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Marijuana legalization and opioid deaths

Neil K. Mathur and Christopher J. Ruhm

Journal of Health Economics, 2023, vol. 88, issue C

Abstract: Many states have legalized marijuana over the last two decades, initially for medical purposes and more recently for recreational consumption. Despite prior research, it remains unclear how these policies are related to rates of opioid-involved overdose deaths, which have trended rapidly upwards over time. We examine this question in two ways. First, we replicate and extend previous investigations to show that the prior empirical results are frequently fragile to the choice of specifications and time periods, and probably provide an overly optimistic assessment of the effects of marijuana legalization on opioid deaths. Second, we present new estimates suggesting that legal medical marijuana, particularly when available through retail dispensaries, is associated with higher opioid mortality. The results for recreational marijuana, while less reliable, also indicate that retail sales may be correlated with greater death rates relative to the counterfactual of no legal cannabis. A likely mechanism for these effects is the emergence of illicit fentanyl, which has increased the riskiness of even small positive effects of cannabis legalization on the consumption of opioids.

Keywords: Marijuana; Cannabis; Marijuana legalization; Opioid deaths; Medical marijuana; Recreational marijuana (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:jhecon:v:88:y:2023:i:c:s016762962300005x

DOI: 10.1016/j.jhealeco.2023.102728

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Journal of Health Economics is currently edited by J. P. Newhouse, A. J. Culyer, R. Frank, K. Claxton and T. McGuire

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