Physicians wrote significantly fewer
prescriptions for painkillers and other medications for elderly and
disabled patients who had legal access to medical marijuana, a new study
finds.
In fact, Medicare saved more
than $165 million in 2013 on prescription drugs in the District of
Columbia and 17 states that allowed cannabis to be used as medicine,
researchers calculated.
If every state in the nation legalized medical
marijuana, the study forecast that the federal program would save more
than $468 million a year on pharmaceuticals for disabled Americans and
those 65 and older.
No health insurance, including Medicare,
will reimburse for the cost of marijuana. Although medical cannabis is
legal today in 25 states and the District of Columbia, federal law
continues to prohibit its prescription in all circumstances.
The
new study, published July 6 in Health Affairs, was the first to ask if
there’s any evidence that medical marijuana is being used as medicine,
said senior author W. David Bradford in a phone interview. The answer is
yes, said Bradford, a health economist and a professor at the
University of Georgia in Athens.
“When states turned on medical marijuana laws, we did see a rather substantial turn away from FDA-approved medicine,” he said.
Researchers
analyzed Medicare data from 2010 through 2013 for drugs approved by the
U.S. Food and Drug Administration (FDA) to treat nine ailments – from
pain to depression and nausea – for which marijuana might be an
alternative remedy.
They expected to
see fewer prescriptions for FDA-approved drugs that might treat the same
conditions as cannabis. Indeed, except for glaucoma, doctors wrote
fewer prescriptions for all nine ailments after medical marijuana laws
took effect, the study found.
The
number of Medicare prescriptions significantly dropped for drugs that
treat pain, depression, anxiety, nausea, psychoses, seizures and sleep
disorders.
For pain, the annual number of daily doses prescribed per physician fell by more than 11 percent.
“The results show that marijuana might be beneficial with diverting people away from opioids,” Bradford said.
A
2014 study found that opioid overdose death rates were on average
nearly 25 percent lower in states where medical marijuana was legal
compared to states where it remained illegal. Chronic or severe pain is
considered a primary indicator for medical marijuana in most states
where it is legal.
Nearly two million
Americans either abused or were dependent on prescription opioids in
2014, according to the U.S. Centers for Disease Control and Prevention
(CDC). Since 1999, more than 165,000 Americans have died from
prescription opioid overdoses.
Addiction
psychiatrist Dr. Kevin Hill questioned whether medical marijuana
patients might in some cases be getting inferior or incorrect treatment,
and if so, whether the resulting extra healthcare costs would
overshadow the Medicare drug savings. Hill, a professor at Harvard
Medical School in Boston, was not involved in the new study.
“Fewer
opioid prescriptions in medical marijuana states might be a good thing,
but I am concerned about the overall quality of care delivered in
medical marijuana specialty clinics,” he told Reuters Health in an
email.
He criticized the implementation
of medical marijuana laws in many states as often leading to “medical
care that is of poor quality.”
Part of the problem stems from a dearth of research into the efficacy of medical marijuana.
Although
California became the first state to legalize medical marijuana in
1996, federal law enacted by Congress in 1970 continues to put cannabis
in the same category as heroin, Schedule 1 of the Comprehensive Drug
Abuse Prevention and Control Act, and finds it has no medicinal value.
Consequently, research has been severely limited.
Sheigla
Murphy, a medical sociologist who was not involved in the current
study, praised it as a major contribution to the literature on the role
of medical marijuana in older adults.
Murphy
directs the Center for Substance Abuse Studies in San Francisco and has
done prior research on marijuana and baby boomers. She said some older
adults prefer marijuana to painkillers and sleeping pills.
“It
fits with the problems of older age, problems with sleeping,
depression, arthritis, worn-out body parts that begin to hurt. Marijuana
can relieve these without the side effects of grogginess and worrying
about addiction,” she said.
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