Legal Cannabis Reduces Prescription Codeine – Cannabis | weed | marijuana

States with legal recreational cannabis are seeing a drop in demand for prescription codeine, according to a new study led by researchers from the University of Pittsburgh and Cornell University.

Codeine is an opioid drug that binds to the opioid receptors in the brain and spinal cord. Like other opioids, it can cause physical and psychological dependence.

The authors concluded: “We find that RCLs [Recreational Cannabis Laws] lead to a reduction in the dispensing of codeine in retail pharmacies. Among the prescription opioids, codeine is the most commonly used non-medically. Therefore, the finding that RCLs appear to reduce codeine delivery is potentially promising from a public health perspective.”

In fact, it’s excellent news that people are swapping opioids for cannabis. But how early should we celebrate? This study was not a randomized control study. A two-way fixed-effects regression was used.

So what’s the verdict? Does legal cannabis reduce prescription codeine?

Cannabis & codeine: The methodology of the study

A two-way fixed effects regression is a statistical method that researchers use to analyze the relationship between two variables when both variables have fixed effects. “Fixed effects” means that the variables are not randomly assigned, but are inherent characteristics of the units under study.

In this example, the relationship between recreational cannabis laws and prescription codeine. This method is popular to control for unobserved heterogeneity in panel data studies. However, there are several disadvantages to using a two-way fixed effects regression in a study:

1. Complexity: Two-way fixed effects regressions can be more complex to estimate and interpret than other regression models, such as a one-sided model with fixed effects or a model with random effects.
2. Assumptions: Two-way fixed-effects regressions rely on certain assumptions about the underlying data, such as B. the independence of the errors and the normality. Regression results can be skewed or unreliable when researchers fail to meet these assumptions.
3. Bounded inference: Researchers typically use two-way fixed-effects regressions to estimate associations within units and to draw inferences about the population of units. It may not be possible to generalize the results to a larger population or to make causal claims.
4. Performance: Two-way fixed-effects regression is computationally intensive. Therefore, a large sample size may be required to have enough power to detect statistical significance. This could be a problem with limited data sets (but is irrelevant for this codeine and cannabis study).
5. Data availability: Two-way fixed effects regression requires panel data, which is a data type that contains observations on multiple units over time. This type of data may not be available for all research questions.

Researchers analyzed data from the Drug Enforcement Administration’s Automation of Reports and Consolidation Orders System (ARCOS).

Details of the study

If the results of this study are correct, this is certainly news worth celebrating. Researchers found that in states where cannabis was legal:

• A 26% reduction in pharmacy-based distribution of codeine, and even a 37% reduction after recreational cannabis laws have been in place for four years.
• Minimal impact on the distribution of other opioids such as oxycodone, hydrocodone and morphine in any setting.
• Minimal impact on codeine distribution by hospitals, which often have less permissive policies than pharmacies.

“This finding is particularly telling,” said senior author Coleman Drake, Ph.D., in a press release. “Among prescription opioids, codeine abuse is particularly high. Our results suggest that recreational cannabis use may be a surrogate for codeine abuse.”

“Increasing legal access to cannabis may move some users away from opioids and towards cannabis,” said Johanna Catherine Maclean, Ph.D., George Mason University. “While all substances carry certain risks, cannabis use is arguably less harmful than non-medical use of prescription opioids.”

Regardless of whether the study describes reality or confirms its bias, the conclusion should always be: legalize it.