Law Cannabis is not reducing opioid deaths

[WTF2008]

Contrary to sensationalized news reporting and public opinion, a study out of Stanford published a few days ago in the Proceedings of the National Academy of Sciences shows that legalization and broader access to cannabis has not has a positive effect on opioid overdose death rates. Legalized marijuana was actually associated with a 23% increase in overdose deaths.

I suspected the initial hype of the 2014 JAMA study was too good to be true. Many people were drawing causal conclusions based on ecological correlations.

Oh shit, it's Stanford. They published a few days ago?
Sounds like a thorough study.

 

[WTF2008]

Reversed? No. Opioid deaths rose regardless of cannabis laws.
The original study has more progressive states that had lower opioid deaths due to other factors unrelated to their cannabis laws.
You need only look at the graph to see opioid deaths rising in spite of cannabis being legalized in more and more places.

And even then, those original states were studied pre-full blown epidemic, so their numbers probably caved by 2017, too.

Again, I haven't read the original study's purpose, but it would be a fail if that were its main focus.
However, it does appear that it may have uncovered more nuanced data to suggest ways in which the states from the original study helped reduce opioid related deaths unrelated to cannabis.

You have to wait for the opioid addicts to die off before the numbers even out.
You're not unaddicting someone that has been taking some sweet ass morphine or higher.

You're preventing it by not giving it to them in the first place so the addiction never happens.

 

[Tycho- Taylor's Version]

Reversed? No. Opioid deaths rose regardless of cannabis laws.
The original study has more progressive states that had lower opioid deaths due to other factors unrelated to their cannabis laws.
You need only look at the graph to see opioid deaths rising in spite of cannabis being legalized in more and more places.

And even then, those original states were studied pre-full blown epidemic, so their numbers probably caved by 2017, too.

Again, I haven't read the original study's purpose, but it would be a fail if that were its main focus.
However, it does appear that it may have uncovered more nuanced data to suggest ways in which the states from the original study helped reduce opioid related deaths unrelated to cannabis.

The expectation was never that cannabis legalization would reverse the trend of opioid deaths rising, but that wasn't the trend of significance here anyway. Again, it's the relationship between death rates between two different sets of States.

Group A: medical MJ permitted.
Group B: medical MJ bant.

2014: Group A has a 25% lower rate of opioid overdose per capita than Group B.
2019: Group A has a 23% higher rate of opioid overdose per capita than Group B.

The original study suggested that your "more progressive states" may have a lower rate of opioid deaths because of the medical cannabis laws. The current study seems to suggest that relationship was spurious.

 

[Tycho- Taylor's Version]

^ further evidence in favour of this link came from a 2018 study, also in JAMA, that associated state implementation of medical marijuana laws with lower rates of opioid prescribing.

This may have been the one I was thinking about earlier @Lubaolong. Friday night me with wine doesn't differentiate between 2018 and 2014, apparently.

 

[Joe265]

Yea, whatever. This thread is too hard for you.

“Before it was lower, now it is higher” doesn’t mean shit. You have to isolate the cause still, not presume it was due to cannibus legalization.

 

[Anung Un Rama]

The expectation was never that cannabis legalization would reverse the trend of opioid deaths rising, but that wasn't the trend of significance here anyway. Again, it's the relationship between death rates between two different sets of States.

Group A: medical MJ permitted.
Group B: medical MJ bant.

2014: Group A has a 25% lower rate of opioid overdose per capita than Group B.
2019: Group A has a 23% higher rate of opioid overdose per capita than Group B.

If the expectation wasn't that cannabis laws would reverse opioid related deaths, then why include states that already had higher death rates prior to legalizing cannabis? Again, if you look at the death rates vs the increased legalization over the last 2 decades you wouldn't need this study to come to the same conclusion. It was probably still good to do because it provided more nuance to the epidemic, but the conclusion shouldn't shock anybody. you will only hear about this study from anti-cannabis/ pro-drug war outlets.

The original study suggested that your "more progressive states" may have a lower rate of opioid deaths because of the medical cannabis laws. The current study seems to suggest that relationship was spurious.

Yes, that is my conclusion as well. And I don't mean "progressive" in a left vs right way, only that it was progressive to legalize cannabis and those states had other factors, ie lower incarceration rates, that the study does suggest contributed to better outcomes.

 

[Madmick]

?

It's not about more deaths, it's the death rate in States with medical marijuana vs. without. Before it was lower. Now it's higher.

He's arguing correlation, not causation.

Nevertheless, I think AUR is misreading intent, because I don't think the purpose of the study's authors is to argue that medical/legalized marijuana is causing deaths from opioids. It's merely observing that it is doing nothing to stop it-- much less reverse it.

 

[Tycho- Taylor's Version]

If the expectation wasn't that cannabis laws would reverse opioid related deaths, then why include states that already had higher death rates prior to legalizing cannabis?

Because the effect of the legalization was what they were trying to measure. 10 states implemented laws within the study period.

Even if the rate isn't reversed, a change in the pace at which it increases can still be significant. I don't think anyone would assume that medical marijuana would be that forceful, just that it would make a difference in states where it was legalized relative to states where it wasn't.

Again, if you look at the death rates vs the increased legalization over the last 2 decades you wouldn't need this study to come to the same conclusion. It was probably still good to do because it provided more nuance to the epidemic, but the conclusion shouldn't shock anybody. you will only hear about this study from anti-cannabis/ pro-drug war outlets.

I mean, I guess you could look at mortality rates in each state individually and come to the same conclusion - the study sort of saves you the effort though. Plus it put some numbers around the potential effects of the legislation, and tracked how those numbers changed in the following years.

The graph you posted above doesn't let you do all that; it seemed to be missing the point. And the conclusion of the current study is only really shocking in the context of the old one (imo), and all we heard about it from *pro*-cannabis outlets. I'm sure this one will stir up the conversation some more.

 

[Tycho- Taylor's Version]

He's arguing correlation, not causation.

Nevertheless, I think AUR is misreading intent, because I don't think the purpose of the study's authors is to argue that medical/legalized marijuana is causing deaths from opioids. It's merely observing that it is doing nothing to stop it-- much less reverse it.

Right. It's in big bold letters in the STAT article.

“This isn’t to say that cannabis was saving lives 10 years ago and it’s killing people today. We’re saying these two things are probably not causally related.”

I think Anung mistook this sentence: "34 states have now legalized medical marijuana and the number of opioid overdose deaths was six times higher in 2017 than it was in 1999" as the purpose of the study, when it was only the purpose of re-running it now.

And for the record, it says pretty explicitly in the 2014 article that the association was only that, and proposed mechanisms are only speculative.

 

[tehJameson]

Wow marijuana didn't stop heroin addicts from dying wahhhh it shouldn't be legal.

Shut up retard.

 

[Anung Un Rama]

Because the effect of the legalization was what they were trying to measure. 10 states implemented laws within the study period

Even if the rate isn't reversed, a change in the pace at which it increases can still be significant. I don't think anyone would assume that medical marijuana would be that forceful, just that it would make a difference in states where it was legalized relative to states where it wasn't.


I mean, I guess you could look at mortality rates in each state individually and come to the same conclusion - the study sort of saves you the effort though. Plus it put some numbers around the potential effects of the legislation, and tracked how those numbers changed in the following years.

The graph you posted above doesn't let you do all that; it seemed to be missing the point. And the conclusion of the current study is only really shocking in the context of the old one (imo), and all we heard about it from *pro*-cannabis outlets. I'm sure this one will stir up the conversation some more.

We're just going to be talking in circles until I actually read the study. I'll try to get to it by Sunday. If you haven't then please do so we can bump this thread. I haven't even searched for it, is behind a paywall? @Lubaolong can you use your Cleveland Clinic connections to post the study in full here or our reading pleasure?

 

[Madmick]

Wow marijuana didn't stop heroin addicts from dying wahhhh it shouldn't be legal.

Shut up retard.

 

[Anung Un Rama]

He's arguing correlation, not causation.

Nevertheless, I think AUR is misreading intent, because I don't think the purpose of the study's authors is to argue that medical/legalized marijuana is causing deaths from opioids. It's merely observing that it is doing nothing to stop it-- much less reverse it.

Right. It's in big bold letters in the STAT article.

“This isn’t to say that cannabis was saving lives 10 years ago and it’s killing people today. We’re saying these two things are probably not causally related.”

I think Anung mistook this sentence: "34 states have now legalized medical marijuana and the number of opioid overdose deaths was six times higher in 2017 than it was in 1999" as the purpose of the study, when it was only the purpose of re-running it now.

And for the record, it says pretty explicitly in the 2014 article that the association was only that, and proposed mechanisms are only speculative.

I'm not suggesting anybody is suggesting that cannabis has lead to more deaths, only that opioid deaths are obviously independent of, and unaffected by, cannabis legalization. And I didn't need this study to tell me that, nor should anybody else in the medical field who has followed this epidemic. I've only read partial articles and not the full study so there might be an explanation for the study, but on its face I don't see how such a study is worth of Stanford.

edit: just seeing the full study is in the OP; thought it was a JAMA study so I didn't think it was so easily available.

okay, its just a simple meta analysis with a little bit of a deep dive in some areas -- just skimming gotta catch some zzzs.
yeah, its no big deal, they were on the same page as I was:

Given mounting deaths from opioid overdose, replicating the Bachhuber et al. (1) finding is a worthy task, especially in light of the changing policy landscape. Between 2010 and 2017, 32 states enacted medical cannabis laws, including 17 that allowed only medical cannabis with low levels of the psychoactive tetrahydrocannabinol (THC) and high levels of the nonpsychoactive component cannabidiol. Eight states enacted recreational cannabis laws during this period. Opioid overdose deaths have also increased dramatically over that time period (8).

 

[Madmick]

I'm not suggesting anybody is suggesting that cannabis has lead to more deaths, only that opioid deaths are obviously independent of, and unaffected by, cannabis legalization. And I didn't need this study to tell me that, nor should anybody else in the medical field who has followed this epidemic. I've only read partial articles and not the full study so there might be an explanation for the study, but on its face I don't see how such a study is worth of Stanford.

edit: just seeing the full study is in the OP; thought it was a JAMA study so I didn't think it was so easily available.

okay, its just a simple meta analysis with a little bit of a deep dive in some areas -- just skimming gotta catch some zzzs.
yeah, its no big deal, they were on the same page as I was:

Given mounting deaths from opioid overdose, replicating the Bachhuber et al. (1) finding is a worthy task, especially in light of the changing policy landscape. Between 2010 and 2017, 32 states enacted medical cannabis laws, including 17 that allowed only medical cannabis with low levels of the psychoactive tetrahydrocannabinol (THC) and high levels of the nonpsychoactive component cannabidiol. Eight states enacted recreational cannabis laws during this period. Opioid overdose deaths have also increased dramatically over that time period (8).

Except that it has been the subject of debate, as Luba pointed out in his OP, and it's been a widely popular argument around the web by marijuana legalization advocates. I know it was very popular on Facebook back in 2015/16 before I left. I support marijuana legalization, but I also don't like ignoring the truth when it isn't convenient to my causes.

I was personally optimistic that legal marijuana would help alleviate the problem, but the unrolling years have left me deflated as my hope hasn't appeared to materialize.

 

[Tycho- Taylor's Version]

FYI we're at a 12 per 100k opioid-related death rate here in Canada now too, as of 2018. Up from 8.4 just 2 years ago.

 

[Madmick]

FYI we're at a 12 per 100k opioid-related death rate here in Canada now too, as of 2018. Up from 8.4 just 2 years ago.

We Americans do love to export our culture.

Even the shittiest parts of it: for the past half century especially those parts.

 

[Deleted member 539235]

doing pharmaceuticals recreationally



get some snow up your snout ye fookin bums

 

[ElKarlo]

The preplanned use of all drugs and things that produce chemicals (serotonin) in our brains will give you an anticipation high (dopamine). It's an ACTH agonist so it produces a calming effect by stopping the reuptake during the negative feedback loop.

True, but from what I've read is that 90% of those that quit heroine end up smoking. It seems to hit the same spots and stimulates the brain in very similar ways

 

[nhbbear]

All of the arguments that state that weed will cure the opioid crisis are ridiculous. I deal with so many heroin addicts who also smoke weed, and it does nothing to curb their drug use.

 

[Anung Un Rama]

Except that it has been the subject of debate, as Luba pointed out in his OP, and it's been a widely popular argument around the web by marijuana legalization advocates. I know it was very popular on Facebook back in 2015/16 before I left. I support marijuana legalization, but I also don't like ignoring the truth when it isn't convenient to my causes.

I was personally optimistic that legal marijuana would help alleviate the problem, but the unrolling years have left me deflated as my hope hasn't appeared to materialize.

I get that now. I wasn't aware of the previous study, or how much it was cited.
I'm in healthcare, never heard of the study, and my initial reaction to this new study was 'but, why', because the epidemic and its statistics destroy any such argument.