Economists found that legal, medical marijuana access has been linked to increased opioid-related deaths in a new study, contrary to earlier findings.
Medical marijuana legalization was linked to 15% to 29% higher rates of opioid-involved fatalities from 1999 to 2019, two economists from the University of Virginia concluded in a new paper circulated in early March by the National Bureau of Economic Research.
The study, which has not yet undergone a peer review, found that the supposed benefits of legalization for reducing opioid overdose deaths were reversed by just adding a few extra years, contradicting what an earlier, more limited study published in 2014 asserted.
“[2019] is the most current data that we had available that we could use for the analysis,” said Dr. Christopher Ruhm, an economist at the University of Virginia’s Frank Batten School of Leadership and Public Policy who co-authored the study. “So, in a number of these studies, they weren’t doing anything wrong by using earlier data. They just were using the data they had at the time.”
The oft-cited 2014 study, with over 760 Google Scholar citations as of February 2022, only had policy data through 2010 to consider and came to a very different conclusion. Its author, University of Pennsylvania economist Marcus Bachhuber, found that states with medical cannabis laws had a 24.8% lower annual opioid overdose mortality rate on average compared to states without them.
The 2014 Bachhuber report became a rallying cry for legalization advocates who pointed to the critical finding that “medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates.” Public health experts considered legal access to marijuana to be part of a multipronged approach to addressing increasing overdose deaths attributed to opioids.
In July, the Centers for Disease Control and Prevention reported that fatal drug overdoses in 2020 increased by nearly 30% over the previous year, reaching an all-time high of more than 93,300. Opioids were the cause of most overdose deaths in every state, and fatal overdoses caused by opioids in Washington, D.C., specifically increased from 50,963 in 2019 to an estimated 69,710 in 2020.
Meanwhile, the working paper out this month took a new macro view of marijuana legalization policies’ effects on opioid overdose deaths, having the advantage of those extra years to consider. Ruhm and his co-author, Dr. Neil Mathur, also a public policy expert at the University of Virginia, wanted to determine how opioid overdose mitigation policies, such as “Good Samaritan” laws, better access to overdose-reversing drug naloxone, and improved tracking of prescribing, might fare when legal marijuana is introduced.
They found that empirical results from prior studies on the linkage were “fragile” and did not hold up when more extended analysis periods and treatment variables were considered.
“Often, advocates for a policy sort of want to assume everything’s good and nothing’s bad. I think this notion that marijuana is a potential treatment or substitute for opioid use disorder is just flat wrong. I want to stress I am not opposed to legalizing marijuana, but understand that there are potential costs involved,” Ruhm said.
In the decade leading up to 2010, 13 states, most of them blue, had legalized medical marijuana. But by the end of 2019, the last year studied, 33 states had legalized medical marijuana, 29 had medical dispensaries in place, 11 states permitted recreational marijuana, and eight had operating retail dispensaries.
This most recent report is not the first to find that legal medical marijuana had a deleterious effect on efforts to curb overdoses. For example, researchers at the Stanford University School of Medicine reported in 2019 that taking into account the policies spanning 2011 to 2017, states passing a medical cannabis law experienced a 22.7% increase in overdose deaths.
Original Location: Legal medical marijuana sales linked to increased opioid deaths
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