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Study: Medical marijuana may help rein in painkiller overdoses.

Study: Medical marijuana may help rein in painkiller overdoses.

by Dr. Steven J. Lipsky MD, FACEP

The legalization of medical marijuana has been sweeping the nation. As of June 2014, 23 states have legalized medical marijuana with several others pending legislation. Recent research has sparked a new debate over whether medical marijuana could be the answer to help stem the rising tide of prescription painkiller overdoses. In an article published by USA Today (8/25, Hughes), federal officials pointed out that prescription painkillers are among the most abused prescription medicines in the U.S., responsible for the deaths of more than 15,000 Americans annually

The study  published in the journal JAMA Internal Medicine received national media coverage in major newspapers and at least one prominent news agency. While several media outlets highlighted that states that have medical marijuana laws in place reported declining deaths due to opioid overdoses, others suggested more studies were needed, quoting experts who cautioned against drawing a direct causal link.

In August, the Washington Post (8/25, Millman) picked up the study in their “Wonkblog.” Research found that states with medical marijuana laws saw 24.8% fewer deaths from painkiller overdoses compared to states that didn’t have such laws. This translated into 1,729 fewer deaths than expected in 2010 alone, and an improvement in overdose rates with medical marijuana laws.

The Los Angeles Times (8/26, Healy) also reported on the study, highlighting the decline in deaths linked to opiate drugs after legalizing medical marijuana in 13 states. In fact, the study points outs that states with formal laws allowing legal medical marijuana experienced a steady drop in opiate-related overdoses, reaching, on average, that 33%, five and six years after the states’ medical marijuana laws were implemented.

In an email to Reuters (8/26, Doyle) lead author of the study, Dr. Marcus A. Bachhuber commented on the studying saying, “Most of the discussion on medical marijuana has been about its effect on individuals in terms of reducing pain or other symptoms. The unique contribution of our study is the finding that medical marijuana laws and policies may have a broader impact on public health.” Dr. Bachhuber and his team at the Philadelphia Veterans Affairs Medical Center, examined state medical marijuana laws and opioid overdose deaths using death certificate data from all 50 states from 1999 to 2010. While overdose deaths continued to fall in states with medical marijuana law, overdose deaths across the US rose sharply, from 4,030 in 1999 to 16,651 in 2010, according to data from the CDC.

ABC News (8/25, Zimmerman) also covered the story in its “Medical Unit” blog quoting that the researchers who conducted the new study suggest “that because legalizing medical marijuana makes it more available to chronic pain patients, it provides a potentially less lethal alternative to pain control on a long-term basis.”

The Boston Globe (8/25, Rice), however, wonders whether Massachusetts is an anomaly because in that state, where Gov. Deval Patrick (D) has “declared a ‘public health emergency,’ the number of deaths due to opioid overdoses has increased by 90 percent from 2000 to 2013.” The article notes that “voters legalized medical marijuana in a November 2012 ballot initiative.”

Criticism and skepticism surrounds the study, even from those closely tied to it. The strongest criticism of the study came from Kevin Sabet, director of the Drug Policy Institute at the University of Florida College of Medicine. In an interview with USA Today (8/25, Hughes) Sabet expresses his concerns about how the study’s authors collected and analyzed the data. “They failed to differentiate between states with strict and lax medical marijuana laws, and didn’t examine emergency-room admission and prescription data, and failed to see what impact methadone clinics might have had.” Sabet finds it hard to believe there has been such an across-the-board reduction in predicted deaths.

The study was also covered by CNN (8/26, Young), TIME (8/26, Sifferlin), Vox (8/26, Lopez), The Hill (8/26, Al-Faruque), Newsweek (8/26, Main), HealthDay(8/26, Thompson), Medscape (8/26, Anderson) and Modern Healthcare (8/26, Johnson, Subscription Publication).

Dr. Steven Lipsky

Steven J. Lipsky MD, FACEP has been a Board Certified Emergency Physician in Arizona for the last 41 years, and a resident of the Town of Paradise Valley for the last 40 years. He received his Doctor of Medicine degree from New York University School of Medicine and did post-graduate training in Family Practice at St. Joseph’s Hospital and Medical Center in Phoenix before going into the full-time practice of Emergency Medicine in 1975. Dr. Lipsky has worked in every type of Emergency Department in Arizona – from inner city and rural, small volume and large, public and private hospitals, teaching and nonteaching hospitals. He has taught at the Midwestern University Arizona College of Osteopathic Medicine – Division of Clinical Education, as well as in Kirksville College of Osteopathic Medicine Arizona. He has received the highest number of patient satisfaction letters in his group at multiple facilities and has been recognized at Paradise Valley Hospital for his outstanding performance. A past president of the Arizona College of Emergency Physicians (representing over 800 Emergency Physicians in our state) along with many other positions in the organization, Dr. Lipsky was also one of six Councillors representing Arizona to the National Council of the American College of Emergency Physicians. Dr. Lipsky built, owned, and was the Medical Director for the first 24hr free-standing Emergicenter and Advanced Life Support Ambulance Service in Jamaica. In conjunction with USAID, Cornell Medical Center’s School of Public Health, the Ministry of Health and Environmental Control of Jamaica, and the U.S. Peace Corps, he participated in a successful program to stem infant mortality in rural areas.

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