Marijuana is a drug. This nobody can deny. Look: there it is—marijuana!—on the country’s Controlled Substances Act, the list of America’s most dangerous drugs.

But when they’re not being bad, drugs are also medicine. And, in the 28 states where medical cannabis is legal, so is marijuana. In those 28 states, something interesting happened over the past decade: sick people on Medicaid filled fewer prescriptions—so fewer prescriptions, that if medical marijuana were available in all 50 states, Americans would save more than $1 billion on Medicaid costs, according to a new study.

By now, it’s no secret that cannabis is useful for many of the ailments associated with aging and accompanying serious diseases including chronic pain and cancer (two common ailments for which the typical pharmaceutical cocktail prescribed by a doctor will include some kind of opiate).

Seeking to quantify the extent to which cannabis flower, CBD oil and other medical marijuana preparations may be supplementing or replacing outright prescription pharmaceuticals, researchers from Health Affairs studied prescription data from Medicaid programs in states between 2007 and 2014. And, in five out of the nine clinical categories examined, the authors found fewer prescriptions filled where cannabis was available. Far, far fewer prescriptions.

Specifically, the authors found “a 13 percent reduction for drugs used to treat depression, a 17 percent reduction for those used to treat nausea, 12 percent reductions for those used to treat psychosis and those used to treat seizure disorders, and an 11 percent reduction for drugs used to treat pain.”

“If all states had had a medical marijuana law in 2014, we estimated that total savings for fee-for-service Medicaid could have been $1.01 billion,” the authors wrote. “Our findings suggest that patients and physicians in the community are reacting to the availability of medical marijuana as if it were medicine.”

Of course, this study only parses data from health-care programs funded by Medicaid, the country’s low-income healthcare program (which, unless you are a military veteran, is about as close as America comes to a single-payer system). About 20 percent of Americans are on some form of Medicaid—which suggests that the total savings in prescription drug costs is several billions more.

Furthermore, as most marijuana advocates know, not every medical marijuana program is created equal. Reacting to a conception that medical marijuana was too easy to obtain—as compared to, you know, actually deadly drugs like Tylenol or opiates—many of the states that created medical marijuana programs in the past decade have strict lists of qualifying conditions and tightly controlled methods of access. This means, in some states such as New York, medical marijuana is next to impossible to obtain, despite being “legal.” Thus, it stands to reason that if cannabis were as simple to purchase as prescription or over-the-counter drugs, Medicaid would save even more.

This news, coming as it does at a vital time for Medicaid in America, is both good and bad. Marijuana’s number-one enemy in America is almost certainly Big Pharma—which, as this study shows, stands to lose much from widespread legal cannabis access. Fear over legal marijuana spurred Insys Therapeutics, a marketer of an overdose-inducing fentanyl-based drug that’s also working on a synthetic marijuana pill, to donate heavily to an anti-legalization campaign in Arizona. Those Medicaid dollars, spent on prescriptions, amount to a public subsidy to pharmaceutical companies. And in America, public support for private enterprise does not go away quietly.

Earlier in the year, House Republicans, led by Speaker Paul Ryan, attempted to cut $839 billion over the next 10 years from Medicaid. Nearly 75 million Americans rely on Medicaid, as Republican lawmakers were reminded at town-hall meetings across the country. The Medicaid bloodbath, part of the “repeal and replace” of Obamacare, failed spectacularly, but the risk hasn’t gone away.

It’s hard to tell from the Joycean exercise in free thought and word association that passed for a lengthy interview with the leader of the free world, but Donald Trump is apparently still interested in gutting Medicaid—if that’s what the congressional leaders to which he’s delegated the onerous task of fulfilling his own campaign promise want.

And they do. If there’s one thing Trump can listen to for more than a few seconds (other than friendly coverage on Fox and Friends), it’s money. And medical marijuana no doubt costs the country’s healthcare industrial complex serious money.

You can keep up with all of HIGH TIMES’ marijuana news right here.

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