Legalizing recreational marijuana reduces demand for expensive prescription drugs through state Medicaid programs, according to an analysis by a Cornell researcher and collaborator.

When states legalize marijuana, the volume of prescriptions in drug classes that fit medical indications for pain, depression, anxiety, sleep, psychosis, and seizures drops dramatically, researchers found. .

Cornell Jeb E. Brooks School of Public Policy doctoral student Shyam Raman and Indiana University doctoral student Ashley Bradford conducted the research. Their paper, “Recreational cannabis legalizations associated with reductions in prescription drug use among Medicaid enrollees,” was published April 15 in the journal Health Economics.

Most research on cannabis has focused on the impact of medical marijuana on the demand for prescription drugs or the impact of the legalization of recreational use on the demand for opioids. This is one of the first studies to focus on the impact of legal personal cannabis on a wide range of prescription drugs.

“These findings have important implications,” Raman said. “The reductions in drug use we see could result in significant savings for state Medicaid programs. The findings also point to an opportunity to reduce the harm that can result from dangerous side effects associated with certain prescription drugs.

Raman and Bradford based their study on an analysis of data extracted from the Centers for Medicare and Medicaid Services in all 50 states from 2011 to 2019, a period that saw a growth in the number of states allowing the personal use of marijuana.

About 40 states have legalized medical marijuana which must be prescribed by a doctor. So far, about 20 states have legalized cannabis for personal use for all adults, but that number is likely to grow. In these states, Raman and Bradford found a significant change in demand for drugs used to treat sleep disorders and anxiety, but no real impact on drugs used to treat nausea.

Raman and Bradford warn that cannabis use is not inherently safe, noting the numerous studies that link it to a potential trigger for anxiety and psychoses such as schizophrenia. In addition, patients who use marijuana to treat their health problems may stop seeing their doctor and thus create discontinuities in primary care.

Jim Hanchett is assistant dean for communications and marketing at the Cornell Jeb E. Brooks School of Public Policy.