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The Effects Of Recreational Marijuana Legalization And Dispensing On Opioid Mortality

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  • Nathan W. Chan
  • Jesse Burkhardt
  • Matthew Flyr

Abstract

This study documents how the changing legal status of marijuana has impacted mortality in the United States over the past two decades. We use a difference‐in‐difference approach to estimate the effect of medical marijuana laws (MML) and recreational marijuana laws (RML) on fatalities from opioid overdoses, and we find that marijuana access induces sharp reductions in opioid mortality rates. Our research corroborates prior findings on MMLs and offers the first causal estimates of RML impacts on opioid mortality to date, the latter of which is particularly important given that RMLs are far more expansive in scope and reach than MMLs. In our preferred econometric specification, we estimate that RMLs reduce annual opioid mortality in the range of 20%–35%, with particularly pronounced effects for synthetic opioids. In further analysis, we demonstrate how RML impacts vary among demographic groups, shedding light on the distributional consequences of these laws. Our findings are especially important and timely given the scale of the opioid crisis in the United States and simultaneously evolving attitudes and regulations on marijuana use. (JEL I18, K32, H75)

Suggested Citation

  • Nathan W. Chan & Jesse Burkhardt & Matthew Flyr, 2020. "The Effects Of Recreational Marijuana Legalization And Dispensing On Opioid Mortality," Economic Inquiry, Western Economic Association International, vol. 58(2), pages 589-606, April.
  • Handle: RePEc:bla:ecinqu:v:58:y:2020:i:2:p:589-606
    DOI: 10.1111/ecin.12819
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    Cited by:

    1. Mathur, Neil K. & Ruhm, Christopher J., 2023. "Marijuana legalization and opioid deaths," Journal of Health Economics, Elsevier, vol. 88(C).
    2. Marinello, Samantha & Powell, Lisa M., 2023. "The impact of recreational cannabis markets on motor vehicle accident, suicide, and opioid overdose fatalities," Social Science & Medicine, Elsevier, vol. 320(C).
    3. Thanh Lu, 2021. "Marijuana legalization and household spending on food and alcohol," Health Economics, John Wiley & Sons, Ltd., vol. 30(7), pages 1684-1696, July.
    4. Johanna Catherine Maclean & Keshar M. Ghimire & Lauren Hersch Nicholas, 2021. "Marijuana legalization and disability claiming," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 453-469, February.
    5. Beth Ann Griffin & Megan S. Schuler & Elizabeth A. Stuart & Stephen Patrick & Elizabeth McNeer & Rosanna Smart & David Powell & Bradley Stein & Terry Schell & Rosalie Liccardo Pacula, 2020. "Variation in Performance of Commonly Used Statistical Methods for Estimating Effectiveness of State-Level Opioid Policies on Opioid-Related Mortality," NBER Working Papers 27029, National Bureau of Economic Research, Inc.
    6. Coleman Drake & Jiebing Wen & Jesse Hinde & Hefei Wen, 2021. "Recreational cannabis laws and opioid‐related emergency department visit rates," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2595-2605, September.
    7. Mir M. Ali & Chandler McClellan & Ryan Mutter & Daniel I. Rees, 2023. "Recreational marijuana laws and the misuse of prescription opioids: Evidence from National Survey on Drug Use and Health microdata," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 277-301, February.
    8. Carrieri, Vincenzo & Madio, Leonardo & Principe, Francesco, 2020. "Do-It-Yourself medicine? The impact of light cannabis liberalization on prescription drugs," Journal of Health Economics, Elsevier, vol. 74(C).
    9. Sabia, Joseph J. & Dave, Dhaval & Alotaibi, Fawaz & Rees, Daniel I., 2024. "The effects of recreational marijuana laws on drug use and crime," Journal of Public Economics, Elsevier, vol. 234(C).
    10. Calkins, Lindsay N. & Ryan, Alexander J. & Zlatoper, Thomas J., 2023. "The Political Economy of Recreational Marijuana Laws in the U.S.: A Spatial Approach," Journal of Regional Analysis and Policy, Mid-Continent Regional Science Association, vol. 53(1), April.
    11. Anderson, D. Mark & Rees, Daniel I., 2021. "The Public Health Effects of Legalizing Marijuana," IZA Discussion Papers 14292, Institute of Labor Economics (IZA).
    12. Rahi Abouk & Keshar M. Ghimire & Johanna Catherine Maclean & David Powell, 2023. "Pain Management and Work Capacity: Evidence From Workers’ Compensation and Marijuana Legalization," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(3), pages 737-770, June.
    13. Borbely, Daniel & Lenhart, Otto & Norris, Jonathan & Romiti, Agnese, 2022. "Marijuana Legalization and Mental Health," IZA Discussion Papers 15729, Institute of Labor Economics (IZA).
    14. Eric L. Sevigny & Rosalie L. Pacula & Ariel M. Aloe & Danye N. Medhin & Jared Greathouse, 2021. "PROTOCOL: The effects of cannabis liberalization laws on health, safety, and socioeconomic outcomes: An evidence and gap map," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(1), March.
    15. Alex Hollingsworth & Coady Wing & Ashley C. Bradford, 2022. "Comparative Effects of Recreational and Medical Marijuana Laws on Drug Use among Adults and Adolescents," Journal of Law and Economics, University of Chicago Press, vol. 65(3), pages 515-554.
    16. Shishir Shakya & Jane E. Ruseski, 2023. "The effect of Prescription Drug Monitoring Programs on county‐level opioid prescribing practices and spillovers," Contemporary Economic Policy, Western Economic Association International, vol. 41(3), pages 435-454, July.
    17. Aparna Keshaviah & Eric Morris & Dara Lee Luca & Huihua Lu & Sarah Bardin & Colleen Staatz & David Jones, "undated". "Marijuana Legalization: Public Health, Safety, and Economic Factors for States to Consider," Mathematica Policy Research Reports 2244c433671741ab990a99636, Mathematica Policy Research.
    18. Kim, Bokyung, 2021. "Must-access prescription drug monitoring programs and the opioid overdose epidemic: The unintended consequences," Journal of Health Economics, Elsevier, vol. 75(C).

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K32 - Law and Economics - - Other Substantive Areas of Law - - - Energy, Environmental, Health, and Safety Law
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare

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