Medical marijuana laws increased cannabis use in women but did not reduce opioid misuse overall

State medical marijuana laws were associated with increased marijuana use and marijuana use disorder among women but were not associated with reduced opioid misuse, initiation, or opioid use disorder.

Ali, Mir M et al.·Women's health issues : official publication of the Jacobs Institute of Women's Health·2021·Moderate EvidenceLongitudinal Cohort
RTHC-02956Longitudinal CohortModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Medical marijuana laws were not associated with opioid misuse, initiation, or OUD among all women, pregnant women, or parenting women. The laws were positively correlated with marijuana use and MUD among all women and women with children. For pregnant women, MMLs were associated with increased frequency of opioid misuse. For parenting women, MMLs were associated with decreased frequency of opioid misuse.

Key Numbers

MMLs not associated with opioid misuse, initiation, or OUD in any women subgroup. MMLs associated with increased marijuana use and MUD among all women and women with children. Increased opioid misuse frequency in pregnant women. Decreased opioid misuse frequency in parenting women.

How They Did This

Difference-in-differences analysis using NSDUH data from 2002-2014. Compared opioid-related outcomes among women in states with and without medical marijuana laws before and after implementation. Analyzed separately for all women, pregnant women, and parenting women.

Why This Research Matters

The idea that medical marijuana can serve as an opioid substitute for women, including pregnant and parenting women, is not supported by this analysis, challenging a common policy argument for medical marijuana laws.

The Bigger Picture

While ecological studies have linked medical marijuana laws to reduced opioid prescribing, this individual-level analysis suggests the relationship is more complex, particularly for women with unique risk profiles during pregnancy and parenting.

What This Study Doesn't Tell Us

Survey data with self-reported substance use. Difference-in-differences assumes parallel trends. Cannot account for all policy variations across states. Data ends in 2014, before many states expanded marijuana programs.

Questions This Raises

  • ?Why do effects differ between pregnant and parenting women?
  • ?Would more recent data (post-2014) show different patterns?
  • ?Could specific features of MMLs (dispensary access, qualifying conditions) matter more than the laws themselves?

Trust & Context

Key Stat:
Medical marijuana laws did not reduce opioid misuse among women
Evidence Grade:
Rigorous quasi-experimental design with large national dataset, but self-reported data and pre-2014 time frame.
Study Age:
2021 publication using 2002-2014 NSDUH data. Pre-dates many state marijuana program expansions.
Original Title:
Medical Marijuana Laws, Marijuana Use, and Opioid-Related Outcomes among Women in the United States.
Published In:
Women's health issues : official publication of the Jacobs Institute of Women's Health, 31(1), 24-30 (2021)
Database ID:
RTHC-02956

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Do medical marijuana laws help women reduce opioid use?

This study found no evidence that medical marijuana laws reduced opioid misuse, initiation, or opioid use disorder among women overall. Results were mixed for specific subgroups.

Did the laws affect pregnant women differently?

Yes. Medical marijuana laws were associated with increased frequency of opioid misuse among pregnant women but decreased frequency among parenting women, suggesting different risk profiles.

Read More on RethinkTHC

Cite This Study

RTHC-02956·https://rethinkthc.com/research/RTHC-02956

APA

Ali, Mir M; McClellan, Chandler; West, Kristina D; Mutter, Ryan. (2021). Medical Marijuana Laws, Marijuana Use, and Opioid-Related Outcomes among Women in the United States.. Women's health issues : official publication of the Jacobs Institute of Women's Health, 31(1), 24-30. https://doi.org/10.1016/j.whi.2020.09.003

MLA

Ali, Mir M, et al. "Medical Marijuana Laws, Marijuana Use, and Opioid-Related Outcomes among Women in the United States.." Women's health issues : official publication of the Jacobs Institute of Women's Health, 2021. https://doi.org/10.1016/j.whi.2020.09.003

RethinkTHC

RethinkTHC Research Database. "Medical Marijuana Laws, Marijuana Use, and Opioid-Related Ou..." RTHC-02956. Retrieved from https://rethinkthc.com/research/ali-2021-medical-marijuana-laws-marijuana

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.