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

Greta Hsu, professor1, Balázs Kovács, associate professor2 1Graduate School of Management, University of California, Davis, California, USA 2School of Management, Yale University, 165 Whitney Avenue, New Haven, CT 06520, USA Correspondence to: B Kovács balazs.kovacs{at} Accepted 25 November 2020 Abstract

Objective To examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates.

Design Panel regression methods.

Setting 812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017.

Participants The study used US mortality data from the Centers for Disease Control and Prevention combined with US census data and data from on storefront dispensary operations. Data were analyzed at the county level by using panel regression methods.

Main outcome measure The main outcome measures were the log transformed, age adjusted mortality rates associated with all opioid types combined, and with subcategories of prescription opioids, heroin, and synthetic opioids other than methadone. The associations of medical dispensary and recreational dispensary counts with age adjusted mortality rates were also analyzed.

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