Prevalence of Cannabis Dispensaries Linked to Reduced Opioids Deaths Interview with:

Balázs Kovács PhD Associate Professor of Organizational Behavior Yale School of Management

Dr. Kovács

Balázs Kovács PhD
Associate Professor of Organizational Behavior
Yale School of Management What is the background for this study?

Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S.  We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates.   We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older.  The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs. What are the main findings? 

Response: As business school researchers, we first became interested in the increasing prevalence of legal cannabis stores  as an organizational issue.  We tracked evolving cannabis markets across the U.S. from 2014 onwards in an effort to understand how this new category of organizations emerged.  We realized, however, that our county-level database could also be used to examine whether the availability of legal cannabis in an increasing number of geographic areas has any implications for opioid misuse.  Given how serious the epidemic of opioid misuses and drug overdose deaths has become, we thought this was an important public health question worth investigation. Are there important confounders you weren’t able to control for, or other limitations?

Response: The associations we document cannot be assumed to be causal–they only suggest a potential relationship between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid-related mortality rates.  Further, while we find a particularly strong association between the prevalence of storefront dispensaries and fentanyl-related opioid deaths, it is not clear whether cannabis use and fentanyl mortality rates are more specifically linked, or if the strength of the association is due to the rise in fentanyl use and mortality rates during the study period.  Finally, one cannot ignore cannabis’ potential harms for adolescent’s cognitive development, medical conditions such as schizophrenia, and public safety risks.  Overall, we believe greater understanding the public health outcomes of cannabis legalization on opioid misuse is needed so that policymakers can properly weigh the potential benefits versus harms of promoting cannabis legalization.


Hsu Greta, Kovács Balázs. Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study BMJ 2021; 372 :m4957



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Last Updated on January 29, 2021 by Marie Benz MD FAAD