The greater availability of cannabis access via storefront dispensaries and retailers is associated with declines in opioid-related deaths, according to an analysis of county level data published in the British Medical Journal (BMJ).

Commenting on the available data, NORML’s Deputy Director Paul Armentano 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.”

A pair of researchers affiliated with the University of California at Davis and with Yale University in Connecticut assessed the relationship between the volume of storefront dispensaries and opioid-related mortality rates in legal marijuana states over a four year period (2014-2018).

Consistent with prior ecological studies, such as those here, here, and here, investigators “found that increased medical and recreational storefront dispensary counts are associated with reduced opioid related mortality rates during the study period. These associations appear particularly strong for deaths related to synthetic opioids such as fentanyl. 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. Overall, our study contributes to understanding the supply side of related drug markets and how it shapes opioid use and misuse.”

The publication of the study comes just days after a team of Canadian investigators similarly reported that retail marijuana legalization in that country preceded a “marked decline” in the volume of opioids prescribed to patients enrolled in both public and private health care plans.

Days earlier, two additional longitudinal studies separately reported that patients provided medical cannabis for chronic pain significantly reduce or eliminate their use of opioids over time. In the first study, participants’ mean opioid dosage fell by 78 percent within six-months after initiating cannabis therapy. In the second study, subjects accessing medical cannabis exhibited “opioid-sparing effects” over a twelve-month period.

Full text of the study, “Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study,” appears online here. Additional information is available in the NORML fact-sheet, “Relationship Between Marijuana and Opioids.”


NORML advocates for changes in public policy so that the responsible possession and use of marijuana by adults is no longer subject to criminal penalties. NORML further advocates for a regulated commercial cannabis market so that activities involving the for-profit production and retail sale of cannabis and cannabis products are safe, transparent, consumer-friendly, and are subject to state and/or local licensure. Finally, NORML advocates for additional changes in legal and regulatory policies so that those who use marijuana responsibly are no longer face either social stigma or workplace discrimination, and so that those with past criminal records for marijuana-related violations have the opportunity to have their records automatically expunged.

Find out more at and read our Fact Sheets on the most common misconceptions and myths regarding reform efforts around the country.

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