks Paul for launching it for discussion here. @fireweed made a good point by introducing the possible reduction in driving fatalities. @Galileo mentioned the prohib-dependent “spice” ersatz scam. Not to mention alcohol…

      Now the elephant in the room: 800,000 new nicotine tobacco addictions a year (USA), near 20,000,000 worldwide, could a massive reduction in those (and, a generation later, in the 6,000,000-a-year death toll) result from YOUTH ACCESS to cannabis, not just medicinal but for “recreation” or any purpose? (Uh oh don’t say that, protect our children.)

    12. Julian says:

      What a wonderful concert of remedies… Glad to know our college students are studying what’s good for us in defiance of the ONDCP.

      Annual Deaths in the U.S. Recorded by the CDC:
      Tobacco: 450,000
      Prescription drugs: +110,000
      Alcohol related: 110,000
      Caffeine: 10,000
      Lightning strikes: 3
      Marijuana: 0 (in all recorded human history)

    13. Anonymous says:

      In my early years I prayed for the people in my life that they would(someday) be in a political/ life position that… Our lifestyle would finally have a positive effect on our view & perspective (redundant). I’m truly happy to see this generation smoking.


    14. Chris Newman says:

      This is some of the best news that I’ve heard since learning that, since rec legalization in Colorado, DUI tickets there are down by about 10% and DUI highway deaths are down by about 25%. Clearly, legal cannabis isn’t just safer than alcohol, it’s better. A little early in the game to try to sell that one to the plebeians, though.

      But, from a legalization marketing approach, there’s a big gap in this current story: “How many souls has legal cannabis saved since the ‘post-prohibition’ era began in 1999?”

      Phrasing it that way is something that almost everyone can relate to. 25% means something to me on a gut level, but it’s just a number to many voters.

      Another important number that will sell especially well to the Right is, “How many taxpayer dollars have these avoided opiate deaths saved?” They think with their pocketbooks and consider taxes to be an Assault on America.

      Complimentary to this for the same fear-based demographic: “Because of legalization, how many prescription opiate painkiller patients did NOT go on to supporting foreign drug cartels by buying their heroin?” That’s the number one drug scourge going today.

      Someone needs to parse through the statistics in the JAMA article and winnow out the total number of souls saved, so far. I wish that I had the time, but don’t.

      In fact, it would be nice is someone launched a running “Lives Saved by Legal Cannabis” online counter. One of those numbers is me.

      But, if nothing else, if someone does some statistics-digging, please post souls-saved number here.


      THINK! While it’s still legal.

    15. Ilion, NY says:

      I think that most people who have some basic knowledge of the properties of natural cannabis arrived at this conclusion many moons ago. Of course, there were all those naysayers that responded with their nonsensical mindset that cannabis has no medical benefits, but we in the know don’t engage with those people. Some will never change their minds.

      However, as time goes on and more and more empirical data is provided, even the naysayers will have to change their tune. Now, we need the POLITICIANS (who supposedly represent us) to give up their prohibitionist platforms; read, understand and acknowledge the data, AND let their constituents, as individuals and as a society decide what should be legal or illegal.

      Keep up the excellent work, NORML, on providing factual information and current news on the fight against prohibition of the most useful and beneficial substance in the medical universe.

      I also would like to commend ASA and LEAP for their efforts in helping positive change take place regarding cannabis prohibition. Totally, all three organizations have made great strides in helping the ordinary citizen enjoy renewed freedoms that were removed by the power of Politics and Big Business .

      Kudos, and peace.
      Ilion, New York

    16. Young Smoker says:

      @Ilion,NY= Maybe one of the most beneficial plants on this planet that we have come across so far but there is a very large amount of space out there.. We have only explored metaphorically a drop in the ocean of what truly exist.

    17. Sharon Parker says:

      I believe Medical Marijuana should be Legalized in NC, because of it’s positive effects on a broad spectrum of medical issues. My husband is a veteran and has health issues that Marijuana has helped. He was prescribed drugs for pain and drugs for depression from the VA but stopped using them because of side effects and addiction issues.

    18. Bonny says:

      The U.S. Food and Drug management has actually proposed a rule to modify
      e-cigarettes whilst regulates cigarette.

    19. John says:

      i still wait for the day i see more vaporizers than cigarette and cigarette smoke in the streets of every cities.

    20. g king says:

      16,000 deaths from opiate overdoses in 2010 as compared to 400,000 annual deaths from the legal drug alcohol. Then there are cigarettes. The DEA should be abolished and get out of the lives of adults, who are capable of making their own choices of which drugs improve their lives and ones that do not.

    21. g king says:

      The potential harm from pairing alcohol with pain killers is but a footnote with pain management clinics. I was a patient (10 years) at a local clinic and was recently kicked out due to THC, but I had decided to wean myself from morphine, Fentanyl, and oxycodone, and try THC for pain. They did NOT care if I used alcohol along with their drugs.

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