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A recently published research paper investigating the impacts of legalizing recreational cannabis has determined that legalization leads to a reduction in deaths caused by opioid overdoses. The research found a “consistent negative relationship” between legalization and overdose deaths, particularly in states that legalized adult-use cannabis early in the opioid overdose epidemic.
The paper was written in 2023 and published by the Social Science Research Network (SSRN) on December 16. In it, the authors estimated that legalizing recreational cannabis “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”
“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” the authors wrote. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”
“Further, this effect increases with earlier implementation of” recreational marijuana legalization (RML), they added, “indicating this relationship is relatively consistent over time.”
The paper was written by a team of five researchers from Texas Tech University, Angelo State University, Metropolitan State University, New Mexico State University, and the American Institute for Economic Research, a libertarian think tank, online cannabis news source Marijuana Moment reported late last month. Titled “Because I Got High? Recreational Marijuana Legalization’s Impact on Opioid Overdose Deaths,” the paper has not been peer-reviewed.
Research Utilized Innovative Approach
The authors of the research noted that their study is the first to use a difference-in-differences approach with multiple time periods, which they refer to as the “C&S approach” after the researchers who developed it, to examine opioid overdose deaths and cannabis legalization.
“Although the causal effects of marijuana legalization on opioid mortality rates is a well-examined topic, there is no general consensus on the direction and magnitude of its effects,” the authors wrote, noting that previous studies suggest that the choice of the time periods being analyzed influences the results. “Most studies examining the effect of staggered marijuana legalization policies in the US suffer from this problem,” the researchers maintain, “which partly explains the inconsistent estimates.”
Using the C&S approach, the authors wrote, enabled them to “draw a plausible causal link between RML adoption and opioid overdose death rates,” which indicated “a nearly immediate impact of RML adoption.”
Among the group of states to legalize cannabis before other states, “legalization led to an immediate decline in opioid overdose death rates, which grew even stronger and persisted after five years,” the authors wrote. “Groups that implemented RML in later years do not have as much post-treatment data, but their short-term trends are consistent with the effects in the first group of states.”
“For later groups,” they continued, “RML was particularly effective three years after it went into effect, corroborating prior observations that there may be a lag time between the time of policy implementation and the action opening of recreational marijuana dispensaries.”
The study used information from the Kaiser Family Foundation’s State Health Facts database, which uses data provided by the U.S. Centers for Disease Control and Prevention. The authors noted that their research did not include hospitalizations, nonfatal overdoses, or “other abuse measures.”
“Further, while many of our empirical findings are consistent and statistically significant,” the researchers wrote, “RML as a state-level policy began only 11 years ago, with many states implementing it in the last few years. This limits our ability to assess longer-term effects on opioid overdose deaths and related variables.”
Despite the lack of long-term data, the authors note that states “continue to implement RML and consider introducing legislation to grant those with opioid use disorder greater access to marijuana as a substitute, and our findings strongly suggest RML could help address opioid-related public health concerns.”
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