The impact of cannabis legislation on benzodiazepine and opioid use and misuse

Abstract

<abstract><sec> <title>Background</title> <p>Several have claimed that the overreliance on benzodiazepines for many approved and off-label uses poses substantial human and social consequences comparable to those observed with the opioid epidemic. In light of these problems, alternatives are required to properly manage patients. Numerous states now permit the use of medical cannabis to treat conditions, such as chronic pain, that were traditionally treated with benzodiazepines, opioids, or both. As patients and physicians seek alternative treatments, little is known about whether the presence of cannabis laws helps to alleviate the burdens caused by these more traditional medications owing to the displacement of benzodiazepines and/or opioids toward cannabis.</p> </sec><sec> <title>Methods</title> <p>Using data from multiple years of the National Survey on Drug Use and Health (2017, 2018, 2019), the effect of Medical Marijuana Laws (MMLs) on benzodiazepine and/or opioid use and misuse is examined while controlling for a variety of demographic characteristics. Supplemental analysis also is performed including the 2020 and 2021 survey years.</p> </sec><sec> <title>Results</title> <p>MMLs did not affect lone, legitimate benzodiazepine usage, but lower use of opioids and combinations of benzodiazepines and opioids was observed. MMLs appear to help attenuate benzodiazepine and/or opioid misuse to a substantial degree. Additional results suggest that the presence of an MML was related to annual, varying decreases in the use and misuse of benzodiazepines, opioids, and their combination across the years of data evaluated.</p> </sec><sec> <title>Conclusions</title> <p>MMLs may serve to attenuate the consequences of benzodiazepine, opioid, and their combined use and/or misuse to varying degrees.</p> </sec></abstract>