Department of Economics, University of Virginia, United States.
Frank Batten School of Leadership & Public Policy, University of Virginia and National Bureau of Economic Research, 235 McCormick Road, Charlottesville, VA 22903-4893, United States.
J Health Econ. 2023 Mar;88:102728. doi: 10.1016/j.jhealeco.2023.102728. Epub 2023 Jan 6.
Many states have legalized marijuana over the last two decades, initially for medical purposes and more recently for recreational consumption. Despite prior research, it remains unclear how these policies are related to rates of opioid-involved overdose deaths, which have trended rapidly upwards over time. We examine this question in two ways. First, we replicate and extend previous investigations to show that the prior empirical results are frequently fragile to the choice of specifications and time periods, and probably provide an overly optimistic assessment of the effects of marijuana legalization on opioid deaths. Second, we present new estimates suggesting that legal medical marijuana, particularly when available through retail dispensaries, is associated with higher opioid mortality. The results for recreational marijuana, while less reliable, also indicate that retail sales may be correlated with greater death rates relative to the counterfactual of no legal cannabis. A likely mechanism for these effects is the emergence of illicit fentanyl, which has increased the riskiness of even small positive effects of cannabis legalization on the consumption of opioids.
在过去的二十年里，许多州已经将大麻合法化，最初是出于医疗目的，最近则是出于娱乐目的。尽管有先前的研究，但仍不清楚这些政策与阿片类药物过量死亡的比率有何关联，而这些比率随着时间的推移呈快速上升趋势。我们通过两种方式来研究这个问题。首先，我们复制和扩展了之前的调查，以表明先前的经验结果往往对规范和时间段的选择很敏感，并且可能对大麻合法化对阿片类药物死亡的影响做出了过于乐观的评估。其次，我们提出了新的估计，表明合法的医用大麻，特别是通过零售药房提供的大麻，与更高的阿片类药物死亡率有关。娱乐用大麻的结果虽然不太可靠，但也表明与没有合法大麻的情况下相比，零售销售可能与更高的死亡率相关。这些影响的一个可能机制是非法芬太尼的出现，它增加了大麻合法化对阿片类药物消费产生任何微小积极影响的风险。
