Medicare and Cannabis

Prescription painkillers have led to an opioid epidemic where opiate use and overdose is at an all time high in America. Studies show that 4 out of every 5 new heroin users began by first misusing prescription opioids. Deaths from opiate abuse and overdose have nearly quadrupled in the last 16 years.

There has been a lot of news lately generated by a study, which appeared in the medical journal Health Affairs, that measured the effects that legal medical marijuana may be having on the amount of prescriptions written for certain specific conditions as well as the cost savings for the medicare program due to a possible decrease in prescriptions filled. The study was conducted by a father-daughter team at the University of Georgia over a 3 year period from 2010 to 2013. The team narrowed their research to include only those ailments when an opiate would commonly be prescribed and when marijuana has also been recommended as a treatment. They included any opiate based prescriptions such as morphine and oxycodone that are commonly prescribed to treat conditions like pain, drugs that that are used to treat anxiety and depression as well as seizures and glaucoma. What they found was that, with the exception of glaucoma, prescription use for these conditions fell significantly during the 3 year period over which the study was conducted. They found that during this period doctors were writing fewer prescriptions for 8 different ailments; chronic pain, anxiety and depression, nausea, psychosis, seizures, sleep disorders and spasticity, all conditions where marijuana is known to have an effect.

Due to the fact that these numbers only fell in states that have medical marijuana programs, they were able to deduce that the decrease in opiate prescriptions was solely due to patients choosing medical marijuana as a safer alternative in their efforts to manage these types of conditions. The findings also confirmed that various other prescriptions that treat ailments where marijuana is not touted to be a treatment did not fall during this period, further proving that if a patient believes that marijuana is the best choice to manage their condition they will choose it if they are able.

The study was able to determine that this reduction in prescriptions written and/or filled saved Medicare over $165 million during the course of the 3 years in question. At that time only 17 states plus Washington, D.C. had medical marijuana programs. Based on these numbers, the researchers calculated that Medicare would have saved about $468 million on prescription drug costs if every state had a medical marijuana program, and while that number sounds enormous it only amounts to about  .5% of the spending budget for 2013. Medicare Part D is a multibillion dollar business.

There have been many studies that show that where medical cannabis laws are in effect there is a significantly lower mortality rate due to opioid overdose. In fact, it’s been shown that there is a 25% less incidence of opiate related overdose in states that have legalized medical marijuana. It could be argued that the use of marijuana to manage the types of conditions that would normally require an opiate based medication has saved lives.

Still, marijuana remains a Schedule 1 drug on the List of Controlled Substances. Which means it has a high potential for abuse, is deemed to be very harmful, and possesses “no possible medical value”. It shares court with such drugs as heroin, LSD, MDMA or Ecstasy, and Quaaludes.   

This study helps to lend to the opinion that the Schedule 1 status of marijuana is completely unwarranted. Obviously patients are using it to effectively treat their conditions in place of drugs that are opiate derivatives. These findings will likely lend credibility to the value of marijuana as a medical option for patients and possibly cause lawmakers to consider making medical marijuana available in the states where it is not yet legalized.

Keep in mind that just because Medicare isn’t paying for these drugs doesn’t mean nobody is. Because medical marijuana isn’t covered by insurance that means these patients were paying out of pocket for their medications. The cost of a regimen that would be required for ailments where medical marijuana would be recommended could be several hundred dollars a month. It’s not that you can look at this as a savings, but as a savings for whom. The fact that many Americans are willing to bypass their health insurance and reach into their own pockets to try a remedy speaks measures.

The fact that doctors are writing fewer prescriptions for opioid medications also means that pharmaceutical companies aren’t making that money….which won’t be tolerated for long. If the DEA were to decide to reschedule marijuana as a Schedule 2 drug it is likely that doctors would be able to actually prescribe it and programs such as medicare and medicaid would cover some of it. If  this were to happen there would still likely be a cost saving because frankly, the cost of medical marijuana is still less than many of the drugs usually prescribed for these types of conditions.

The cost savings for the public health end of the government coupled with the enormous income for the states and the nation through taxation of the industry makes for an interesting point to be considered and may actually entice lawmakers across the nation when faced with the decision of introducing legalization efforts in their respective states. The bigger take away, though, is the fact that where and when patients are able to, they are increasingly choosing medical marijuana as their drug of choice to try to manage their conditions safely and effectively. And they should have a choice. In the words of Ghandi, “When the people lead, the leaders will follow.”