# The Effect of Medical Cannabis Laws on Health Care Use in Insured Populations with Pain

> **NIH NIH R01** · UNIVERSITY OF GEORGIA · 2021 · $519,938

## Abstract

There is a nationwide recognition of the public health challenges arising from the incidence and
prevalence of chronic pain. In 2017, the National Academies of Sciences published a landmark
review of the literature and found conclusive evidence that cannabis can be an effective
treatment for chronic pain. To date, 31 states and the District of Columbia have adopted medical
cannabis laws (MCLs) legalizing either home cultivation or dispensary-based sales of cannabis
for qualifying medical conditions. However, little is known about substitution away from medical
treatment of pain when MCLs go into effect, or the impact such substitution has on other health
care utilization. The goal of the current study is to examine the association between MCLs and
health care utilization for patients with chronic non-cancer pain enrolled in public and private
insurance plans. Using the National Institutes of Health 2015 National Pain Strategy as an
organizational framework, we will conduct a retrospective, longitudinal, analysis of the difference
in prescription medication and pain-related health service utilization in a cohort of patients with
chronic pain in states with and without MCLs. In addition, we will conduct sub-analyses for
patients living in rural compared to urban areas, and will examine the relationship between
MCLs and health care utilization for patients with neuropathic versus nociceptive chronic pain.
We will analyze patient-level panel data measured quarterly. Data for this study will come from a
sample of privately insured individuals from the Health Care Cost Institute comprehensive
claims databases (N ≈ 40 million covered lives; 2015-2019) and two separate samples of
publically insured individuals from Medicare (N ≈ 5 million enrollees; 2011-2018) and Medicaid
(N ≈ 5 million enrollees; 2011-2017) claims databases. We will employ a series of difference-in-
differences regressions estimated separately for each of the insured groups. Our key policy
variables will be a measure of any implemented MCL, measures of implemented MCLs by type
(dispensary, home-cultivation-only, or THC oils). Individual patient characteristics, county and
state demographics, and a series of fixed effects at the state and quarter level will be used as
controls in all models. We will also control for policy endogeneity where necessary. Chronic pain
and the opioid epidemic are clear public health crises. Preliminary evidence suggests that
access to medical cannabis can alter prescription pain medication use. It is thus essential to
understand the relationship between MCLs and health care utilization for chronic pain patients
in order to optimize public policies and to provide guidance to clinical practitioners on likely
patient responses to MCL implementation.

## Key facts

- **NIH application ID:** 10172882
- **Project number:** 5R01DA047365-03
- **Recipient organization:** UNIVERSITY OF GEORGIA
- **Principal Investigator:** W David Bradford
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $519,938
- **Award type:** 5
- **Project period:** 2019-07-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10172882

## Citation

> US National Institutes of Health, RePORTER application 10172882, The Effect of Medical Cannabis Laws on Health Care Use in Insured Populations with Pain (5R01DA047365-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10172882. Licensed CC0.

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