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Prescription Opioid Distribution after the Legalization of Recreational Marijuana in Colorado. 2020

Amalie K Kropp Lopez, and Stephanie D Nichols, and Daniel Y Chung, and Daniel E Kaufman, and Kenneth L McCall, and Brian J Piper
Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, PA 18509, USA.

There have been dynamic changes in prescription opioid use in the US but the state level policy factors contributing to these are incompletely understood. We examined the association between the legalization of recreational marijuana and prescription opioid distribution in Colorado. Utah and Maryland, two states that had not legalized recreational marijuana, were selected for comparison. Prescription data reported to the Drug Enforcement Administration for nine opioids used for pain (e.g., fentanyl, morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone) and two primarily for opioid use disorder (OUD, methadone and buprenorphine) from 2007 to 2017 were evaluated. Analysis of the interval pre (2007-2012) versus post (2013-2017) marijuana legalization revealed statistically significant decreases for Colorado (P < 0.05) and Maryland (P < 0.01), but not Utah, for pain medications. There was a larger reduction from 2012 to 2017 in Colorado (-31.5%) than the other states (-14.2% to -23.5%). Colorado had a significantly greater decrease in codeine and oxymorphone than the comparison states. The most prevalent opioids by morphine equivalents were oxycodone and methadone. Due to rapid and pronounced changes in prescription opioid distribution over the past decade, additional study with more states is needed to determine whether cannabis policy was associated with reductions in opioids used for chronic pain.

UI MeSH Term Description Entries
D007880 Legislation, Drug Laws concerned with manufacturing, dispensing, and marketing of drugs. Drug Laws,Food, Drug and Cosmetic Act,Narcotic Laws,Drug Legislation,Drug Law,Law, Drug,Law, Narcotic,Laws, Drug,Laws, Narcotic,Narcotic Law
D008396 Maryland A state bounded on the north by Pennsylvania, on the east by Delaware and the Atlantic Ocean, on the south by Virginia and West Virginia, and on the west by West Virginia.
D010098 Oxycodone A semisynthetic derivative of CODEINE. Dihydrohydroxycodeinone,Oxiconum,Oxycodeinon,Dihydrone,Dinarkon,Eucodal,Oxycodone Hydrochloride,Oxycone,Oxycontin,Pancodine,Theocodin
D010818 Practice Patterns, Physicians' Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided. Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D002188 Cannabis The plant genus in the Cannabaceae plant family, Urticales order, Hamamelidae subclass. The flowering tops are called many slang terms including pot, marijuana, hashish, bhang, and ganja. The stem is an important source of hemp fiber. Bhang,Ganja,Hashish,Hemp,Cannabis indica,Cannabis sativa,Hemp Plant,Marihuana,Marijuana,Bhangs,Cannabi,Ganjas,Hashishs,Hemp Plants,Hemps,Plant, Hemp,Plants, Hemp
D003120 Colorado State bounded on the north by Wyoming and Nebraska, on the east by Kansas and Nebraska, on the south by New Mexico and Oklahoma, and on the west by Utah.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000701 Analgesics, Opioid Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS. Opioid,Opioid Analgesic,Opioid Analgesics,Opioids,Full Opioid Agonists,Opioid Full Agonists,Opioid Mixed Agonist-Antagonists,Opioid Partial Agonists,Partial Opioid Agonists,Agonist-Antagonists, Opioid Mixed,Agonists, Full Opioid,Agonists, Opioid Full,Agonists, Opioid Partial,Agonists, Partial Opioid,Analgesic, Opioid,Full Agonists, Opioid,Mixed Agonist-Antagonists, Opioid,Opioid Agonists, Full,Opioid Agonists, Partial,Opioid Mixed Agonist Antagonists,Partial Agonists, Opioid
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.

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