Rutgers Study Finds Modest Decrease in Non-Prescription Opioid Use with Cannabis Legalization, But Concentrated in People Addicted to Cannabis Interview with:
Hillary Samples, PhD, MHS
Assistant Professor of Health Systems and Policy
Rutgers School of Public Health
Core Faculty
Center for Pharmacoepidemiology and Treatment Science

Rutgers Institute for Health, Health Care Policy and Aging Research
New Brunswick, NJ 08901 What is the background for this study?

Response: Early studies suggesting that cannabis legalization is associated with lower rates of opioid-related harms received considerable media attention. At the time, overdose deaths were driven by prescription opioids, and medical cannabis was often framed as a policy approach to address the opioid epidemic. However, as research in this area grew, the relationship between medical cannabis legalization and opioid-related harms became less clear. Many studies of cannabis legalization were unable to examine opioid use by individual people, and individual-level studies outside the legal context showed links between cannabis use and higher risk of opioid-related harms. Thus, our goal was to build evidence of the relationship between medical cannabis legalization and individual-level opioid use. What are the main findings?

Response: We found that medical cannabis legalization was associated with modest declines in the frequency of non-medical prescription opioid use among U.S. adults who report non-medical prescription opioid use in the past year. However, these decreases were concentrated among people who met clinical criteria for cannabis addiction. What should readers take away from your report?

Response: In the context of opioid-related harms, our findings suggest there could be some benefits to legalizing medical cannabis since these laws were associated with less frequent non-medical use of prescription opioids. Yet, this was not a strong relationship. While medical cannabis may be a viable alternative to opioid medication for pain treatment, other policies are likely to have a greater impact on the ongoing opioid epidemic, such as those that aim to increase access to medications for opioid addiction. What recommendations do you have for future research as a result of this study?

Response: Future research is needed to understand whether reductions in the frequency of non-medical opioid use are clinically meaningful in relation to risk of opioid addiction and overdose, whether these reductions might coincide with undesirable changes in cannabis use, and whether the impact of medical cannabis legalization on opioid use differs for key health care populations, such as people with chronic pain.

Disclosures: I have received consulting fees from the American Society of Addiction Medicine and the Pew Charitable Trusts outside of this work.


Samples, H., Levy, N.S., Bruzelius, E. et al. Association Between Legal Access to Medical Cannabis and Frequency of Non-Medical Prescription Opioid Use Among U.S. Adults. Int J Ment Health Addiction (2023).

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Last Updated on November 26, 2023 by