Two new studies find that opioid-related deaths decline when states legalize access to marijuana. In fact, when adult-use cannabis laws are in place, the rate of opioid overdoses declines by at least 20 percent.
Both papers, published in the journal Economic Inquiry, not only show the impact of passing such laws, but also how dispensaries play a role in helping to quell these deaths.
The first study, helmed by researchers in Massachusetts and Colorado, claims to be the first to show the causal effects of access to recreational cannabis on opioid mortality.
“We find that marijuana legalization causes a significant decline in opioid mortality— especially deaths from synthetic opioids—with particularly pronounced benefits in states that have legalized recreational usage,” the study’s authors write. “Yet it is not legalization, per se, that produces these gains; rather, states that have legal access via dispensaries see the largest reductions in mortality.”
“We estimate that [recreational marijuana laws] reduce annual opioid mortality in the range of 20%–35%, with particularly pronounced effects for synthetic opioids.”
The study used three main sources of data: death rates involving all opiates, prescription opioids and synthetic opioids from January 1999 through the end of 2017; the history of marijuana legalization in each state (including when legislation was passed and when dispensaries opened for business) and state-level demographic information. During the study period, 29 states had approved medical cannabis, while recreational marijuana was legalized in eight states plus the District of Columbia. According to the Centers for Disease Control and Prevention, the number of opioid-related deaths has increased six times over between 1999 and 2017. Additionally, 36 percent of the 47,600 opioid overdoes in 2017 involved prescription opioids.
After running several statistical and mathematical models that included checks to ensure their results were consistent, the study’s authors found that broader adult-use laws reduce a state’s opioid death rate between 20 percent (for all opiates and prescription opioids) to 35 percent (for synthetic opioids).
“Recreational marijuana laws affect a much larger population than medical marijuana laws, yet we know relatively little about their effects,” study co-author Nathan W. Chan, PhD said in a press release. “Focusing on the recent wave of recreational marijuana laws in the U.S., we find that opioid mortality rates drop when recreational marijuana becomes widely available via dispensaries.”
“Our estimates are sizable,” the study itself states. “For reference, the average never-legalizer state has 4.82 fatalities per 100,000 people from All Opiates (Synthetic Opioids) annually, while for the average [medical marijuana law] state, these are 6.067 and 0.856 per 100,000 people. Thus, our estimates imply annual reductions in All Opioid mortality between 1.01 and 1.27 deaths per 100,000 people for non-[recreational marijuana law] states, on average. For a state with a population of 5 million (near the nationwide median), this would save on the order of 50 lives per year, or roughly 10 averted deaths from Synthetic Opioids alone.”
Those are conservative estimates, the authors add.
Additionally, models showed that white people and women saw the highest reductions in synthetic opioid deaths in states that legalized recreational cannabis: Whites experienced a 32 percent decrease, while the statistical effect for women was larger and “highly statistically significant” compared to what they found for men.
The authors did not identify what mechanism is responsible for this reduction in mortality rates, though past research suggests people who can legally access marijuana may substitute it for opioids. A recent study, for example, found the majority of people who shopped at cannabis retail shops reported using marijuana to help with pain and sleep.
The new study’s authors do stress, however, that the causal effect they identified is “highly robust.”
“Our bedrock findings remain unmoved by variations in modeling assumptions and selections of control variables, and our findings are further corroborated through placebo tests,” they write. “Our results show that there are substantial ancillary benefits to marijuana legalization, especially [recreational marijuana laws], and they offer important food for thought as many states continue to contemplate expansions to both medical and recreational marijuana access.”
Their findings support a growing body of research that has linked the availability of medical marijuana dispensaries with a drop in the rate of local opioid-related deaths.
In fact, that was the focus of the second cannabis-related study published recently in Economic Inquiry. According to its findings, after a medical cannabis dispensary opened in a county, prescription opioid deaths fell locally by approximately 11 percent. These results, the author writes, suggest “a substitutability between marijuana and opioids.”
“Furthermore,” the study concludes, “the unintended beneficial effects of allowing for marijuana dispensary operations should be considered by policymakers as they aim to curtail narcotic abuse and limit the impact of the opioid epidemic.”
Legalizing Medical Marijuana Makes People Have More Sex, Study Shows
Legalizing medical marijuana appears to encourage people to have more sex, according to a recent study.
“We find that [medical marijuana laws] cause an increase in sexual activity,” researchers from the University of Connecticut and Georgia State University concluded.
That’s not the only related effect, however, as the study also determined that there’s a decrease in the use of contraceptives and an increase in the number of births following the enactment of medical cannabis policies.
To determine how such laws influence how often people have sex, the team of researchers analyzed a large data set that included “detailed questions about sexual activity and substance use” in young people between 1997 and 2011. The survey asked respondents explicitly about past-month marijuana use and sex frequency.
The analysis found a 4.3 percent increase in the “likelihood of having sex once or more in the past month” after a medical cannabis law was enacted and “an increase in sex beginning directly after the law change.”
“The primary change in sexual behavior we observe is increased engagement in sexual activity.”
Additionally, the effect of medical marijuana laws on births translates to a 2 percent increase, or 684 more births per quarter, “for all women of childbearing range.”
“These results provide evidence that marijuana use has a considerable, unintended, and positive effect on birthrates,” the authors wrote in the paper, which was published late last month in the Journal of Health Economics.
When it comes to contraceptives, the researchers highlight that the sensory effects of cannabis “may change attitudes toward sexual risks by making users less concerned about the consequences of intercourse, resulting in decreased contraceptive use.”
Such behavioral changes could explain why birthrates increase when people have access to medical cannabis, despite what the study authors described as physiological effects associated with marijuana use that could decrease fertility.
“Our findings on births suggest that behavioral factors can counteract the physiological changes from marijuana use that tend to decrease fertility,” they wrote.
“We find that passage of [medical marijuana laws] result in both increased engagement in sexual activity and decreases in contraceptive use conditional on being sexually active,” the study concludes. “Jointly, both mechanisms suggest that behavioral responses may be due to increased attention to the immediate hedonic effects of sexual contact, increased willingness to engage in sex, as well as delayed discounting and ignoring the future costs associated with sex.”
While this study aims to describe behavioral changes in sexual activity after a medical marijuana law is in place, recent research also points to cannabis’s ability to intensify sexual pleasure and increase sex drive for both men and women.
Photo courtesy of Aphiwat chuangchoem.
People Visiting Safe Injection Sites Are Less Likely To Die Compared To Other Drug Consumers, Study Finds
As a growing number of Democratic presidential contenders are voicing support for harm reduction programs such as supervised injection facilities (SIFs), a recent study shows that these candidates are on the right track if they’re really interested in helping save the lives of people who use currently illegal drugs.
Researchers in British Columbia, Canada, found that people “who reported using supervised injection facilities on an at least weekly basis had a reduced risk of dying compared to those who reported less than weekly or no use of this health service.”
Previous studies have shown that safe injection sites help reduce overdose deaths. However, there are only approximately 140 legally operating sites in the world, including in Canada, Australia and Europe. To date, no SIFs have legal approval to operate in the U.S., though some cities are exploring allowing such facilities to open.
To understand whether SIFs affect overall mortality, researchers used data from two prospective cohort studies of people who inject drugs (PWID) in Vancouver, Canada. Every six months between December 2006 and June 2017, participants responded to a questionnaire asking about sociodemographic information, drug use, use of health interventions such as SIFs and more. They were also asked to provide blood samples for medical testing or monitoring.
Ultimately, the total sample included 811 participants. More than half (432) reported frequent (that is, at least weekly) SIF use at baseline. Over the span of the study period, 112 participants died, corresponding to a crude mortality rate of 22.7 deaths per 1,000 person-years. The leading causes of deaths were non-accidental (which included neoplasms and circulatory disease), ill-defined or unknown, overdose and HIV-related.
After adjusting for several factors, including age, sex, HIV seropositivity, public injection and more, researchers found that “frequent SIF use remained significantly associated with decreased risk of all-cause mortality.”
“Existing modeling and simulation studies indicate that SIFs avert numerous overdose deaths per year,” the study, which was published in the journal PLOS Medicine in late November, states. “Moreover, past research relying on aggregate data has demonstrated the role of SIFs in reducing local population-based rates of fatal overdose. However, we believe that ours is the first study to identify an individual-level association between frequent SIF use and decreased risk of all-cause mortality among a community-recruited cohort of PWID.”
Although researchers did not investigate why there was an association between frequent SIF use and a lower risk of all-cause mortality, they do offer some potential explanations based on existing literature. Studies have shown that supervised consumptions sites are associated with safer syringe use, including a decline in sharing, reusing, outdoor injecting and hurried injecting. Additionally, these facilities are equipped to handle medical emergencies, such as overdose, and are staffed with people trained in addiction treatment.
“Together with the findings of previous research,” the authors write, “our findings underscore the need for continued efforts to enhance access to SIFs as a strategy to reduce mortality among PWID. In particular, given that SIFs have limited geographic coverage and that PWID have been found to often encounter long wait times in accessing SIF services in this setting, the broader expansion of SIFs may serve to improve service accessibility and thereby reduce the potential for mortality and other harms among this population.”
At a time when evidence-based interventions are urgently needed to address the disproportionately high burden of preventable deaths and suffering experienced by people who use drugs, efforts to scale up access to supervised injection facilities should be a public health priority.
— Mary Clare Kennedy, PhD (@MCKennedy_) November 27, 2019
Lead author Mary Clare Kennedy summarized her study results online, tweeting in part: “Our findings add to the large body of scientific evidence demonstrating the critical role of supervised injection facilities in saving lives, reducing harm & promoting health among people who inject drugs.”
“At a time when evidence-based interventions are urgently needed to address the disproportionately high burden of preventable deaths and suffering experienced by people who use drugs, efforts to scale up access to supervised injection facilities should be a public health priority.”
On the presidential campaign trail, entrepreneur Andrew Yang, South Bend, Indiana Mayor Pete Buttigieg, former Housing and Urban Development Secretary Julián Castro, Sen. Elizabeth Warren (D-MA) and Sen. Bernie Sanders (I-VT) have all voiced support for safe consumption sites.
Photo by Jair Lázaro on Unsplash
Scientists Uncover ‘Strong Relationship’ Between Psychedelic Use And Connection With Nature
People who claim a stronger bond with nature following a psychedelic experience aren’t just blowing smoke, according to new research.
“We found a strong relationship between the amount of lifetime use of psychedelics and nature relatedness, as well as increases in nature relatedness from before to after psychedelic use,” researchers concluded in a study published last month in the International Journal of Environmental Research and Public Health.
To measure how psychedelics influence perspectives on nature, 654 people planning to take substances such as psilocybin mushrooms, LSD, ayahuasca, DMT, mescaline and ibogaine were invited by Imperial College London’s Centre for Psychedelic Research to take part in the online study. Participants were then sent email reminders “at multiple time-points before and after the indicated date of the experience.”
Using statistical analysis, the researchers found that “nature relatedness was significantly increased with two weeks, four weeks and two years after the psychedelic experience” and that participants’ experience boosted feelings of “well-being” when their attitudes toward nature increased.
In other words, psychedelic-induced appreciation for the natural world seems to correspond with psychological health.
“A significant positive association was observed between changes in nature relatedness and changes in psychological well-being,” the authors wrote.
“The here presented evidence…bears relevance for psychedelic treatment models in mental health and, in the face of the current ecological crisis, planetary health.”
Surprisingly, associations with nature were “not only sustained, but rather elevated even further after two years” following the experience. According to the authors, the participants could be experiencing a “positive-feedback-like effect,” where psychedelic use “led individuals to subsequently seek more exposure to nature,” thus reinforcing connections with the natural world.
“These findings point to the potential of psychedelics to induce enduring positive changes in the way humans relate to their natural environments,” the authors wrote.
The research team noted that the sample population’s baseline connection with nature was “substantially higher than demographically similar populations,” but that “may be explained by the psychedelic-experienced nature of the current sample—implying that prior psychedelic use had already caused an increase in nature relatedness.”
“It is an increasingly well-established principle that the quality of an individual’s acute experience under a psychedelic is predictive of subsequent long-term psychological outcomes—such as improvements in mental health.”
According to the researchers, this study is “the first empirical evidence for a causative role of psychedelic use in the enhancement of nature relatedness in a large sample of healthy participants.”
“By meaningfully connecting with nature during a psychedelic experience (especially so if the experience is within the context of pleasing natural surroundings), otherwise healthy individuals may be enticed to spend more time in nature in the future, thereby adopting healthier, more nature-related lifestyles,” the study concluded.
The research results come amid a growing nationwide movement to decriminalize psychedelics across the U.S. following successful campaigns last year to reform laws criminalizing psilocybin in Denver, and those covering a broader array of psychedelics in Oakland.
Decriminalize Nature, the aptly named group that led the Oakland campaign, is now spearheading similar efforts that have extended to nearly 100 other cities. Localities considering decriminalizing psychedelics next include Chicago, Berkeley and Dallas.
A separate group is working to qualify a statewide measure for Oregon’s 2020 ballot that would legalize psilocybin for therapeutic use. Additionally, activists in Portland also began collecting signatures last month for a local measure that would decriminalize a wide range of psychedelics such as mescaline and ayahuasca.
Meanwhile, California activists are aiming to place an initiative on the state’s ballot to legalize psilocybin for adult use.
The psychedelics movement is also reaching the presidential campaign, with Democratic contender Andrew Yang saying last month that he wants to make psilocybin mushrooms “more freely available,” especially for military veterans.