Cannabis Dispensary Access Linked to Modestly Lower Prescription-Opioid Use in Oregon
A 2024 study of Oregon communities found that areas located within one mile of a recreational cannabis dispensary had modestly lower per-capita prescription-opioid use than areas farther away. The researchers estimated that opioid prescribing was 1.0% to 3.9% lower in the closest communities—but they found no evidence that the reduction translated into fewer opioid-related deaths.
Published in Regional Science and Urban Economics, the study by W. Jason Beasley and Steven J. Dundas examined neighborhood-level opioid-prescription data alongside the locations and opening dates of state-licensed recreational cannabis dispensaries in Oregon.
The analysis covered monthly data from January 2014 through December 2017, a period that included nearly two years before and after Oregon’s recreational-cannabis market expanded. The researchers compared communities according to the distance residents would need to travel to reach a dispensary.
The pattern was nonlinear: prescription-opioid use was lowest in communities within one mile of a dispensary and generally increased as dispensaries became more distant. Communities located one to four miles away had higher prescribing rates than those within a mile, with rates rising further among communities four to 10 miles away and those 10 to 20 miles away.
One possible explanation is a substitution effect, in which some people use cannabis in place of prescription opioids for pain. However, the study did not track individual patients or determine whether people who filled fewer opioid prescriptions actually switched to cannabis. The findings therefore show a community-level association, not proof that dispensary access directly caused patients to change treatments.
The results also differ from some earlier studies of medical-cannabis laws, which reported larger reductions in opioid prescribing and, in some cases, opioid-related mortality. Beasley and Dundas found that the decline in prescriptions associated with recreational dispensary access was not accompanied by a meaningful change in opioid mortality in their data.
That distinction is important. Lower prescribing does not necessarily eliminate opioid misuse or prevent overdoses, particularly because mortality can involve illicit opioids, polysubstance use, changes in the drug supply and barriers to treatment. The study’s findings suggest that easier access to recreational cannabis may play a limited role in reducing prescription-opioid use, but they do not support treating cannabis legalization as a stand-alone response to the opioid crisis.
Readers can compare the study’s results with the Oregon Health Authority’s prescribing and overdose data and the CDC’s opioid-dispensing-rate maps. More research is needed to determine whether the observed relationship reflects actual substitution, differences in local health-care access or other characteristics of communities with nearby dispensaries.
