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Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.m4957 (Published 27 January 2021) Cite this as: BMJ 2021;372:m4957

Linked Editorial

Cannabis liberalisation and the US opioid crisis

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Re: Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study

Dear Editor,
The notion that lower opioid deaths is related to having more marijuana dispensaries is incongruent with the national opioid epidemic trends. The CDC issued its most recent overdose data recently showing yet another record in overdose deaths in 2020, up 12.5% in one year from 72,000 to 81,000. This correlates with more states expanding marijuana programs for both medical and recreational use. In some states the number of marijuana dispensaries outnumber of McDonalds and Starbucks combined.
Colorado has had medical marijuana since 2001 and 90% of marijuana recommendations are for pain. If marijuana was an effective pain reliever, or opioid substitute, the Colorado should see decreases in drug deaths over time. However, 2019 was a record year in drug overdose deaths in Colorado, particularly prescription opioid overdoses. Based on the provisional 2020 data, Colorado will have yet another record in drug overdose deaths. Preliminarily, between 2019 and 2020 in Colorado, prescription opioid overdose deaths will be up 78%, fentanyl 110%, cocaine 44%, and methamphetamine 23%. Other states have seen similar trends.
There is a mountain of data outlining harms associated with rampant marijuana use, normalization of drug use, and expanded marijuana programs which outstrip any real or perceived benefit. The idea that we need more marijuana stores to combat the opioid epidemic is a complete fallacy. In the midst of the COVID-19 pandemic, the is a need to "listen to the doctors and scientists" and "we need the data". Somehow, marijuana got a free pass. There is sufficient data that there are more opioid overdose deaths in those states with expanded marijuana programs and this has become a serious public health and safety concern.

Competing interests: No competing interests

30 January 2021
Kenneth P Finn
Physician
Catherine Antley, MD; Eric Voth, MD; Roneet Lev, MD
Springs Rehabilitation, PC
6005 Delmonico Drive, Suite 130, Colorado Springs, CO 80919