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Cannabis Legalization Linked To Lower Prescription Drug Use Among Medicaid Patients


Ben Taub

Freelance Writer

clockApr 20 2022, 12:18 UTC
Legal cannabis

Recreational cannabis is now legal in 18 states and the District of Columbia. Image: Adam Melnyk/

As the US mulls over the prospect of legalizing cannabis at the federal level, new research highlights the impact that state-level reforms have had on prescription drug use. After analyzing all Medicaid prescriptions over an eight-year period, researchers discovered that recreational cannabis legalization is associated with significant reductions in prescriptions for the treatment of pain, depression, anxiety, sleep disorders, psychosis, and seizures.

To date, 38 states and the District of Columbia (DC) have passed medical cannabis laws, while recreational consumption is legal in 18 states and DC. A number of previous studies have indicated that access to medical cannabis may be linked to lower rates of prescription opioid use, though little is known about the influence of fully legal weed on pharmaceutical uptake.


Writing in the journal Health Economics, the study authors explain that “since RCLs [recreational cannabis laws] impact the entire adult population within a state as opposed to only those with active medical cannabis cards, it seems plausible that the effect of RCLs on pharmaceutical drug utilization may be even greater than that of medical laws.” To investigate, they collected data on Medicaid prescriptions from all 50 states for every quarter-year between 2011 and 2019. Prior to this period, no US state had legalized recreational cannabis use.

Results indicated that states that joined the so-called green wave during this timeframe experienced major changes in prescription drug use. On average, recreational legalization was associated with a 12.2 percent reduction in Medicaid prescriptions for anxiety drugs, while scripts for anti-depressants and painkillers fell by 11.1 percent and 8 percent respectively.

Seizure medication prescriptions were also reduced by 9.5 percent, with antipsychotic use down 10.7 percent and sleep medication use falling by 10.8 percent. However, no changes in the use of drugs for nausea, spasticity or glaucoma were observed following legalization.

“These results have important implications,” write the researchers, adding that “the reductions in drug utilization that we find provide information about potential cost savings for state Medicaid programs.”


“The results also indicate a potential harm reduction opportunity, as pharmaceutical drugs often come with dangerous side effects or – as with opioids – potential for misuse,” they say.

However, while these figures indicate a move away from pharmaceutical drugs, the data doesn’t reveal whether or not patients are actually substituting these medications with cannabis, which makes it difficult to draw any firm conclusions on the power of weed to replace other drugs. Furthermore, the researchers point out that these results don’t provide any insights into patient wellness, and can’t therefore be used to determine if this trend away from pharmaceuticals is actually beneficial for people’s health.

Still, figures like these are sure to add weight to the argument for federal cannabis legalization, and could help to ensure that this 4/20 is one of the last of the prohibition era.

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