Working Paper: NBER ID: w21345
Authors: David Powell; Rosalie Liccardo Pacula; Mireille Jacobson
Abstract: Many medical marijuana patients report using marijuana to alleviate chronic pain from musculoskeletal problems and other sources. If marijuana is used as a substitute for powerful and addictive pain relievers in medical marijuana states, a potential overlooked positive impact of medical marijuana laws may be a reduction in harms associated with opioid pain relievers, a far more addictive and potentially deadly substance. To assess this issue, we study the impact of medical marijuana laws on problematic opioid use. We use two measures of problematic use: treatment admissions for opioid pain reliever addiction from the Treatment Episode Data Set (TEDS) and state-level opioid overdose deaths in the National Vital Statistics System (NVSS). Using both standard differences-in-differences models as well as synthetic control models, we find that states permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not. We find no impact of medical marijuana laws more broadly; the mitigating effect of medical marijuana laws is specific to states that permit dispensaries. We evaluate potential mechanisms. Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.
Keywords: Medical Marijuana; Opioid Use; Substance Abuse; Public Health
JEL Codes: I12; I28
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Medical marijuana laws allowing dispensaries (K23) | decrease in opioid addictions (I12) |
| Medical marijuana laws allowing dispensaries (K23) | decrease in opioid misuse (I12) |
| Medical marijuana laws (I18) | decrease in opioid addictions (I12) |
| Medical marijuana laws allowing dispensaries (K23) | decrease in opioid overdose deaths (I12) |
| Medical marijuana laws (I18) | decrease in opioid overdose deaths (I12) |