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Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population

Overview of attention for article published in JAMA Internal Medicine, May 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#12 of 3,316)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

news
189 news outlets
blogs
11 blogs
twitter
447 tweeters
facebook
17 Facebook pages
googleplus
6 Google+ users
reddit
1 Redditor

Citations

dimensions_citation
31 Dimensions

Readers on

mendeley
82 Mendeley
Title
Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population
Published in
JAMA Internal Medicine, May 2018
DOI 10.1001/jamainternmed.2018.0266
Pubmed ID
Authors

Ashley C. Bradford, W. David Bradford, Amanda Abraham, Grace Bagwell Adams

Abstract

Opioid-related mortality increased by 15.6% from 2014 to 2015 and increased almost 320% between 2000 and 2015. Recent research finds that the use of all pain medications (opioid and nonopioid collectively) decreases in Medicare Part D and Medicaid populations when states approve medical cannabis laws (MCLs). The association between MCLs and opioid prescriptions is not well understood. To examine the association between prescribing patterns for opioids in Medicare Part D and the implementation of state MCLs. Longitudinal analysis of the daily doses of opioids filled in Medicare Part D for all opioids as a group and for categories of opioids by state and state-level MCLs from 2010 through 2015. Separate models were estimated first for whether the state had implemented any MCL and second for whether a state had implemented either a dispensary-based or a home cultivation only-based MCL. The primary outcome measure was the total number of daily opioid doses prescribed (in millions) in each US state for all opioids. The secondary analysis examined the association between MCLs separately by opioid class. From 2010 to 2015 there were 23.08 million daily doses of any opioid dispensed per year in the average state under Medicare Part D. Multiple regression analysis results found that patients filled fewer daily doses of any opioid in states with an MCL. The associations between MCLs and any opioid prescribing were statistically significant when we took the type of MCL into account: states with active dispensaries saw 3.742 million fewer daily doses filled (95% CI, -6.289 to -1.194); states with home cultivation only MCLs saw 1.792 million fewer filled daily doses (95% CI, -3.532 to -0.052). Results varied by type of opioid, with statistically significant estimated negative associations observed for hydrocodone and morphine. Hydrocodone use decreased by 2.320 million daily doses (or 17.4%) filled with dispensary-based MCLs (95% CI, -3.782 to -0.859; P = .002) and decreased by 1.256 million daily doses (or 9.4%) filled with home-cultivation-only-based MCLs (95% CI, -2.319 to -0.193; P = .02). Morphine use decreased by 0.361 million daily doses (or 20.7%) filled with dispensary-based MCLs (95% CI, -0.718 to -0.005; P = .047). Medical cannabis laws are associated with significant reductions in opioid prescribing in the Medicare Part D population. This finding was particularly strong in states that permit dispensaries, and for reductions in hydrocodone and morphine prescriptions.

Twitter Demographics

The data shown below were collected from the profiles of 447 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 82 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 82 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 15 18%
Student > Master 11 13%
Unspecified 10 12%
Student > Bachelor 9 11%
Student > Ph. D. Student 9 11%
Other 28 34%
Readers by discipline Count As %
Medicine and Dentistry 22 27%
Unspecified 21 26%
Social Sciences 7 9%
Nursing and Health Professions 6 7%
Biochemistry, Genetics and Molecular Biology 4 5%
Other 22 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 1916. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 January 2019.
All research outputs
#684
of 12,384,832 outputs
Outputs from JAMA Internal Medicine
#12
of 3,316 outputs
Outputs of similar age
#50
of 273,155 outputs
Outputs of similar age from JAMA Internal Medicine
#1
of 115 outputs
Altmetric has tracked 12,384,832 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,316 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 124.6. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,155 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 115 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.