El uso de cannabis disminuye la mortalidad por sobredosis de analgésicos opioideos un 33%

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El uso de cannabis disminuye la mortalidad por sobredosis de analgésicos opioideos un 33%

Notapor Fisio » Mié, 27 Ago 2014, 00:10

La muerte por sobredosis de analgésicos se reduce un 24,8% en los Estados que lo permiten. “En términos absolutos, los Estados con leyes de marihuana médica tuvieron unas 1.700 muertes menos por sobredosis de analgésicos opiáceos en 2010 de lo que se esperaría según las tendencias antes de que se aprobase la legislación”, señala Marcus Bachhuber, investigador de la Universidad de Pensilvania y líder del equipo que ha realizado el estudio. Aproximadamente el 60% de las muertes por sobredosis de analgésicos opiáceos se producen en pacientes con recetas legítimas para ellos.

"People already taking opioids for pain may supplement with medical marijuana and be able to lower their painkiller dose, thus lowering their risk of overdose."

Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010 ONLINE FIRST
Marcus A. Bachhuber, MD1,2,3; Brendan Saloner, PhD3,4; Chinazo O. Cunningham, MD, MS5; Colleen L. Barry, PhD, MPP3,6

Importance Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them.

Objective To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality.

Design, Setting, and Participants A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included.

Exposures Presence of a law establishing a medical cannabis program in the state.

Main Outcomes and Measures Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate.

Results Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (−19.9%; 95% CI, −30.6% to −7.7%; P = .002), year 2 (−25.2%; 95% CI, −40.6% to −5.9%; P = .01), year 3 (−23.6%; 95% CI, −41.1% to −1.0%; P = .04), year 4 (−20.2%; 95% CI, −33.6% to −4.0%; P = .02), year 5 (−33.7%; 95% CI, −50.9% to −10.4%; P = .008), and year 6 (−33.3%; 95% CI, −44.7% to −19.6%; P < .001). In secondary analyses, the findings remained similar.

Conclusions and Relevance Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. Further investigation is required to determine how medical cannabis laws may interact with policies aimed at preventing opioid analgesic overdose.


http://archinte.jamanetwork.com/article ... id=1898878

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