Study finds decrease in opioid prescriptions, expenditure following cannabis legalization in Canada

U of T researchers say that cannabis legalization helped destigmatization of its use for pain management
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TORONTO — A recent study conducted by the University of Toronto, published January 25, found that the total number of opioid prescriptions and expenditure in Canada declined after recreational cannabis was legalized nationally on October 17, 2018.

According to the report, easy access to cannabis for pain relief may reduce opioid use for both public and private drug plans. The authors said the legalization of cannabis increased access to the plant drug and decreased the stigma associated with its use for pain management. 

The study examined the total opioid prescribing volumes and expenditures before and after cannabis legalization, using monthly claims of public and private payers from January 2016 to June 2019. 

In the study, researchers evaluated various drugs, including morphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, oxycodone, tramadol, and the non-opioids gabapentin and pregabalin. Claims data for gabapentin and pregabalin were examined separately.

As part of the study’s method, all the opioid volumes were converted to a mean morphine equivalent dose (MED)/claim, which is tantamount to a doctor’s prescription.

“Over the 42-month period, the mean MED/claim declined within public plans (p < 0.001),” according to the report. “However, the decline in MED/claim was 5.4 times greater in the period following legalization (22.3 mg/claim post vs. 4.1 mg/claim pre).”

The study also found total monthly opioid spending reduced drastically after cannabis legalization: dropping from C$267,000 to C$95,000.

The opioid crisis in Canada has wrought devastation on families and communities across the country, particularly the western provinces, Ontario, and Territories. According to data from the Government of Canada, there have been 17,602 apparent opioid toxicity deaths between January 2016 and June 2020. 

Middle-aged males continue to be the most impacted, comprising 73% of EMS responses for suspected opioid overdoses from January to June 2020.

The country has also seen an exacerbation of the opioid crisis since the pandemic, with 1,628 apparent opioid toxicity deaths between April and June 2020. According to the government website, this number represents “the highest quarterly count since national surveillance began in 2016.”

INN24 also covered the impact of Ontario’s state of emergency on opioid-related deaths.

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