Medical, recreational cannabis dispensaries lead to reduced opioid prescriptions
Medical marijuana isn’t one size fits all but could help mitigate prescription painkiller crisis, researcher says
University of Georgia
Cannabis may be a pain-management substitute for people experiencing chronic or acute pain from conditions like cancer, according to new research from the University of Georgia.
The studies comprise two articles, one forthcoming in the American Journal of Health Economics and one published in JAMA Health Forum focusing on patients with cancer diagnoses.
The first study found that laws legalizing the sale and use of medical marijuana led to fewer opioid prescriptions. On average, the rate of patients receiving opioid prescriptions fell by 16% in states that had legalized medical cannabis.
These decreases were seen across sexes, age groups, and different races and ethnicities.
The second study focused on data from patients with cancer diagnoses, following how cannabis dispensary openings affected opioid prescription rates, the average number of days per prescription and the average number of prescriptions per patient.
"The results of these two studies are consistent across states and subpopulations: Cannabis legalization has a role to play in mitigating the opioid epidemic.”
—Felipe Lozano-Rojas,
School of Public and International Affairs
The researchers found medical and recreational cannabis dispensary openings were associated with significant reductions in all opioid outcomes.
“The results of these two studies are consistent across states and subpopulations: Cannabis legalization has a role to play in mitigating the opioid epidemic,” said Felipe Lozano-Rojas, lead author of the study and an assistant professor in the UGA School of Public and International Affairs. “The opioid epidemic is ongoing. Moving away from opiates and toward cannabis seems to be a safer way of managing chronic and acute pain after discussing with the physician in charge of the case.
“That being said, this is not a free for all. These findings do not mean that everyone experiencing any pain should use cannabis.”
Medical marijuana led to fewer opioid prescriptions, slight NSAID increases
Prescriptions for non-steroidal anti-inflammatory drugs, like ibuprofen and aspirin, slightly increased during the same time period, suggesting a move toward non-opioid pain management strategies.
The study relied on data from claims of millions of commercially insured patients, with approximately 15 million to 20 million enrollees per year from 2007 to 2020. The article also addresses concerns about previous studies that compared states that had legalized cannabis to those that had not. Because of differences in timing, populations and other factors, these comparisons can’t always draw causal conclusions.
The present studies are among the first to test the relationship between legalized cannabis and opioid use using methods that can plausibly support causation.
“We were able to leverage the data we had access to in a way that shows the decrease in opioids happens across genders, across ages, across races, across socioeconomic demographics when medical cannabis is available as an alternative,” Lozano-Rojas said.
Those patient level characteristics remained unexplored until this article.
“Even those who do receive opioid prescriptions received less in situations when medical cannabis was available.”
It may be safer to use cannabis for chronic, acute pain than opioids
Prescription opioids like hydrocodone (brand name Vicodin), oxycodone (Oxycontin, Percocet) and morphine (Kadian) help manage pain. But the painkillers come with risks of addiction, overdose and even death. Rural areas were particularly hard hit and continue to face high rates of opioid abuse and use disorders.
To date, 39 states and Washington, D.C., have legalized medical cannabis for these patients and others with qualifying conditions. Almost half of all states (plus Washington, D.C.) also legalized recreational cannabis.
Pain patients are less likely to develop a substance use disorder to marijuana than opioids, the researchers said.
“It’s nuanced, but if you’re in a lot of chronic or acute pain, it may be safer to use cannabis than opioids, provided your physician recommends that as an appropriate course of treatment,” Lozano-Rojas said.
This study was co-authored by David Bradford and Amanda Abraham, of UGA’s Department of Public Administration and Policy, and Sumedha Gupta, an associate professor at Indiana University.
Cancer patients may benefit from greater access to cannabis
More than half of all cancer patients report experiencing pain during their health struggles.
The study focused on cancer patients due to the high volume of opioid prescriptions they receive for pain management. However, the findings extend beyond this population as the previous study showed.
The researchers also found greater reductions in opioid prescriptions when dispensaries opened than when medical cannabis was legalized. This finding suggests removing barriers to access may be key in swaying some individuals from opioids to cannabis.
The JAMA Health Forum study is among the first to draw a plausible causal relationship between the opening of dispensaries and a reduction in opioid prescriptions for cancer patients, a population that has remained understudied.
The study was co-authored by Victoria Bethel, David Bradford and Amanda Abraham, of UGA’s Department of Public Administration and Policy; Shelby Steuart, a doctoral graduate of UGA’s School of Public and International Affairs who is now an assistant professor at University of Maryland; and Sumedha Gupta, an associate professor at Indiana University.
Journal
JAMA Health Forum
Article Title
Cannabis Laws and Opioid Use Among Commercially Insured Patients With Cancer Diagnoses
Research hints at the potential of pain relief with CBD
University of Rochester Medical Center
video:
Del Monte Institute for Neuroscience at the University of Rochester | https://doi.org/10.1016/j.chembiol.2025.10.005
view moreCredit: Del Monte Institute for Neuroscience at the University of Rochester
Reaching for CBD-infused lotion or oil may seem like a low-risk way to find pain relief, but little is actually known about the impact that CBD has on the nervous system.
Over the past decade, the use of cannabis products for pain management has increased, in part because in 2018 Congress signed a law removing hemp from the federal Controlled Substances Act, thereby legalizing hemp-derived CBD. Today, it is most commonly found in oil form, as well as in lotions and cosmetics, and it is widely understood that CBD does not cause a ‘high’. However, what CBD does in the human body and brain is not well understood. Currently, the Food and Drug Administration has only approved CBD as an adjunctive treatment for certain forms of epilepsy, and it is not recommended for use during pregnancy.
“We need to understand more about this compound, what mechanisms it interacts with in the brain, its impact on the body, and whether it is a potentially safer solution for treating the chronic pain epidemic,” said Kuan Hong Wang, PhD, professor of Neuroscience and member of the Del Monte Institute for Neuroscience at the University of Rochester, whose lab in collaboration with researchers at Harvard Medical School and Boston Children’s Hospital, recently discovered that in mice, they could effectively deliver CBD to the brain for neuropathic pain relief with no adverse side effects. This research was published today in the journal Cell Chemical Biology.
Devising a Delivery Method
The first hurdle researchers had to cross was the blood-brain barrier. This part of our anatomy does an incredible job of keeping our brain healthy, as it essentially acts as a protective force field around the brain. Because of this barrier and the fact that CBD does not dissolve well in water, very little CBD reaches the brain when taken in its common oil form. Staff scientist Jingyu Feng, PhD, in the Wang Lab, and the first author of the study, helped develop the delivery mechanism: inclusion-complex-enhanced nano-micelle formulation or CBD-IN. CBD-IN is a method that encapsulates CBD molecules within nano-micelles or water-soluble spheres that are considered safe in food and drugs.
Researchers found that when CBD-IN was given to mice, it provided pain relief within 30 minutes, and with none of the common adverse side effects, like loss of movement, balance, or memory, that often occur when taking conventional pain drugs. “The pain relief also lasted through repeated use,” said Feng. “We did not see its effect wear off over time.”
Impact on the Brain
Using imaging and genetic mapping tools, researchers revealed that when CBD-IN is ingested by mice, it calms overactive nerve circuits in the areas of the brain and spinal cord responsible for sensing touch and pain. This calming effect only occurs where abnormal activation is present, like after a nerve injury. Importantly, CBD-IN does not affect healthy neurons.
Researchers were surprised to discover that the pain-relieving effect did not rely on the typical cannabinoid receptors (CB1 and CB2) that THC and other cannabis compounds target in the body. “Instead, CBD-IN seems to influence broader electrical and calcium signaling in nerve cells, offering a new way to control nerve hyperactivity without triggering the 'high' or dependency risks associated with traditional cannabinoids or opioids,” Feng said.
“The broader implication of this research is that nanotechnology can make natural compounds like CBD more effective and precise,” said Wang, co-senior author of this research. “By enhancing brain delivery and targeting only disease-related neural overactivity, this strategy could open new doors for treating chronic pain and possibly other neurological disorders, such as epilepsy or neurodegenerative diseases, where abnormal nerve activity plays a central role.”
This research was a collaboration between the University of Rochester, Harvard Medical School, and Boston Children’s Hospital. Other authors include Jessica Page, PhD, and Leeyup Chung, PhD, both co-first authors, and Zhigang He, PhD, co-senior author, of Harvard Medical School. The research was supported by the National Institutes of Health and the Del Monte Institute for Neuroscience.
Journal
Cell Chemical Biology
Article Title
Rapid suppression of neuropathic pain and somatosensory hyperactivity by nano-formulated cannabidiol
Article Publication Date
7-Nov-2025
University of Houston joins $21.2 million statewide effort to fight opioid crisis
College of Pharmacy examines HIV and opioid use disorder in Harris County to integrate prevention
University of Houston
image:
Dipali Rinker, University of Houston research associate professor and member of the Prescription Drug Misuse Education and Research (PREMIER) Center, is examining HIV and opioid use disorder to integrate treatment.
view moreCredit: University of Houston
Key takeaways:
- The University of Houston is part of a $21.2 million Texas effort to tackle the opioid epidemic by examining opioid use disorder among people living with HIV in Harris County and integrating prevention.
- Harris County has higher numbers of drug poisoning-related deaths due to commonly prescribed opiates, heroin, fentanyl and other synthetic opioids than any other public health region in the state.
- Of the approximately 1.2 million people living with HIV in the U.S., nearly twice as many are likely to misuse opioids as people not living with HIV.
HOUSTON, Nov. 11-- Continuing its national leadership in stemming the opioid crisis, the University of Houston is part of a $21.2 million effort across Texas fighting this public health emergency. The Texas Opioid Abatement Fund Council awarded 109 grants to entities that are working on solutions to the epidemic. These funds were made available through the Short-term Community-based Opioid Recovery Effort grant opportunity.
In fact, the money comes from opioid lawsuits.
The Texas Legislature formed the OAFC in 2021 to ensure money recovered through the joint efforts of the state and its political subdivisions from statewide opioid settlement agreements is allocated fairly and spent to remediate the opioid crisis using efficient, cost-effective methods.
HIV and opioid use disorder in Harris County
At the UH College of Pharmacy Dipali Rinker, research associate professor and member of the Prescription Drug Misuse Education and Research (PREMIER) Center, will use a $250,000 grant (the maximum individual grant award) to investigate HIV and opioid use disorder in Harris County, which includes the city of Houston.
The county has higher numbers of drug poisoning-related deaths due to commonly prescribed opiates, heroin, fentanyl and other synthetic opioids than any other public health region in the state. As of mid-2024, in Houston/Harris County, approximately 27,674 individuals are living with HIV, with over 1000 new HIV diagnoses annually, which is higher than both the state and national averages.
Researchers understand why people with HIV are more likely to have opioid use disorder.
“There are shared risk factors in both disease states with a high likelihood of pain among people living with HIV leading to opioid prescriptions,” said Rinker. “Then in seeking treatment for opioid use disorder, people living with HIV are more likely to experience stigma, social marginalization and discrimination due to their dual diagnosis.”
Intervention and prevention
Rinker will seek to determine the extent to which Screening, Brief Intervention, and Referral to Treatment (SBIRT) is implemented into the treatment of people living with HIV and opioid use disorder among patients engaged in treatment at one of five Ryan White-funded clinics in Houston/Harris County. Ryan White–funded clinics are health care providers and organizations that receive federal funding through the Ryan White HIV/AIDS Program, a U.S. federal initiative administered by the Health Resources and Services Administration (HRSA). SBIRT is a healthcare approach used to identify and help people who may be prone to drug or alcohol use before their problems become severe.
“SBIRT is an empirically supported framework for reducing substance misuse, but to date, there are no strategic initiatives in Houston/Harris County among people living with HIV engaged in care to better integrate SBIRT for opioid use disorder,” said Rinker. “We hope to develop a community of practice - a group of people who come together to create stronger academic-community partnerships to better screen, provide a brief intervention, and refer a person living with HIV to treatment for opioid use disorder.”
To do this, Rinker will collect data from patient records as well as from patients and providers through interviews and surveys.
“We need to understand both what prevents and enables them and their providers to seek treatment,” said Rinker, who added that integrating effective treatment for OUD is paramount for not only reducing harm related to substance use, but to improve HIV-related outcomes.
“The intersection of HIV and OUD can also worsen adherence to antiretroviral therapy. It is expected that at the end of this project we will have a comprehensive assessment of barriers and facilitators to implement SBIRT in HIV care,” she said.
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