ReviewInjury epidemiology2019
State marijuana laws and opioid overdose mortality.
Review in Injury epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Association between state cannabis laws and opioid outcomes: A systematic review.Drug and alcohol dependence · 2026Pooled it
- The impact of cannabis legalization and decriminalization on acute poisoning: A systematic review.Addiction (Abingdon, England) · 2023Pooled it
- The Impact of Medical Cannabis Laws on Cannabis and Opioid Use Disorder Treatment and Overdose-Related Health Care Utilization Among Adults With Chronic Noncancer Pain.The Milbank quarterly · 2025Article
- The role of prescription opioid and cannabis supply policies on opioid overdose deaths.American journal of epidemiology · 2025Article
- Cannabinoids in Chronic Pain Management: A Review of the History, Efficacy, Applications, and Risks.Biomedicines · 2025Review
- The relationship of medical and recreational cannabis laws with opioid misuse and opioid use disorder in the USA: Does it depend on prior history of cannabis use?The International journal on drug policy · 2025Article
- Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map.Campbell systematic reviews · 2023Article
- Adult Medical Cannabinoid Use and Changes in Prescription Controlled Substance Use.Cannabis and cannabinoid research · 2023Article
- Impact of Recreational Cannabis Legalization on Opioid Prescribing and Opioid-Related Hospital Visits in Colorado: an Observational Study.Journal of general internal medicine · 2023Observational
- An answered call for aid? Cannabinoid clinical framework for the opioid epidemic.Harm reduction journal · 2023Review
- Changes in Opioid and Benzodiazepine Poisoning Deaths After Cannabis Legalization in the US: A County-level Analysis, 2002-2020.Epidemiology (Cambridge, Mass.) · 2023Article
- Article
- Association between fatal opioid overdose and state medical cannabis laws in US national survey data, 2000-2011.The International journal on drug policy · 2022Article
- Legal status of recreational cannabis and self-reported substitution of cannabis for opioids or prescription pain medication in Canada and the United States.Substance abuse · 2022Article
- The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases.International journal of molecular sciences · 2021Review
- Positive Toxicology Results Are Not Associated with Emergency Physicians' Opioid Prescribing Behavior.The western journal of emergency medicine · 2021Article
- Trends in cannabis use and attitudes toward legalization and use among Australians from 2001-2016: an age-period-cohort analysis.Addiction (Abingdon, England) · 2021Article
- Cannabis use in patients treated for opioid use disorder pre- and post-recreational cannabis legalization in Canada.Substance abuse treatment, prevention, and policy · 2021Article
- The associations of medical marijuana policies with opioid-related health care utilization.Health services research · 2021Article
- Demand curve analysis of marijuana use among persons living with HIV.Drug and alcohol dependence · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe opioid epidemic in the United States is a national public health crisis. In recent years, marijuana legalization has been increasingly adopted by state governments as a policy intervention to control the opioid epidemic under the premise that marijuana and opioids are substitutive substances. The purpose of this systematic review is to synthesize the empirical evidence regarding the impact of state marijuana laws on opioid overdose mortality and other opioid-related health outcomes.
methodA comprehensive search of the research literature in 18 bibliographic databases returned 6640 records, with 5601 abstracts reviewed, 29 full text articles screened for eligibility, and 16 eligible studies included in the systematic review. Comprehensive Meta-Analysis software was used to generate summary estimates, forest plots, funnel plots, and heterogeneity statistics.
resultsOf the 16 eligible studies, 4 assessed the association of state marijuana law status with opioid overdose mortality, 7 with prescription opioids dispensed, and the remaining with nonmedical use and opioid-related hospitalizations. Random effects modeling based on pooled data revealed that legalizing marijuana for medical use was associated with a statistically non-significant 8% reduction in opioid overdose mortality (95% confidence interval: - 0.21 to 0.04;
conclusionsLegalizing marijuana might contribute to a modest reduction in opioid prescriptions. Evidence about the effect of marijuana legalization on opioid overdose mortality is inconsistent and inconclusive. If any, the effectiveness of state marijuana laws in reducing opioid overdose mortality appears to be rather small and limited to states with operational marijuana dispensaries. It remains unclear whether the presumed benefit of legalizing marijuana in reducing opioid-related harms outweighs the policy's externalities, such as its impact on mental health and traffic safety.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.