Another important issue in the policy debate regarding marijuana legalization is the relationship between marijuana and opioid use. Evidence suggests that marijuana and/or cannabinoids can effectively mitigate some forms of pain or discomfort. It is an empirical question whether medical marijuana would allow those prescribed opioid analgesics to taper off or at least reduce the dose of their traditional pain medications (61). To our knowledge, no clinical trial evaluating the efficacy of cannabis or cannabinoids for chronic pain has shown that cannabis use allows patients to lower their dose of opioid analgesics. Also, cannabis use has traditionally been associated with an increased use of opioids (62). However, one recent study suggests that the passage of medical marijuana laws may be associated with a decrease over time in opioid overdose mortality compared to estimates of overdose mortality had these laws not been passed. Notably, states with medical marijuana laws have higher rates of age-adjusted opioid overdose mortality than do states without such laws (63). Further research is needed from epidemiological studies (to examine the relationship between the passage of medical marijuana
