ArticleBMJ (Clinical research ed.)2021
Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study.
Article in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 65 citations in OpenAlex.
- Cannabis Use and Analgesic Prescribing in UK Primary Care: A Retrospective Cohort Study of Patients with Osteoarthritis.Medicines (Basel, Switzerland) · 2025Article
- Cannabis Use in Opioid Maintenance Therapy: Prevalence, Clinical Correlates and Reasons for Use.Brain sciences · 2025Article
- The role of prescription opioid and cannabis supply policies on opioid overdose deaths.American journal of epidemiology · 2025Article
- Cannabis Policies, Cannabis, and Opioids in Suicide and Undetermined Intent Death.American journal of preventive medicine · 2025Article
- Do Medical and Recreational Marijuana State Laws Impact Trends in Postoperative Opioid Prescriptions Among Patients Who Have Undergone TJA?Clinical orthopaedics and related research · 2025Article
- 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
- Cannabis retail store density and county-level mortality from injury in the state of Washington from 2009-2020.The American journal of drug and alcohol abuse · 2025Article
- "Smoking weed it gets you over the hump": Cannabis co-use as a facilitator of decreased opioid use among people who inject drugs in Los Angeles, California.Drug and alcohol dependence reports · 2024Article
- Assessing Risk Factors and Comorbidities in the Treatment of Chronic Pain: A Narrative Review.Current pain and headache reports · 2024Review
- Cannabis donation as a harm reduction strategy: a case study.Harm reduction journal · 2024Article
- Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana.Journal of cannabis research · 2024Article
- 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
- Associations of recreational cannabis dispensaries' availability, storefront signage and health benefit signs with cannabis use: findings from a representative adult sample in California, United States.Addiction (Abingdon, England) · 2023Article
- Association of a Positive Drug Screening for Cannabis With Mortality and Hospital Visits Among Veterans Affairs Enrollees Prescribed Opioids.JAMA network open · 2022Article
- Association between fatal opioid overdose and state medical cannabis laws in US national survey data, 2000-2011.The International journal on drug policy · 2022Article
- Characteristics of People Seeking Prescribed Cannabinoids for the Treatment of Chronic Pain: Evidence From Project Twenty 21.Frontiers in pain research (Lausanne, Switzerland) · 2022Article
- Does Accessibility of Cannabis Mediate the Relation Between Method of Acquisition and Cannabis Use Frequency among Adolescents?Cannabis (Albuquerque, N.M.) · 2022Article
- The state of the evidence on the association between state cannabis laws and opioid-related outcomes: A review.Current addiction reports · 2021Article
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates.
designPanel regression methods.
setting812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017.
participantsThe study used US mortality data from the Centers for Disease Control and Prevention combined with US census data and data from Weedmaps.com on storefront dispensary operations. Data were analyzed at the county level by using panel regression methods.
main outcome measureThe main outcome measures were the log transformed, age adjusted mortality rates associated with all opioid types combined, and with subcategories of prescription opioids, heroin, and synthetic opioids other than methadone. The associations of medical dispensary and recreational dispensary counts with age adjusted mortality rates were also analyzed.
resultsCounty level dispensary count (natural logarithm) is negatively related to the log transformed, age adjusted mortality rate associated with all opioid types (β=-0.17, 95% confidence interval -0.23 to -0.11). According to this estimate, an increase from one to two storefront dispensaries in a county is associated with an estimated 17% reduction in all opioid related mortality rates. Dispensary count has a particularly strong negative association with deaths caused by synthetic opioids other than methadone (β=-0.21, 95% confidence interval -0.27 to -0.14), with an estimated 21% reduction in mortality rates associated with an increase from one to two dispensaries. Similar associations were found for medical versus recreational storefront dispensary counts on synthetic (non-methadone) opioid related mortality rates.
conclusionsHigher medical and recreational storefront dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl. While the associations documented cannot be assumed to be causal, they suggest a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates. This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.
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