From the March 2025 Healer webinar | Image Credit: © Healer.com
On March 19, 2025, Dustin Sulak, DO, founder of Healer, a cannabis education and product resource, presented an analysis and discussion of five studies examining the various effects of cannabis policies in the US. The webinar was open to all audiences, but could be particularly useful for advocates, Dr. Sulak explained.
The first study presented, “Highs and Lows: A Mixed-Methods Analysis of the Impact of Adult Use Legalization on Medical Cannabis Patients,” was published in November 2024 in the Journal of Psychoactive Drugs. This online survey tested the hypothesis that recreational cannabis laws negatively impact medical cannabis programs in terms of cost and specific products. A total of 505 participants in medical cannabis programs were surveyed on product access, therapeutic efficacy, and more. As a sample of some responses, most responded agreed that after adult use laws passed, it was easier to find products and they were satisfied with the state’s medical use program, and few responded they could no longer access the same products. Prices of products were seen to increase, and about 18% of patients said they did not renew their card, with cost being one reason. “I’m glad to hear that a lot of people feel like they have better access and better efficacy after adult use,” Dr. Sulak stated. “This might be less of a problem than I thought it was.”
The next study, “Recreational Cannabis Laws and Fills of Pain Prescriptions in the Privately Insured,” was published in Cannabis in January 2025. Noting that there was evidence associating cannabis legalization with a decrease in opioid prescriptions, this study aimed to see if patients were using cannabis to treat pain with other medications or alone. Though the study did not measure direct substitution, one of the results was that opioid prescriptions decreased by 13%. “This is just more evidence that more cannabis equals less opioids,” Dr. Sulak noted. “The public health impact of cannabis prohibition has caused so many harms to our society. The other question is, what else does legalization of cannabis impact? If it’s helping so much with this opioid problem, how many other problems that we might not typically consider could it be helping with?”
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Is Cannabis a Solution to the Opioid Crisis? This research overview analyzes how even though the impact of cannabis on chronic pain and opioid reduction remains evident, limitations exist and flaws in methodologies in ecological studies complicate conclusions.
The next study discussed was, “Using Penalized Synthetic Controls on Truncated Data: A Case Study on Effect of Marijuana Legalization on Direct Payments to Physicians by Opioid Manufacturers,” which was published in November 2024 in Journal of the American Statistical Association. “These authors suggested that in response to cannabis availability for pain management, opioid manufacturers are likely to adjust their push marketing strategies to interact with physicians,” Dr. Sulak summarized. “One of the most common practices to facilitate interactions in pharmaceuticals, is through what they call direct payments to physicians from opioid manufacturers, such as consulting and speaking fees, conference travel reimbursements and meal vouchers.” The study authors examined data over three years on 15 opioid brands from five manufacturers that physicians were receiving payments for. The researchers found a significant decrease in payments due to the passage of medical cannabis laws, which made cannabis an available substitute. “It just shows us how precise and strategic these companies are,” Dr. Sulak stated. He discussed the motives behind the manufacturers spending less money in certain markets. “If this was a deliberate retreat, which it sure looks like, this means that the opioid manufacturers perceive cannabis as a superior substitute, right? If they thought that their product was better, if they thought that patients and doctors were more likely to like and benefit from their product, then they probably wouldn’t have retreated.”
Lastly, Dr. Sulak discussed cannabis policy and parenting. The first study, a preprint article, “Trends in Daily Cannabis Use and Cannabis Use Disorder Among Parents in the U.S., 2012-2023,” analyzed data from the National Survey on Drug Use and Health. Cannabis use among parents has increased, specifically, rates of daily or near-daily use have tripled since 2012, with alcohol use remaining relatively the same, the researchers found. “To these researchers, it highlighted the need for more research on how cannabis use affects parenting, and I think that’s a relevant question,” Dr. Sulak stated. “This is another seldomly considered negative impact of prohibition. It’s broken the chain of this longitudinally passed along information about how to use this substance in a safe and healthy way. Because the prohibition took it out of the conversation. It took it out of the media for the most part, what you end up having are a lot of kids that are clueless about how to use cannabis in a healthy way.”
Additionally, Dr. Sulak discussed the retrospective cohort study, “Prenatal cannabis exposure and the risk of subsequent maltreatment,” which was published in December 2024 in Child Abuse & Neglect. This study examined racial bias in newborn drug testing, and associations between THC exposure and subsequent child maltreatment. Out of 35,437 live births, analysis showed that Black and multiracial newborns were significantly more likely to be drug tested at birth. Additionally, a positive THC only test was not associated with an increased likelihood of maltreatment. “Child Protective Service investigations can be stressful and traumatic for families,” Dr. Sulak stated. “But the investigations themselves are harmful, and so they should only commence with evidence that the health and safety of the child is at risk, and a drug test does not provide that evidence. A drug test is not a parenting test.”
This month’s healer webinar explored how recent cannabis policies impact patients, parents, and more. Read More
