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Association between medical cannabis laws and opioid overdose mortality has reversed over time

Author

Listed:
  • Chelsea L. Shover

    (Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305)

  • Corey S. Davis

    (The Network for Public Health Law, Carrboro, NC 27516)

  • Sanford C. Gordon

    (Wilf Family Department of Politics, New York University, New York, NY 10012)

  • Keith Humphreys

    (Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305; Center for Innovation to Implementation, Veterans Affairs Health Care System, Palo Alto, CA 94304)

Abstract

Medical cannabis has been touted as a solution to the US opioid overdose crisis since Bachhuber et al. [M. A. Bachhuber, B. Saloner, C. O. Cunningham, C. L. Barry, JAMA Intern. Med. 174, 1668–1673] found that from 1999 to 2010 states with medical cannabis laws experienced slower increases in opioid analgesic overdose mortality. That research received substantial attention in the scientific literature and popular press and served as a talking point for the cannabis industry and its advocates, despite caveats from the authors and others to exercise caution when using ecological correlations to draw causal, individual-level conclusions. In this study, we used the same methods to extend Bachhuber et al.’s analysis through 2017. Not only did findings from the original analysis not hold over the longer period, but the association between state medical cannabis laws and opioid overdose mortality reversed direction from −21% to +23% and remained positive after accounting for recreational cannabis laws. We also uncovered no evidence that either broader (recreational) or more restrictive (low-tetrahydrocannabinol) cannabis laws were associated with changes in opioid overdose mortality. We find it unlikely that medical cannabis—used by about 2.5% of the US population—has exerted large conflicting effects on opioid overdose mortality. A more plausible interpretation is that this association is spurious. Moreover, if such relationships do exist, they cannot be rigorously discerned with aggregate data. Research into therapeutic potential of cannabis should continue, but the claim that enacting medical cannabis laws will reduce opioid overdose death should be met with skepticism.

Suggested Citation

  • Chelsea L. Shover & Corey S. Davis & Sanford C. Gordon & Keith Humphreys, 2019. "Association between medical cannabis laws and opioid overdose mortality has reversed over time," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 116(26), pages 12624-12626, June.
    • Handle: RePEc:nas:journl:v:116:y:2019:p:12624-12626
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    Citations

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    Cited by:

    1. Sunday Azagba & Lingpeng Shan & Lauren Manzione & Fares Qeadan & Mark Wolfson, 2019. "Trends in Opioid Misuse among Marijuana Users and Non-Users in the U.S. from 2007–2017," IJERPH, MDPI, vol. 16(22), pages 1-11, November.
    2. Mathur, Neil K. & Ruhm, Christopher J., 2023. "Marijuana legalization and opioid deaths," Journal of Health Economics, Elsevier, vol. 88(C).
    3. 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).
    4. Junxing Chay & Seonghoon Kim, 2022. "Heterogeneous health effects of medical marijuana legalization: Evidence from young adults in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 31(2), pages 269-283, February.
    5. 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.
    6. 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).
    7. Anderson, D. Mark & Rees, Daniel I., 2021. "The Public Health Effects of Legalizing Marijuana," IZA Discussion Papers 14292, Institute of Labor Economics (IZA).
    8. Sam Parsons & Ingrid Schoon & Emla Fitzsimons, 2022. "Evidence from the UK Millennium Cohort Study. Teenage children of mothers who experienced out-of-home care: How are they doing?," DoQSS Working Papers 22-08, Quantitative Social Science - UCL Social Research Institute, University College London.
    9. Cornelius A. Rietveld & Pankaj C. Patel, 0. "Prescription opioids and new business establishments," Small Business Economics, Springer, vol. 0, pages 1-25.
    10. Cheng, Stephanie F. & De Franco, Gus & Lin, Pengkai, 2023. "Marijuana liberalization and public finance: A capital market perspective on the passage of medical use laws," Journal of Accounting and Economics, Elsevier, vol. 75(1).
    11. Dmitry Arkhangelsky & Guido W. Imbens & Lihua Lei & Xiaoman Luo, 2021. "Design-Robust Two-Way-Fixed-Effects Regression For Panel Data," Papers 2107.13737, arXiv.org, revised Mar 2024.
    12. Grant W. Neeley & Lilliard E. Richardson Jr., 2022. "Marijuana Policy Bundles in the American States Over Time and Their Impact on the Use of Marijuana and Other Drugs," Evaluation Review, , vol. 46(2), pages 165-199, April.
    13. Shyam Raman & Ashley C. Bradford, 2022. "Recreational cannabis legalizations associated with reductions in prescription drug utilization among Medicaid enrollees," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1513-1521, July.
    14. Cornelius A. Rietveld & Pankaj C. Patel, 2021. "Prescription opioids and new business establishments," Small Business Economics, Springer, vol. 57(3), pages 1175-1199, October.

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