Legalization of Cannabis Does Not Reduce Opioid Prescribing in Patients With Inflammatory Bowel Disease: A Difference-in-Difference Analysis

Mohamed Noureldin; Tony Van; Shirley Cohen-Mekelburg; Frank I Scott; Peter D R Higgins; Ryan W Stidham; Jason Hou; Akbar K Waljee; Jeffrey A Berinstein

doi:10.14309/ajg.0000000000002834

Legalization of Cannabis Does Not Reduce Opioid Prescribing in Patients With Inflammatory Bowel Disease: A Difference-in-Difference Analysis

Am J Gastroenterol. 2024 May 21. doi: 10.14309/ajg.0000000000002834. Online ahead of print.

Authors

Mohamed Noureldin¹, Tony Van², Shirley Cohen-Mekelburg^{1

2

3}, Frank I Scott⁴, Peter D R Higgins¹, Ryan W Stidham^{1

3

5}, Jason Hou^{6

7}, Akbar K Waljee^{1

2

3

8

9}, Jeffrey A Berinstein^{1

3}

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA.
² VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA.
³ Institute of Healthcare Policy and Innovation, University of Medicine, Ann Arbor, MI, USA.
⁴ Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
⁵ Department of Computational Medicine and Bioinformatics University of Michigan Ann Arbor, Michigan.
⁶ Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA.
⁷ Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, TX, USA.
⁸ Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA.
⁹ Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA.

PMID: 38767951
DOI: 10.14309/ajg.0000000000002834

Abstract

Introduction: Cannabis may provide inflammatory bowel disease (IBD) patients with an alternative to opioids for pain.

Methods: We conducted a difference-in-difference analysis using MarketScan. Changes over time in rates of opioid prescribing were compared in states with legalized cannabis to those without.

Results: We identified 6,240 patients with IBD in states with legalized cannabis and 79,272 patients with IBD in states without legalized cannabis. The rate of opioid prescribing decreased over time in both groups and were not significantly different (attributed differential = 0.34, confidence interval -13.02 to 13.70, P = 0.96).

Discussion: Opioid prescribing decreased from 2009 to 2016 among patients with IBD in both states with legalized and state without legalized cannabis, similar to what has been observed nationally across a variety of diseases. Cannabis legalization was not associated with a lower rate of opioid prescribing for patients with IBD.

Abstract

Grants and funding