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

Chelsea L. Shover (), Corey S. Davis, Sanford C. Gordon and Keith Humphreys
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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

Proceedings of the National Academy of Sciences, 2019, vol. 116, issue 26, 12624-12626

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.

Keywords: medical cannabis; opioid overdose; public policy (search for similar items in EconPapers)
Date: 2019
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Citations: View citations in EconPapers (16)

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