Madeline Grant, Business Development Manager, Management Science Associates, Inc.
Medical cannabis has many promising applications, including treating chronic pain. It can reduce or replace prescription opioids, thereby reducing overdoses and death rates. Cannabis is a Schedule 1 substance under the Controlled Substance Act. Due to its legal status, and the fact that it has a schedule 1, there have not been many clinical studies on its effectiveness as an adjunct or replacement therapy for opioids or the optimal dosage. Due to a lack of data and research, there is still uncertainty about the access that patients have to cannabis for pain relief and management. Limited research and data create uncertainty around the access of patients to cannabis for pain management. Management Science Associates, Inc. has decided to work with cannabis operators like Vireo Health to study the impact of cannabis on health outcomes for patients. These empirical data are crucial to enhancing our knowledge of cannabis usage.
MSA Health Study
MSA and Vireo Health of Minnesota teamed up to conduct a study of a unique nature for Minnesotans who are enrolled in state-funded medical programs. We studied several hundred Vireo customers in eight Vireo dispensaries located across Minnesota. MSA’s de-identification technology revealed that eight Minnesota dispensaries reduced the legal opioid consumption of their customers by 30% on average. An extensive analysis revealed that, on average these customers consumed 115mg of morphine-equivalent (MME) each month in addition to their original cannabis purchase. This figure dropped to 80 MME/month during the cannabis consumption period, a 30% reduction. After customers had completed their last cannabis purchase, the opioid prescriptions returned to a higher level. Individual circumstances may dictate specific medication use, but aggregating the data across a larger cohort can reveal trends.
After establishing that cannabis could reduce opioid use in this data set, we looked at additional contributing factors to find out which patients were most successful. MSA’s de-identification software was used to match cannabis purchases with prescription records, while maintaining confidentiality. Understanding the relationship between cannabis purchase trends and medical outcomes can be extremely valuable when making informed decisions regarding dosing or connecting customers with products that best meet their needs. There is less information about cannabis than there is about traditional pharmaceuticals due to the limited amount of clinical research, randomized control studies in particular, in the United States. These studies are essential to gathering credible data to help medical patients purchase and consume the right products and dosage.
Continued Results from the MSA and Vireo Health Study
The impact of cannabis on opioid prescribing is different in different age groups. The average opioid prescription dropped by 35% for those under 45 years old, and 47% for those between 45 and 64. The elderly, who tend to be the ones with the most opioid prescriptions, did not see a significant drop in their opioid prescriptions during this time period. Men and women had small differences. Women took more opioids on prescription, but their percentage of use decreased when they started buying cannabis.
This may be due to the fact that different demographic groups have different preferences for cannabis. Table below shows the percentages of spending on cannabis by gender or age. The table below shows that younger customers tend to spend more money on vape cartridges and men tend to spend more money on flower.
There does not appear to be a significant correlation between the amount of THC that was purchased and the reduction in opioid prescriptions. The amount of THC purchased by patients who reduced their opioid prescriptions varied widely, but on average they bought 418 mg per month. Those with no reduction in opioid prescriptions bought an average of 563mg of THC each month. Those who reduced their opioids showed a preference for cannabis products that had a high ratio THC:CBD. They spent over 70% of their cannabis budgets on products that had a ratio 19:1 and higher.
We also looked at the relationship between cannabis forms and decreases in opioid prescriptions. It is interesting to see how patients are divided based on whether they only buy one type of cannabis, or if they try out many products in order to find the right product for them. Patients who spent more than 60% of their cannabis budget on a single form had an average 16% decrease in their opioid prescriptions. Patients who focused less on one form experienced an average 44% decrease. This analysis shows that customers who purchase many forms of cannabis tend to use cannabis for longer periods. The average time between the first and last cannabis purchase for customers who purchased one or two types of cannabis was 136 days. Three or four cannabis forms were consumed by customers on average in 342 days. Customers who tried five forms or more of cannabis averaged 833 day.
Grouping patients according to their preferred cannabis form is another way to determine the effectiveness of cannabis. Customers who spend the majority of their cannabis budgets on capsules experienced a 63% decrease in opioids, while those who prefer tablets experienced a 34% reduction. Customers who bought mainly vape products, the most popular type of cannabis in these dispensaries, saw a decrease of 28%. However, they did not return to their previous levels as quickly after stopping purchasing cannabis. These analyses are statistically less significant due to the small numbers of customers within each group.
Next steps
These preliminary findings, while intriguing, highlight the need for more research. MSA will continue looking at cannabis customers from multiple states where different products are available. This could either confirm our findings or reveal some interesting differences among customers in different markets. The findings about the preferred cannabis forms would become more significant if we looked at a larger number of customers. This would help future customers find the best products for them. MSA will work with cannabis companies and healthcare professionals to continue conducting studies. MSA also plans to continue sharing reliable data to the cannabis industry.
We’d love to know if you want to learn more about MSA or become a leader in medical marijuana research. Makeline Grant can be reached at mgrant@msa.com for an introductory phone call.
Leading research initiatives with Vireo Health Leads research initiatives alongside Vireo Health first appeared on The National Cannabis Industry Association.
