The development of the opioid crisis: Interview with Li Guohua, editor-in-chief of Injury Industries

Title: State marijuana laws and opioid overdose mortality
Journal:
Stanford Chihuri and Guohua Li
Published: 2019/09/02
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The opioid crisis has claimed more than 500,000 lives in the United States since 1996. In a follow-up interview, Li Guohua
editor-in-chief of BMC's journal, discussed the origins and recent developments of the epidemic.。 The opioid crisis is an increase in unusual and large-scale opioid overdoses, largely based on the number of deaths from opioid overdoses in the United States. The origins of this crisis date back to the advent of the prescription opioid painkiller Oxcondzen in 1996, and have been developing over the years. The crisis was initially caused by prescription opioids and later developed into prescription heroin and synthetic fentanine and its analogo. Since 2016, stimulant drugs such as cocaine and methamphetamine have become new drivers. So from now on we should call this crisis a "drug overdose crisis" rather than an "opioid crisis".
man-made public health crisis has claimed more than 500,000 lives in the United States since 1996. Although it occurs mainly in the United States, deaths from drug overdoses have also risen sharply in many other countries, including Canada and the United Kingdom, over the past decade.U.S. federal government declared a national public health emergency in October 2017 because of the increasing incidence and spread of drug overdose-related diseases. The announcement made controlling the opioid crisis a national priority, promoted the development and implementation of a comprehensive national response plan, and helped mobilize communities, government agencies, hospitals, schools, businesses and other sectors of society to contain the crisis. Over the past two years, the federal government has allocated more than 100We must bear in mind that the evidence base is currently quite weak, with only a few studies specifically assessing the impact of marijuana legalization on opioid-related harm, with different results. The rapidly evolving opioid crisis makes it particularly challenging to clearly identify the impact, if any, of state marijuana policies from the effects of other interventions implemented simultaneously by state and local communities. Legalizing marijuana for medical use is unlikely to have a significant impact on the opioid crisis at the population level, as the law covers only a small number of individuals with specific medical conditions. As more and more states begin legalizing recreational marijuana, research in the coming years will help answer that question more clearly., opioids are used as painkillers and sedatives.
high doses of opioids can induce respiratory suppression and lead to death. Our study shows that opioid use has increased by more than 700 percent among drivers with fatal injuries over the past 20 years, and the use of opioids has doubled the risk of fatal crashes among drivers., there has been a significant increase in deaths from overdoses of excitable drugs such as cocaine and methamphetamine since 2016. In addition, combined drug use (i.e., the use of two or more drugs at the same time) is also increasing. For example, about 40 percent of drivers who tested positive for marijuana also had elevated blood alcohol levels. In fact, cannabis cocktails are becoming increasingly popular in bars and clubs. The synergy of multiple drugs makes these beverages particularly dangerous. Unfortunately, these products are largely unregulated.。 The opioid epidemic in the United States is a national public health crisis. In recent years, marijuana legalization has been increasingly adopted by state governments as a policy intervention to control the opioid epidemic under the premise that marijuana and opioids are substitutive substances. The purpose of this systematic review is to synthesize the empirical evidence regarding the impact of state marijuana laws on opioid overdose mortality and other opioid-related health outcomes.。 A comprehensive search of the research literature in 18 bibliographic databases returned 6640 records, with 5601 abstracts reviewed, 29 full text articles screened for eligibility, and 16 eligible studies included in the systematic review. Comprehensive Meta-Analysis software was used to generate summary estimates, forest plots, funnel plots, and heterogeneity statistics.。 Of the 16 eligible studies, 4 assessed the association of state marijuana law status with opioid overdose mortality, 7 with prescription opioids dispensed, and the remaining with nonmedical use and opioid-related hospitalizations. Random effects modeling based on pooled data revealed that legalizing marijuana for medical use was associated with a statistically non-significant 8% reduction in opioid overdose mortality (95% confidence interval: − 0.21 to 0.04; p = 0.201) and a 7% reduction in prescription opioids dispensed (95% confidence interval: − 0.13 to − 0.01; p = 0.017). Legalizing marijuana for recreational use was associated with an additional 7% reduction in opioid overdose mortality in Colorado and 6% reduction in opioid prescriptions among fee-for-service Medicaid and managed care enrollees.。 Legalizing marijuana might contribute to a modest reduction in opioid prescriptions. Evidence about the effect of marijuana legalization on opioid overdose mortality is inconsistent and inconclusive. If any, the effectiveness of state marijuana laws in reducing opioid overdose mortality appears to be rather small and limited to states with operational marijuana dispensaries. It remains unclear whether the presumed benefit of legalizing marijuana in reducing opioid-related harms outweighs the policy's externalities, such as its impact on mental health and traffic safety.
(Source: Science.com)