Washington State saw more traffic crashes after marijuana legalization and retail sales

Using county-level crash data and interrupted time series analysis, marijuana legalization and especially the start of retail sales in Washington State were associated with increased traffic collisions.

Voy, Annie·Traffic injury prevention·2023·Moderate Evidencequasi-experimental
RTHC-05005Quasi ExperimentalModerate Evidence2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
quasi-experimental
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Traffic collisions increased following both the legalization of recreational cannabis and the opening of retail stores in Washington State. The commercialization phase (retail sales) showed a stronger association with crash increases than legalization alone.

Key Numbers

Washington legalized recreational cannabis December 6, 2012. Retail stores opened approximately 19 months later. County-level monthly crash data analyzed. Both events associated with increased collisions.

How They Did This

Interrupted time series analysis using county-level monthly vehicle crash data from the Washington State Department of Transportation. Measured the impact of two events: legalization (December 2012) and retail commercialization (~19 months later).

Why This Research Matters

As more states legalize cannabis, understanding the traffic safety implications is critical for policy design. Washington was among the first to legalize, providing the longest available data window.

The Bigger Picture

Traffic safety is one of the most concrete measurable public health outcomes of cannabis legalization. If retail access (not just legal status) drives crash increases, it suggests availability and access patterns matter more than legal status alone.

What This Study Doesn't Tell Us

Ecological study cannot link crashes to individual cannabis use. Other factors changing simultaneously (e.g., economic conditions, tourism, smartphone use) may confound results. Pre-legalization cannabis use was already common. Cannot distinguish cannabis-impaired crashes from general crash increases.

Questions This Raises

  • ?Do states with different regulatory models (e.g., delivery-only, limited retail) see smaller crash increases?
  • ?Did crash rates stabilize or continue rising after the initial commercialization period?

Trust & Context

Key Stat:
Retail cannabis sales associated with greater crash increases than legalization alone
Evidence Grade:
Quasi-experimental design with appropriate time series methods. Ecological data limits individual-level causal inference.
Study Age:
Published 2023. Data from Washington State, legalization in 2012.
Original Title:
Collisions and cannabis: Measuring the effect of recreational marijuana legalization on traffic crashes in Washington State.
Published In:
Traffic injury prevention, 24(7), 527-535 (2023)
Authors:
Voy, Annie
Database ID:
RTHC-05005

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Does legalizing marijuana increase car accidents?

This Washington State study found traffic collisions increased after both legalization and the opening of retail stores, with retail sales showing a stronger association. However, the study cannot prove cannabis use caused the crashes, as many factors changed during the same period.

Why did retail sales matter more than legalization itself?

Legalization changed legal status but retail commercialization changed access. When stores opened, cannabis became easier to obtain for more people, potentially increasing the population of impaired drivers. This suggests that availability and access drive traffic safety outcomes more than legal status alone.

Read More on RethinkTHC

Cite This Study

RTHC-05005·https://rethinkthc.com/research/RTHC-05005

APA

Voy, Annie. (2023). Collisions and cannabis: Measuring the effect of recreational marijuana legalization on traffic crashes in Washington State.. Traffic injury prevention, 24(7), 527-535. https://doi.org/10.1080/15389588.2023.2220853

MLA

Voy, Annie. "Collisions and cannabis: Measuring the effect of recreational marijuana legalization on traffic crashes in Washington State.." Traffic injury prevention, 2023. https://doi.org/10.1080/15389588.2023.2220853

RethinkTHC

RethinkTHC Research Database. "Collisions and cannabis: Measuring the effect of recreationa..." RTHC-05005. Retrieved from https://rethinkthc.com/research/voy-2023-collisions-and-cannabis-measuring

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.