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Legal Marijuana States Have Lower Opioid Use, New Studies Show

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Letting people legally access marijuana appears to reduce reliance on addictive opioids, two new studies published by the American Medical Association find.

“Medical cannabis laws are associated with significant reductions in opioid prescribing in the Medicare Part D population,” concludes one paper from researchers at the University of Georgia, Athens. “This finding was particularly strong in states that permit dispensaries, and for reductions in hydrocodone and morphine prescriptions.”

The second study, from scientists at the University of Kentucky and Emory University, noted that “marijuana is one of the potential nonopioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose.” It found that laws allowing medical cannabis or recreational marijuana “have the potential to lower opioid prescribing for Medicaid enrollees, a high-risk population for chronic pain, opioid use disorder, and opioid overdose.”

“Marijuana liberalization may serve as a component of a comprehensive package to tackle the opioid epidemic,” the researchers conclude.

The two papers, released Monday by JAMA Internal Medicine, a publication of the AMA, looked at use of opioids such as fentanyl by people enrolled in Medicare and Medicaid, with both examinations finding that states with legal marijuana access saw lower reliance on the pharmaceutical drugs.

And the easier the access to legal marijuana, the lower the rate of opioid prescribing.

“States with active dispensaries saw 3.742 million fewer daily doses filled; states with home cultivation only [laws] saw 1.792 million fewer filled daily doses,” one of the studies, which focused on medical cannabis laws, found.

The other new paper shows that while medical marijuana is associated with reduced opioid prescriptions, recreational laws have an even greater effect.

“State implementation of medical marijuana laws was associated with a 5.88% lower rate of opioid prescribing,” the authors wrote. “Moreover, the implementation of adult-use marijuana laws, which all occurred in states with existing medical marijuana laws, was associated with a 6.38% lower rate of opioid prescribing.”

U.S. Sen. Kirsten Gillibrand (D-NY) recently suggested that pharmaceutical companies oppose marijuana legalization for selfish reasons.

“To them it’s competition for chronic pain, and that’s outrageous because we don’t have the crisis in people who take marijuana for chronic pain having overdose issues,” she said. “It’s not the same thing. It’s not as highly addictive as opioids are.”

The results of the new studies add to a growing body of research indicating that legal marijuana access is associated with reduced opioid issues.

In 2014, for example, a previous JAMA study showed that states with medical cannabis laws have roughly 25 percent lower opioid overdose rates.

A separate analysis published in February concluded that “legally protected and operating medical marijuana dispensaries reduce opioid-related harms,” suggesting that “some individuals may be substituting towards marijuana, reducing the quantity of opioids they consume or forgoing initiation of opiates altogether.”

And previous work by Ashley and David Bradford of the University of Georgia, who authored one of the new studies released on Monday, showed broad reductions in Medicare and Medicaid pain prescriptions when state medical cannabis laws went into effect. Their new paper builds on that by zeroing in on opioid painkillers and showing that the type of state marijuana law has an effect on the reduction in prescriptions.

“The type of [medical cannabis law] matters,” David Bradford said in an email. “Dispensaries have the biggest effect.”

The other paper, by the Kentucky and Emory researchers, tabulated reductions in opioid prescriptions associated with changes in laws, finding that medical cannabis policies lead to 39.41 fewer opioid prescriptions per 1,000 enrollees annually and that the effect for recreational legalization was even larger.

“Furthermore, the implementation of adult-use marijuana laws was associated with a 9.78% lower Medicaid spending on prescription opioids, equivalent to an annual saving of $1,815 Medicaid spending per 1,000 enrollees,” the study found. “The implementation of medical and adult-use marijuana laws was also associated with a lower rate of Medicaid-covered prescriptions for nonopioid pain medications of 8.36% and 8.69%, respectively.”

The research teams behind both new studies said that medical cannabis shows promise as a partial solution to opioid issues.

“Combined with previously published studies suggesting cannabis laws are associated with lower opioid mortality, these findings further strengthen arguments in favor of considering medical applications of cannabis as one tool in the policy arsenal that can be used to diminish the harm of prescription opioids,” the Bradfords’ Georgia team wrote. “Furthermore, a growing consensus suggests that cannabis can be used to effectively manage pain in some patients. If initial licit prescriptions for opioids can be reduced, then there is a plausible theoretical pathway to anticipate that opioid misuse and abuse could also fall.”

When legal marijuana is available, some patients appear to be more likely to choose it instead of prescription pain pills that can lead to addiction or overdose.

“Most opioid use disorder and overdose cases occurred in patients with legitimate prescriptions from health care professionals for pain management. Marijuana liberalization, therefore, may have benefited these patients by providing them with legal protection and access to marijuana as an alternative relief from their pain conditions,” the Kentucky and Emory team wrote. “The widespread public support will bring medical marijuana laws to more and more states for years to come, which may help decrease the use of prescription opioids in pain management and the adverse consequences, such as opioid use disorder and overdose.”

Those researchers also noted that “marijuana may help ease opioid withdrawal symptoms.”

“Thus, marijuana liberalization potentially reduced prescription opioid use on 2 fronts, serving as a substitute for opioid pain medications, and as a complement to opioid use disorder treatment,” the wrote. “The potential of adult-use marijuana laws to reduce the use and consequences of addictive opioids deserves consideration, especially in states that have been hit hard by the opioid epidemic.

This piece was first published by Forbes.

Marijuana Moment is made possible with support from readers. If you rely on our cannabis advocacy journalism to stay informed, please consider a monthly Patreon pledge.

Tom Angell is the editor of Marijuana Moment. A 20-year veteran in the cannabis law reform movement, he covers the policy and politics of marijuana. Separately, he founded the nonprofit Marijuana Majority. Previously he reported for Marijuana.com and MassRoots, and handled media relations and campaigns for Law Enforcement Against Prohibition and Students for Sensible Drug Policy. (Organization citations are for identification only and do not constitute an endorsement or partnership.)

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Banking Activity Increases In States That Legalize Marijuana, Study Finds

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While marijuana businesses often struggle to find banks that are willing to take them on as clients due to risks caused by the ongoing federal prohibition of cannabis, a new study found that banking activity actually increases in states that legalize marijuana.

The research doesn’t make a direct connection between state-level marijuana reform and the increased activity, but it does strongly imply that there’s a relationship—even if the factors behind the trend aren’t exactly clear.

Researchers set out to investigate banking trends in states that have legalized cannabis, looking at bank regulatory filings with the Federal Deposit Insurance Corporation (FDIC) from 2011 to 2016. They found evidence that “banking activity (deposits and subsequent loans) increase considerably in legalizing states relative to non-legalizing states.”

That’s in spite of the fact that banks and credit unions run the risk of being penalized by federal regulators for working with businesses that deal with a federally controlled substance.

“While uncertainty can result in overly cautious behavior and hinder economic activity, we do not find evidence of this with cannabis laws and the banking industry,” the authors wrote in the new paper—titled, “THC and the FDIC: Implications of Cannabis Legalization for the Banking System.”

The study analyzed data from “150,566 bank-quarter observations from 6,932 unique banks located in 46 different states.” It found that deposits increased by an average range of 3.14-4.33 percent—and bank lending increased by 6.54-8.62 percent—post-legalization.

“Our results indicate that deposits and loans increased for banks after recreational cannabis legalization.”

Of course, it makes sense that legal states would see increased financial activity in the banking sector after opening a new market, even if only some banks choose to take the risk of working directly with cannabis businesses. The emerging marijuana industry also supports an array of ancillary firms and traditional companies that provide services to dispensaries and grow operations.

As of June 30, there were 706 financial institutions that had filed requisite reports saying they were actively serving cannabis clients. Thats up from 689 in the previous quarter but still down from a peak of 747 in late 2019.

But the question remains: why are some banks deciding to take on marijuana clients while others remain wary of federal repercussions?

The study authors—from the University of Arizona, Drexel University, San Diego State University and Scripps College—put forward two possibilities about why “the risk from regulatory uncertainty did not decrease banks’ willingness to accept deposits or make loans.”

The increase “may suggest that banks were either unconcerned about the potential risk associated with accepting cannabis related deposits or optimistic about the chances that regulations will adapt to the needs of legalizing states,” the paper reasons.

Confidence about working with a federally illegal industry may well have been bolstered in 2014 when the Financial Crimes Enforcement Network (FinCEN) under the Obama administration issued guidance to financial institutions on reporting requirements for cannabis-related businesses.

The second option, optimism about federal reform, also seems possible. It was around the time that the bipartisan Secure and Fair Enforcement (SAFE) Banking Act was first introduced that there was a notable spike in financial institutions reporting that they have marijuana business clients.

In the years since, that legislation has been approved in some form five times in the U.S. House of Representatives, but it’s continued to stall in the Senate. In general, banks reporting marijuana accounts has remained relatively stable since 2019.

“Although many have speculated about the increased legal risks to banks, there is a lack of evidence for instances where banks are criminally prosecuted or lose their federally insured status,” the study states. “If these negative repercussions rarely happen, it makes sense that banks would not respond to the legislative uncertainty.”

“As more state regulators issue statements in support of banks and credit unions serving the cannabis industry, the financial institutions can become more optimistic about the chances that regulations will adapt in their favor with time,” the authors wrote.

Despite optimism for future reform that certain lawmakers have expressed, it doesn’t necessarily take the sting out of the latest failed attempt to secure protections for banks that choose to work with state-legal cannabis businesses as part of a large-scale defense bill.

A pro-reform Republican senator recently slammed Democrats for failing to advance marijuana banking reform despite having a congressional majority and control of the presidency.

For what it’s worth, the secretary of the U.S. Treasury Department recently said that freeing up banks to work with state-legal marijuana businesses would “of course” make the Internal Revenue Service’s (IRS) job of collecting taxes easier.

With respect to the SAFE Banking Act, a bipartisan coalition of two dozen governors recently implored congressional leaders to finally enact marijuana banking reform through the large-scale defense legislation.

A group of small marijuana business owners also recently made the case that the incremental banking policy change could actually help support social equity efforts.

Rodney Hood, a board member of the National Credit Union Administration, wrote in a recent Marijuana Moment op-ed that legalization is an inevitability—and it makes the most sense for government agencies to get ahead of the policy change to resolve banking complications now.

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Science & Health

Young People Who Use Marijuana Have Better Orgasms and Sexual Function, Study Says

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Young people who smoke marijuana and drink alcohol have better orgasms and overall sexual function than their peers who abstain or use less, a study in Spain recently concluded.

Because the existing scientific literature on the impact of drinking and drug use on sexual functioning is contradictory—finding both benefits and harms—a team of researchers from the University of Almeria designed the new observational study to analyze their affect with three commonly used surveys to detect potential risky drinking and cannabis use, as well as changes to one’s sexual functioning.

“Sexual function in young people who use cannabis and alcohol more frequently was shown to be better than in those who do not use either.”

From January to June 2020, researchers assessed 185 females and 89 males between the ages of 18 and 30 who were either regular cannabis or alcohol users or non-users, excluding those who used other substances like opiates or MDMA, as well as screening out those with pre-existing conditions like depression and diabetes, which could have a negative impact on their sexual performance.

“Sexual function is improved in young people who are high-risk cannabis consumers with a moderate risk of alcohol use, resulting in increased desire, arousal, and orgasm,” the study, published at the end of last month in the Journal Healthcare, found. “This improvement is usually associated with a reduction in anxiety and shame, which facilitates sexual relationships.”

The cannabis users scored higher than non-users on both the overall sexual functioning scale and the subscales of arousal and orgasm. And those who used cannabis the most were found to report higher sexual functioning and arousal scores than the moderate users. No differences were found on the desire and orgasm subscales between moderate and heavy users and no differences were detected amongst men and women respondents to the survey.

“Our findings indicate that young people who use cannabis frequently, regardless of gender, have better overall sexual function.”

When it comes to alcohol use, no significant differences in either overall sexual function or in any of the subscales measured, were found between drinking and non-drinking participants. However, there were statistically significant differences based on levels of alcohol consumption, potentially suggesting some dose dependent outcomes.

Those who reported heavy drinking scored higher on the total sexual function questionnaire and the arousal subscale than those who did not drink at all, the study found. And the high consumption participants had significantly higher total questionnaire and orgasm subscale scores than the moderate consumption participants. But those participants who reported an existing alcohol dependence had significantly lower scores than their peers whose drinking was evaluated to be merely at a higher risk for dependency.

These marijuana results are consistent with previous studies that found cannabis use enhances sex and masturbation, increases sexual desire and leads to better orgasms, as well as those that have found cannabis consumers have more sex than cannabis abstainers, and a higher score on sexual health inventories and serum testosterone levels.

“The findings of this study revealed a higher score in sexual function, as well as arousal and orgasm, in subjects at risk of having cannabis-related problems and risk of addiction associated with alcohol consumption.”

Older studies that previously found some evidence of erectile dysfunction among heavier alcohol consumers may have been influenced by the older ages of the respondents, according to the research team behind the new paper, which focused on individuals in their late teens and 20s, “where erectile dysfunction is less common.”

Questions remain about the different types of sexual relationships (long-term vs sporadic vs unstable) that frequent consumers engage in or if there is any correlation between use and relationship type.

The research team also cautioned that this study did not capture any potential medium range and longer-term consequences of heavier drinking and cannabis use, including any potential proclivity to engage in less safe sex practices due to inebriation.

Since the increased desire, arousal, and orgasms in young people who are high-risk cannabis consumers with a moderate risk of alcohol use, is usually associated with a reduction in anxiety and shame, which facilitates sexual relationships, the study called for future sex education practices to focus on strategies that reduce shame and anxiety, to prevent young people from developing potential drug and alcohol dependency issues later on in their lives.

Photo courtesy of Martin Alonso.

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One-Third Of Programmers Use Marijuana While Working, With Many Touting Creative Benefits, Study Finds

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More than one-third of software programmers say they’ve used marijuana while working, with many finding that it helps promote creativity and get them into the “programming zone,” according to a new study.

Researchers at the University of Michigan said that anecdotal evidence suggested that those in programming were more likely to use cannabis on the job, so they set out to conduct the “first large-scale survey” on the topic, asking 803 developers to detail how marijuana comes into play in their work.

A main motivation for the study was the fact that drug testing policies remain common in the programming sector, which may be contributing to “hiring shortages for certain jobs.”

That’s even the case at the federal level, the study authors note, citing comments by former FBI Director James Comey, who said in 2014 that he was interested in loosening employment policies around cannabis because some prospective agents “want to smoke weed on the way to the interview.”

“This prohibition of cannabis use in software engineering has contributed to a widely-reported hiring shortage for certain US government programming jobs,” the study says.

All told, 35 percent of survey participants said that they’ve “tried cannabis while programming or completing another software engineering-related task.” Seventy-three percent of that group said they’ve consumed marijuana while working in the past year.

The study—titled “Hashing It Out: A Survey of Programmers’ Cannabis Usage, Perception, and Motivation” and published this month in Cornell University’s arXiv—also looked at frequency of use among those who said they’ve used marijuana while engineering.

Fifty-three percent said they’ve consumed cannabis while programming at least 12 times, 27 percent said they used it at least twice a week and four percent said they use it while working on a nearly daily basis.

The study authors wanted to get a better understanding of why programmers chose to consume marijuana, too. And they found that the most common tasks that people used marijuana for were brainstorming, prototyping, coding and testing.

“Overall, we found that programmers were more likely to report enjoyment or programming enhancement motivations than wellness motivations: the most common reasons were ‘to make programming-related tasks more enjoyable’ (61%) and ‘to think of more creative programming solutions’ (53%),” the study found. “In fact, all programming enhancement reasons were selected by at least 30% of respondents. On the other hand, general wellness related reasons (such as mitigating pain and anxiety) were all cited by less than 30% of respondents. Thus, while wellness does motivate some cannabis use while programming, it is not the most common motivation.”

While there’s a notable prevalence of cannabis consumption among programmers, even most of those who don’t use marijuana are supportive of reform, the study found.

“Ninety-one percent of our participants say that marijuana use should be legal for both recreational and medicinal use compared to 60 percent of the general United States population in 2021,” the authors wrote.

The study also found that “cannabis use while programming occurs at similar rates for programming employees, managers and students despite differences in cannabis perceptions and visibility.”

“Our results have implications for programming job drug policies and motivate future research into cannabis use while programming,” the study states.

Drug testing policies have become a hot topic as more states enact legalization.

After New York opted to end prohibition this year, for example, the state Department of Labor announced that most employers are no longer allowed to drug test most workers for cannabis.

Amazon recently said that its earlier decision to end drug testing for cannabis will also be retroactive, meaning former workers and applicants who were punished for testing positive for THC will have their employment eligibility restored.

Lawmakers in the Senate and House have both included language in recent appropriations reports urging a review of employment policies for federal agencies with respect to personal use of cannabis. The House version passed in July, while the Senate Democrats’ report was released in October.

The Office of Personnel Management (OPM) issued a memo to federal agencies this year that says admitting to past marijuana use should not automatically disqualify people from being employed in the federal government.

Meanwhile, the Biden administration came under criticism after it was reported that it had fired or otherwise punished dozens of staffers who admitted to prior marijuana use. That came after the White House instituted a policy of granting waivers to some staff who’ve used cannabis.

Press Secretary Jen Psaki subsequently said that nobody in the White House was fired for “marijuana usage from years ago,” nor has anyone been terminated “due to casual or infrequent use during the prior 12 months.” However, she’s consistently declined to speak to the extent to which staff have been suspended or placed in a remote work program because they were honest about their history with marijuana on a federal form that’s part of the background check process.

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