The association between state cannabis legalization and non-fatal opioid poisonings among adults with employer-sponsored insurance in the United States
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: Although many states have legalized medical and recreational cannabis, its association with non-fatal opioid poisonings remains unclear. This study examines the association between state cannabis legalization policies and non-fatal opioid poisoning diagnoses among enrollees in employer-sponsored health insurance. Methods: The study included 107,480,711 enrollees aged 18-64 with ≥1 year of continuous enrollment (average age 41; 52% females) in the Merative MarketScan Commercial Claims and Encounters Database (2011-2021) in the United States. Utilizing a staggered adoption difference-in-differences regression, this study compared non-fatal opioid poisoning rates in cannabis-legalized and non-legalized states before and after legalization. Four policies were examined: medical cannabis legalization, medical cannabis dispensary opening (MCD), home medical cannabis cultivation, and recreational cannabis legalization (RCL). Results: State MCDs and RCLs were associated with 15.47% (coefficient = -1.73; 95%CI: -2.72, -0.74) and 11.92% (coefficient = -1.33; 95%CI: -2.30, -0.37) reductions in non-fatal opioid poisonings per 100,000 enrollees per quarter, respectively. Reductions associated with MCDs were significant in ages 18-34, males and females, those without prescription opioids or cannabis use disorder diagnoses within the past year, and outpatient service users. Conclusions: State MCDs and RCLs were associated with significant reductions in non-fatal opioid poisonings in the employer-sponsored insured population, particularly among male and younger populations.
Source: Preventive Medicine Reports
Institution: University of Kentucky
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,610
OpenAlex ID: W7161233903