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The impact of cannabis access laws on opioid prescribing

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  • McMichael, Benjamin J.
  • Van Horn, R. Lawrence
  • Viscusi, W. Kip

Abstract

While recent research has shown that cannabis access laws can reduce the use of prescription opioids, the effect of these laws on opioid use is not well understood for all dimensions of use and for the general United States population. Analyzing a dataset of over 1.5 billion individual opioid prescriptions between 2011 and 2018, which were aggregated to the individual provider-year level, we find that recreational and medical cannabis access laws reduce the number of morphine milligram equivalents prescribed each year by 11.8 and 4.2 percent, respectively. These laws also reduce the total days’ supply of opioids prescribed, the total number of patients receiving opioids, and the probability a provider prescribes any opioids net of any offsetting effects. Additionally, we find consistent evidence that cannabis access laws have different effects across types of providers, physician specialties, and payers.

Suggested Citation

  • McMichael, Benjamin J. & Van Horn, R. Lawrence & Viscusi, W. Kip, 2020. "The impact of cannabis access laws on opioid prescribing," Journal of Health Economics, Elsevier, vol. 69(C).
    • Handle: RePEc:eee:jhecon:v:69:y:2020:i:c:s0167629618309020
    DOI: 10.1016/j.jhealeco.2019.102273
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    References listed on IDEAS

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    3. Davide Fortin, 2024. "Legalizing cannabis in Colorado: Displacement or market expansion?," French Stata Users' Group Meetings 2024 03, Stata Users Group.
    4. Dhaval M. Dave & Yang Liang & Caterina Muratori & Joseph J. Sabia, 2025. "The effects of recreational marijuana legalization on employment and earnings," Journal of Population Economics, Springer;European Society for Population Economics, vol. 38(2), pages 1-41, June.
    5. Beasley, W. Jason & Dundas, Steven J., 2024. "Recreational cannabis dispensary access effects on prescription opioid use and mortality," Regional Science and Urban Economics, Elsevier, vol. 108(C).
    6. Mir M. Ali & Chandler McClellan & Ryan Mutter & Daniel I. Rees, 2023. "Recreational marijuana laws and the misuse of prescription opioids: Evidence from National Survey on Drug Use and Health microdata," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 277-301, February.
    7. Carrieri, Vincenzo & Madio, Leonardo & Principe, Francesco, 2020. "Do-It-Yourself medicine? The impact of light cannabis liberalization on prescription drugs," Journal of Health Economics, Elsevier, vol. 74(C).
    8. Johanna Catherine Maclean & Keshar M. Ghimire & Lauren Hersch Nicholas, 2021. "Marijuana legalization and disability claiming," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 453-469, February.
    9. Lucas Mar√≠n Llanes & Hernando Zuleta, 2022. "Myths of drug consumption decriminalization: effects of Portuguese decriminalization on violent and drug use mortality," Documentos CEDE 20328, Universidad de los Andes, Facultad de Economía, CEDE.
    10. George Dranitsaris & Carlo DeAngelis & Blake Pearson & Laura McDermott & Bernd Pohlmann-Eden, 2021. "Opioid Prescribing in Canada following the Legalization of Cannabis: A Clinical and Economic Time-Series Analysis," Applied Health Economics and Health Policy, Springer, vol. 19(4), pages 537-544, July.
    11. Sabia, Joseph J. & Dave, Dhaval & Alotaibi, Fawaz & Rees, Daniel I., 2024. "The effects of recreational marijuana laws on drug use and crime," Journal of Public Economics, Elsevier, vol. 234(C).
    12. Dave, Dhaval & Liang, Yang & Maclean, Johanna Catherine & Muratori, Caterina & Sabia, Joseph J., 2025. "The Effect of E-Cigarette Taxes on Substance Use," Journal of Health Economics, Elsevier, vol. 102(C).
    13. Amanda C. Cook & E. Tice Sirmans & Brenda Wells, 2024. "Does the legalisation of cannabis for medicinal use impact private health insurer prescription drug expenditures?," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 49(1), pages 212-226, January.
    14. Shelby R. Steuart, 2025. "The addition of cannabis to prescription drug monitoring programs and medication fills in Medicaid," Health Economics, John Wiley & Sons, Ltd., vol. 34(2), pages 283-296, February.
    15. Cameron M. Ellis & Martin F. Grace & Rhet A. Smith & Juan Zhang, 2022. "Medical cannabis and automobile accidents: Evidence from auto insurance," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1878-1897, September.
    16. Rahi Abouk & Keshar M. Ghimire & Johanna Catherine Maclean & David Powell, 2023. "Pain Management and Work Capacity: Evidence From Workers’ Compensation and Marijuana Legalization," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(3), pages 737-770, June.
    17. Shyam Raman & Johanna Catherine Maclean & W. David Bradford & Coleman Drake, 2023. "Recreational cannabis and opioid distribution," Health Economics, John Wiley & Sons, Ltd., vol. 32(4), pages 747-754, April.
    18. Jiebing Wen & Hefei Wen & J. S. Butler & Jeffery C. Talbert, 2021. "The impact of medical and recreational marijuana laws on opioid prescribing in employer‐sponsored health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 989-1000, May.
    19. Ahomäki, Iiro & Pitkänen, Visa & Soppi, Aarni & Saastamoinen, Leena, 2020. "Impact of a physician-targeted letter on opioid prescribing," Journal of Health Economics, Elsevier, vol. 72(C).
    20. Thomas Lebesmuehlbacher & Rhet A. Smith, 2021. "The effect of medical cannabis laws on pharmaceutical marketing to physicians," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2409-2436, September.

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    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K19 - Law and Economics - - Basic Areas of Law - - - Other

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