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2023 Study: Marijuana Legalization Reduces Opioid Demand

Updated: 3 days ago

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A January 2023 study entitled "Recreational Cannabis and Opioid Distribution" that was published in the journal Health Economics examined the impact of cannabis legalization on "prescription opioid dispensing" by analyzing data from the U.S. Drug Enforcement Agency.

The study reported that, as of November 2022, 21 U.S. states now feature adult-use ("recreational") cannabis laws. It noted that "cannabis may be a substitute for prescription opioids in the treatment of chronic pain."

The Study

This scientific investigation examined data regarding prescription opioid shipments from 11 U.S. states that was gathered between 2010 and 2019. This data was compared to similar metrics from states that continue to prohibit cannabis. The study included scientists from Cornell University, George Mason University, the University of Georgia, and the University of Pittsburgh.


This research revealed that adult-use cannabis legalization results in a "26 percent reduction in retail pharmacy-based codeine distribution." "We find that RCLs [Recreational Cannabis Laws] lead to a reduction in codeine dispensed at retail pharmacies," reported the study. Its authors interpreted their results as "potentially promising from a public health perspective."

"The fact that recreational cannabis laws appear to reduce codeine dispensing may be a promising sign."

Among prescription opioids, codeine is particularly likely to be used non-medically. Thus, the finding that the implementation of adult-use cannabis laws at the state level appear to reduce codeine dispensing may be a good sign and point toward positive results from cannabis legalization.

More Pronounced Over Time

The study also identified the fact that the effects of cannabis legalization on codeine prescribing "became more pronounced" over time, increasing from 18 percent after one year of cannabis legalization to more than 37 percent after four years.

Adult-Use Cannabis Lowers Codeine Misuse

"Collectively, our findings are consistent with the hypothesis that reductions in opioid demand affected by [recreational cannabis laws], unlike [medical cannabis laws], may be evidence of decreased opioid misuse more than decreased use of prescription opioids to manage chronic pain," the study's authors stressed.

"Reductions in opioid demand affected by [recreational cannabis laws], unlike [medical cannabis laws], may be evidence of decreased opioid misuse more than decreased use of prescription opioids."

The scientists stated that their research results are "of interest" due to the fact that codeine is "particularly likely to be misused and diverted."


"We cannot rule out that these reductions [in opioid misuse] are due to a reduction in use of codeine as prescribed; however, the lack of other reductions in opioid dispensing suggests that this is not the case," concluded the study.

The study summarized that its observations and conclusions "stand in contrast to the literature on MCLs [medical cannabis laws], which finds that MCLs affect reductions in the dispensing of a variety of opioids that do not have misuse rates as high as codeine."

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