By Ashley Bradford
In states the place each medical and leisure marijuana are authorized, fewer sufferers are filling prescriptions for medicines used to deal with nervousness. That’s the important thing discovering of my current examine, printed within the journal JAMA Community Open.
I’m an utilized coverage researcher who research the economics of dangerous behaviors and substance use inside the USA. My collaborators and I needed to grasp how medical and leisure marijuana legal guidelines and marijuana dispensary openings have affected the speed at which sufferers fill prescriptions for anti-anxiety medicines amongst individuals who have personal medical insurance coverage.
These embrace:
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Benzodiazepines, which work by growing the extent of gamma-aminobutyric acid, or GABA, a neurotransmitter that elicits a chilled impact by lowering exercise within the nervous system. This class consists of the depressants Valium, Xanax and Ativan, amongst others.
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Antipsychotics, a category of drug that addresses psychosis signs in quite a lot of methods.
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Antidepressants, which relieve signs of melancholy by affecting neurotransmitters comparable to serotonin, norepinephrine and dopamine. Essentially the most well-known instance of those is selective serotonin re-uptake inhibitors, or SSRIs.
We additionally included barbiturates, that are sedatives, and sleep medicines – generally referred to as “Z-drugs” – each of that are used to deal with insomnia. In distinction to the opposite three classes, we didn’t estimate any coverage impacts for both of all these medicine.
We discover constant proof that elevated marijuana entry is related to reductions in benzodiazepine prescription fills. “Fills” check with the variety of prescriptions being picked up by sufferers, relatively than the variety of prescriptions docs write. That is based mostly on calculating the speed of particular person sufferers who crammed a prescription in a state, the typical days of provide per prescription fill, and common prescription fills per affected person.
Notably, we discovered that not all state insurance policies led to comparable adjustments in prescription fill patterns.
Why It Issues
In 2021, practically 23% of the grownup U.S. inhabitants reported having a diagnosable psychological well being dysfunction. But solely 65.4% of these people reported receiving therapy inside the previous 12 months. This lack of therapy can exacerbate present psychological well being issues, resulting in elevated threat for extra continual situations.
Marijuana entry introduces an alternate therapy to conventional prescription treatment that will present simpler entry for some sufferers. Many state medical legal guidelines permit sufferers with psychological well being issues comparable to post-traumatic stress dysfunction, or PTSD, to use medical hashish, whereas leisure legal guidelines increase entry to all adults.
Our findings have essential implications for insurance coverage programs, prescribers, policymakers and sufferers. Benzodiazepine use, like opioid use, could be harmful for sufferers, particularly when the 2 lessons of medication are used collectively. Given the excessive stage of opioid poisonings that additionally contain benzodiazepines – in 2020, they made up 14% of whole opioid overdose deaths – our findings provide insights into potential substitution with marijuana for medicines the place misuse is believable.
What Nonetheless Isn’t Identified
Our analysis doesn’t make clear whether or not the adjustments in allotting patterns led to measurable adjustments in affected person outcomes.
There’s some proof that marijuana acts as an efficient nervousness therapy. If so, transferring away from benzodiazepine use – which is related to vital unfavorable unwanted side effects – towards marijuana use could enhance affected person outcomes.
This discovering is essential on condition that about 5% of the U.S. inhabitants is prescribed benzodiazepines. Substituting marijuana has the potential to end in fewer unfavorable unwanted side effects nationwide, however it’s not but clear if marijuana will probably be equally efficient at treating nervousness.
Our examine additionally discovered proof of a slight – albeit considerably much less vital – enhance in antipsychotic and antidepressant allotting. But it surely’s not clear but whether or not marijuana entry, notably leisure entry, will increase charges of psychotic issues and melancholy.
Whereas we discovered that, total, marijuana entry led to elevated antidepressant and antipsychotic fills, some particular person states noticed decreases.
There’s loads of variation within the particulars of state marijuana legal guidelines, and it’s potential that a few of these particulars are main to those significant variations in outcomes. I imagine this distinction in outcomes from state to state is a vital discovering for policymakers who could wish to tailor their legal guidelines towards particular objectives.
Ashley Bradford, PhD, is an Assistant Professor of Public Coverage on the Georgia Institute of Know-how. Her analysis focuses on how public insurance policies form well being outcomes inside the USA.
This text initially appeared in The Dialog and is republished with permission.
