Study: The More Dispensaries a County Has, the Fewer Opioid-Related Deaths

Cannabis advocates have long called for allowing people to treat pain with marijuana rather than opioids. A new study shows that this is exactly what happens when you give people the freedom to choose between the two.

The study, published in The British Medical Association Journal, found that in United States counties, medical or recreational cannabis is available for purchase, the number of opioid-related deaths declined.

While the declines occurred with all types of opioids, including prescription painkillers, they found a profound decrease in deaths associated with synthetic opioids. 

“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,” the researchers wrote. “This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.”

What the research shows

University of California-Davis professor Greta Hsu and Yale University professor Balázs Kovács worked together on the study. The pair looked at data from 812 counties in 23 states where the law allowed legal cannabis sales.

They researched the association between the number of storefront dispensaries and opioid-related mortality rates between 2014 and 2018. They used information from the Centers for Disease Control and Prevention (CDC) on deaths related to all opioid types and within the subcategories of prescription opioids, heroin, and synthetic opioids other than methadone.

They found a 17% drop in all opioid deaths when the number of dispensaries increased from one to two, and a further 8.5% reduction in all opioid deaths when the number of dispensaries increased from two to three.

The numbers were even higher when only considering deaths from synthetic non-methadone opioids such as fentanyl. The researchers noted that “given the alarming rise in the fentanyl-based market in the US, and the increase in deaths involving fentanyl and its analogs in recent years, the question of how legal cannabis availability relates to opioid-related deaths is particularly pressing.”

The study revealed similar drops in all opioid-related deaths, whether the dispensaries sold medical or recreational cannabis. The main point was that people needed to have access to legal cannabis to use opioids.

These findings have especially resonance because of the continuing opioid epidemic in the United States. According to the CDC, about 70 percent of all drug overdose deaths in the United States involved an opioid.

The new study follows other research that associates the availability of cannabis to reduce the use of opioids. For example:

A University of Texas-Galveston study found a significant drop in the number of opioid prescriptions in states where cannabis is legal. A study from the University of California-San Diego and Weill Cornell Medical College found that the number of opioid prescriptions from those using Medicaid dropped where cannabis was available. Studies from Minnesota and Israel reported that cannabis proved effective in combating pain, and led to patients using fewer opioids or eliminating them altogether Recent research from Canada also shows that cannabis does not lead to the same level of pain sensitivity as opioids

Commenting on the new study, Paul Armentano, deputy director of the cannabis-advocacy organization NORML, said, “The data to date is consistent and persuasive: For many pain patients, cannabis offers a viable alternative to opioids, potentially improving their quality of life while possessing a superior safety profile.”