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.
Policymakers evaluating medical marijuana laws, obstetricians, women's health researchers, and opioid crisis response teams.
Medical marijuana laws did not reduce opioid misuse among women
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot 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.
How to read the evidence
Rigorous quasi-experimental design with large national dataset, but self-reported data and pre-2014 time frame.
When this study was published
2021 publication using 2002-2014 NSDUH data. Pre-dates many state marijuana program expansions.
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.
Questions still open
- 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?
Common questions
Do medical marijuana laws help women reduce opioid use?
Did the laws affect pregnant women differently?
Read the original research
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
Citation
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