New study on medical cannabis policy could be used as fodder for marijuana friends or foes

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Editor’s Note: This article is cross-posted on

Opponents of marijuana legalization efforts often point to concerns that marijuana use leads to the use of more harmful drugs — the classic gateway drug example. Proponents of medicinal marijuana, conversely, suggest that legalization of cannabis can lead to the more appropriate management of pain, which in turn would reduce the need for and the use of addictive narcotics.

Some doctors and scholars set out to find which of these patterns is actually evidenced in those states that have permitted medical marijuana use over time. Their findings, published this week in the Journal of the American Medical Association Internal Medicine magazine, have mixed results.

I’ll offer a spoiler right up front for impatient readers, taken from the study’s narrative: “The mean age-adjusted opioid analgesic overdose mortality rate increased in states with and without medical cannabis laws during the study period. Throughout the study period, states with medical cannabis laws had a higher opioid analgesic overdose mortality rate and the rates rose for both groups; however, between 2009 and 2010 the rate in states with medical cannabis laws appeared to plateau.”

Overall, they study found that medical cannabis laws are associated with reductions in opioid analgesic overdose mortality levels. However, these results became apparent only after controlling for four state level factors: (1) the presence of a state-level prescription drug monitoring program (a state-level registry containing information on controlled substances prescribed in a state), (2) the presence of a law requiring or allowing a pharmacist to request patient identification before dispensing medications, (3) the presence of regulations establishing increased state oversight of pain management clinics, and (4) state- and year-specific unemployment rates to adjust for the economic climate.

That said, when looking at raw numbers alone, states with medical cannabis laws were found to have overall higher levels of opioid analgesic overdose mortality levels, rising at about the same rates as those in states without such laws.

Of the other four state-level policy factors, increased state oversight of pain management clinics had the greatest statistical relationship with decreased opioid overdose rates.

“In summary, although we found a lower mean annual rate of opioid analgesic mortality in states with medical cannabis laws, a direct causal link cannot be established,” the study concluded. “Further rigorous evaluation of medical cannabis policies, including provisions that vary among states, is required before their wide adoption can be recommended.”

What does this all mean for cannabis advocates or cannabis foes? Very little, right now. Taken in pieces, this study could be used to justify either position. Yet read in whole, this study offers only a cautionary and preliminary look into complex factors at play.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including,,, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.