Recent research indicates a connection between recreational cannabis laws and reduced opioid fatalities, while medicinal laws link to the opposite.
The opioid crisis has deeply affected the United States in recent years, with a dramatic increase in overdose deaths involving opioids and benzodiazepines. As more states legalise both medical and recreational cannabis, researchers are investigating the potential impact of cannabis laws on opioid- and benzodiazepine-related deaths. In this blog post, we examine the surprising results and explore its implications for drug policy and public health considering the recent cannabis law reform in Thailand and the potential lessons for countries like Australia.
Recreational, not medicinal cannabis laws were associated with lower opioid deaths
The researchers examined the correlation between county-level rates of opioid- and benzodiazepine-related poisoning deaths and medical and recreational cannabis laws, including licensed cannabis dispensaries, across 49 US states from 2002 to 2020.
The study discovered that states with medical cannabis laws experienced rapid growth rates in all outcomes. However, implementing medical cannabis laws was associated with an increased rate of poisoning deaths linked to opioids, benzodiazepines, and combined opioid and benzodiazepine poisoning.
In contrast, states with medical cannabis dispensary sales saw a decrease in opioid-related deaths, but no significant change in benzodiazepine-related deaths.
Furthermore, the study found that recreational cannabis laws were associated with a lower incidence of opioid overdoses. The initiation of recreational cannabis dispensary sales consistently led to reduced rates of opioid, benzodiazepine, and combined opioid and benzodiazepine-related poisonings.
Removing California and Colorado from the analysis yielded similar outcomes, except for the increased risk in benzodiazepine- and opioid+benzodiazepine-related poisonings associated with the legalization of medical cannabis dispensaries, which changed from a null to a positive association. The strength of the correlation between policies permitting recreational cannabis dispensaries and opioid+benzodiazepines-related overdose deaths was more significant, but in the same direction
In conclusion, the study found that implementing medical cannabis laws was linked to higher rates of opioid- and benzodiazepine-related deaths, while introducing recreational cannabis dispensary sales consistently reduced opioid, benzodiazepine, and combined opioid and benzodiazepine-related poisonings.
Thailand’s Cannabis Law Reform: A Case Study
In June 2022, Thailand became a trailblazer in Southeast Asia by legalising cannabis, showcasing numerous benefits resulting from this policy shift. Adults can now grow and consume cannabis in food and beverages, a decision that has created new economic opportunities and revitalised the nation’s agricultural sector. This progressive legislation has also significantly impacted Thailand’s prison system, leading to the release of around 4,000 prisoners incarcerated on cannabis-related charges.
Thai Health Minister Anutin Charnvirakul, a driving force behind the new regulations, emphasised the intention to encourage small-scale cannabis farming to support the struggling agricultural sector. The public response was overwhelming, with over 1.1 million Thais applying for home cannabis cultivation licenses within a few months.
Though the Thai government insists on cannabis being utilised solely for medicinal purposes, the absence of specific regulations has created a legal grey area, inadvertently permitting recreational use as well. This ambiguity has spurred the rapid expansion of the cannabis industry, with over 4,100 cannabis-related businesses, such as cafes, restaurants, dispensaries, and head shops, emerging across the country. Furthermore, increased interest from tourists seeking cannabis products has played a crucial role in rejuvenating Thailand’s tourism industry to pre-pandemic levels.
The Case for Legalising Recreational Cannabis in Australia
Based on the study and Thailand’s experience, legalisaing cannabis in Australia could have the following benefits:
- Economic growth through new business opportunities and tax revenue.
- Reduced prison population and easing the burden on the criminal justice system (including cost to tax payers).
- Improved public health outcomes, with the study suggesting that recreational cannabis dispensary sales could be linked to lower rates of opioid and benzodiazepine-related poisoning deaths.
However, as Thailand’s experience demonstrates, concerns must also be addressed:
- The absence of accompanying guidelines and regulations is a concern for doctors who warn about the dangers of an unchecked drug industry.
- The legal gray area created by the new regulations in Thailand permits recreational use, but the government insists that cannabis should only be used for medicinal purposes.
- The lack of clear differentiation between medical and recreational use is a source of confusion, and there are concerns about possible misuse.
By learning from the Thailand and US implementation of cannabis laws, Australia is well-positioned to craft world leading reform that strikes a balance between public health and economic benefits. With all the information in the palm of their hands, Australian officials have no excuse for offering anything less than ground-breaking cannabis law reform.
References
Castillo-Carniglia, A., Rivera-Aguirre, A., Santaella-Tenorio, J., Fink, D. S., Crystal, S., Ponicki, W., … & Cerdá, M. (2023). Changes in opioid and benzodiazepine poisoning deaths after cannabis legalization in the US: a county-level analysis, 2002-2020. Epidemiology, 10-1097.