Colorado sleep aid sales dropped sharply when recreational cannabis dispensaries opened nearby
Over-the-counter sleep aid market share declined 236% from its growth trend after recreational cannabis dispensaries opened in Colorado counties, suggesting widespread substitution of cannabis for conventional sleep medications.
Quick Facts
What This Study Found
Sleep aid market shares were growing before recreational cannabis availability, but the trend reversed with dispensary entry (-0.33 percentage points from a mean growth of 0.14). The decline increased with more dispensaries and higher county-level cannabis sales, and was driven by diphenhydramine and doxylamine products rather than herbal or melatonin supplements.
Key Numbers
236% decrease in sleep aid market share growth trend after dispensary entry. -0.33 percentage point shift (95% CI: -0.43 to -0.24, p < 0.01) from mean growth of 0.14. Effect size increased with dispensary count and sales volume. Driven by diphenhydramine/doxylamine products, not melatonin.
How They Did This
Multivariable panel regression using UPC-level grocery store scanner data comparing monthly sleep aid market shares against dispensary access (existence, sales, count) across Colorado counties between December 2013 and December 2014.
Why This Research Matters
Sleep disturbances are not a qualifying condition under any US medical cannabis law, yet this data shows people are already substituting cannabis for OTC sleep aids at scale. This gap between actual use and regulatory recognition has implications for both policy and clinical research.
The Bigger Picture
This is real-world market data showing large-scale behavior change. People are voting with their wallets, choosing cannabis over drugs like Benadryl and Unisom for sleep. This calls for comparative effectiveness research rather than just more surveys about preferences.
What This Study Doesn't Tell Us
Ecological study design cannot confirm individual-level substitution. Only covers one year of data in one state. Scanner data from grocery stores may not capture all OTC sleep aid purchases. Cannot determine whether cannabis is equally or more effective than OTC sleep aids.
Questions This Raises
- ?Is cannabis actually more effective than diphenhydramine or doxylamine for sleep?
- ?Why was melatonin not affected by the substitution?
- ?What are the comparative side effect profiles of cannabis versus OTC sleep aids for long-term use?
Trust & Context
- Key Stat:
- 236% reversal in sleep aid market share growth after dispensary entry
- Evidence Grade:
- Moderate: rigorous econometric analysis with large dataset and multiple controls, but ecological design.
- Study Age:
- Published in 2019, using 2013-2014 data.
- Original Title:
- Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado.
- Published In:
- Complementary therapies in medicine, 47, 102207 (2019)
- Authors:
- Doremus, Jacqueline M, Stith, Sarah S(3), Vigil, Jacob M(3)
- Database ID:
- RTHC-02017
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Are people replacing sleep pills with cannabis?
This study found strong evidence of substitution in Colorado. When recreational dispensaries opened, sales of antihistamine-based sleep aids like Benadryl and Unisom dropped significantly, while melatonin and herbal products were unaffected.
Is cannabis better for sleep than OTC sleep aids?
This study measured purchasing behavior, not effectiveness. It shows people are choosing cannabis over OTC sleep aids, but comparative clinical trials are needed to determine which option is safer and more effective.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-02017APA
Doremus, Jacqueline M; Stith, Sarah S; Vigil, Jacob M. (2019). Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado.. Complementary therapies in medicine, 47, 102207. https://doi.org/10.1016/j.ctim.2019.102207
MLA
Doremus, Jacqueline M, et al. "Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado.." Complementary therapies in medicine, 2019. https://doi.org/10.1016/j.ctim.2019.102207
RethinkTHC
RethinkTHC Research Database. "Using recreational cannabis to treat insomnia: Evidence from..." RTHC-02017. Retrieved from https://rethinkthc.com/research/doremus-2019-using-recreational-cannabis-to
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.