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States With Medical Marijuana Laws Saw 20% Drop In Some Opioid Prescriptions

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States with active medical marijuana laws saw certain opioid prescription rates drop nearly 20 percent compared to prohibition states, a first-of-its-kind study out of Columbia University’s Irving Medical Center has found. Authors said the findings underscore the importance of providing patients with pain management alternatives, such as cannabis, in efforts to reduce opioid use.

Drug overdoses remain a leading cause of injury-related death in the United States, and the U.S. Centers for Disease Control and Prevention reports that 68 percent of those deaths involve illicit or prescription opioids. The new study examines opioid prescriptions made specifically by orthopedic surgeons, who it notes are the nation’s third-highest prescribers of opioids.

“Although our study does not support a direct causal relationship, these population-level findings show that legalization of medical cannabis and patient access to dispensaries may be associated with reductions in opioid prescribing by orthopaedic surgeons,” the study’s authors concluded. “The observed trends reported in this study may be a reflection of growing availability of alternative pain management options for patients.”

“We found that overall opioid prescribing by orthopaedic surgeons in this cohort was reduced in states permitting patient access to medical cannabis, compared with those who do not.”

Analyzing nationwide Medicare Part D prescription drug data, researchers measured the aggregate daily doses of opioid medications prescribed by orthopedic surgeons in each state annually. They then looked for associations between that state-level data and the legal status of medical marijuana in each state.

As with past studies examining correlations between medical marijuana and opioid prescriptions, the Columbia analysis found a marked drop in prescriptions among states with medical cannabis laws (MCLs). “State MCLs were associated with a statistically significant reduction in aggregate opioid prescribing of 144,000 daily doses (19.7% reduction) annually,” the study, published this month in the Journal of the American Academy of Orthopaedic Surgeons, says.

Medical cannabis laws “were associated with a statistically significant reduction of 72,000 daily doses of hydrocodone annually.”

Not all state legal marijuana programs operate the same way, of course. It can also take years after a state adopts a medical cannabis law before its program is up and running. So the researchers looked at various specific factors, including when storefront dispensaries opened, whether state laws allowed home cultivation by patients, and whether recreational cannabis was legal for adults in each state.

Of the relationships that the researchers found were statistically significant, two stood out most clearly: States with active medical cannabis laws saw a 19.7 percent reductions in Medicare Part D opioid prescriptions made by orthopedic surgeons compared to states without medical cannabis laws. On a more granular level, states with operating storefront dispensaries saw a 13.1 percent reduction in those prescriptions.

Other relationships found by the researchers were just as likely to be due to chance. States with restrictive medical cannabis laws that allowed access only to low-THC products, for example, saw small, statistically insignificant increases in opioid prescriptions.

Researchers also “did not observe any significant association between total opioid prescriptions and home cultivation–only” medical cannabis laws, and concluded that “no significant association between recreational marijuana legalization and opioid prescribing was found.”

In “states that allow physicians to recommend medical cannabis to patients for any reason, there was a significant reduction in prescriptions for fentanyl…”

Cannabis is a particularly appealing alternative pain medication to study the effect of, the authors wrote, “because of its efficacy in treatment of chronic and acute pain and its potential for replacing and/or reducing opioid treatment.”

Researchers adjusted some of their data to better reflect not just the laws on the books but the actual accessibility of medical marijuana in each state. New York, for example, adopted a medical cannabis law in 2014, but home cultivation was prohibited and dispensaries didn’t open until 2016. “As such,” the authors wrote, “we did not classify New York as an MCL state or a dispensary-based MCL state until 2016.”

The study also cautions that its results only mean so much. Because it relied on population-level data and didn’t track individuals’ opioid or medical marijuana use, “we could not make any conclusions about any direct effect of substitution of opioids for cannabis by patients on prescription trends.” the authors wrote. “As such, our study does not draw conclusions of direct causation, but reports observed associations over time using a nationwide cohort database and multivariable regression analysis.”

Still, the study’s results contribute to a growing body of research indicating that medical cannabis accessibility significantly reduces statewide opioid use—and even opioid deaths. As the Columbia authors note in their report, “Multiple large nationwide database studies have shown that states with the legalization of medical marijuana have seen reductions in the opioid prescription rates and opioid-related mortality rates. The authors of these studies have theorized that in states where medical cannabis is more available, patients are likely to substitute cannabis for opioids in their pain management.”

For example, a meta-study that was recently published also signaled that marijuana shows promise as a treatment option for chronic pain and could serve as an alternative to opioid-based painkillers.

Last month, researchers released a study that found cannabis can mitigate symptoms of opioid withdrawal.

In December, researchers determined that states with legal marijuana access experience decreases in opioid prescriptions, and a separate study released the previous month showed that daily marijuana consumption is associated with reduced opioid consumption among chronic pain patients.

Marijuana Seems To Reduce Opioid Use Among Chronic Pain Patients, Meta-Study Finds

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Ben Adlin is a Seattle-based writer and editor. He has covered cannabis as a journalist since 2011, most recently as a senior news editor for Leafly.

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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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Culture

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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