Evidence mapPaperPMID 42061001Full record

SynthesisDrug and alcohol dependence2026

Association between state cannabis laws and opioid outcomes: A systematic review.

David S Fink, Lauren Gorfinkel, Sarah Gutkind, Diana Bachowski, Zachary L Mannes, Ofir Livne, Carol Malte, Emilie Bruzelius, Mark Olfson, Silvia S Martins and 5 more

Abstract readSystematic Review
In one paragraph

Synthesis in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

David S FinkNew York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA; Yale University, Department of Internal Medicine, 33 Cedar Steet, New Haven, CT 06510, USA.
Lauren GorfinkelNew York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA; Columbia University Irving Medical Center Department of Psychiatry, 1051 Riverside Dr, New York, NY 10032, USA.
Sarah GutkindColumbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA.
Diana BachowskiCenter of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA.
Zachary L MannesColumbia University Irving Medical Center Department of Psychiatry, 1051 Riverside Dr, New York, NY 10032, USA; Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA.
Ofir LivneNew York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA.
Carol MalteCenter of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA; Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA.
Emilie BruzeliusColumbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA.
Mark OlfsonColumbia University Irving Medical Center Department of Psychiatry, 1051 Riverside Dr, New York, NY 10032, USA.
Silvia S MartinsColumbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA.
Magdalena CerdáNew York University, 50 West 4th Street, New York, NY 10012, USA.
Salomeh KeyhaniSan Francisco VA Health System, 4150 Clement St, San Francisco, CA 94121, USA; University of California at San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, USA.
Andrew J SaxonCenter of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA; Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA; University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA.
Melanie WallNew York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA; Columbia University Irving Medical Center Department of Psychiatry, 1051 Riverside Dr, New York, NY 10032, USA.
Deborah S HasinNew York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA; Columbia University Irving Medical Center Department of Psychiatry, 1051 Riverside Dr, New York, NY 10032, USA; Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA. Electronic address: dsh2@cumc.columbia.edu.

Funding

Impact of Medical and Recreational Marijuana Laws On Cannabis, Opioids And Psychiatric Medications: National Study of VA Patients, 2000 - 2024R01DA048860 · NIDA · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI DEBORAH S HASIN · 2023 to 2023
$746k
COVID-19 Pandemic: Natural Experiment in Telehealth on Buprenorphine Treatment in a Large Integrated Healthcare SystemR00DA055724 · YALE UNIVERSITY · 2025 to 2025
$249k
Barriers to and Health Consequences of Non- Pharmacological Chronic Pain Treatment among Patients Tapering Prescription Opioids in a Large Integrated Healthcare SystemK01AT012205 · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2025 to 2025
$133k
NCCIH NIH HHS K01 AT012205NIDA NIH HHS K23 DA057417NIDA NIH HHS K99 DA055724NIDA NIH HHS R00 DA055724NIDA NIH HHS R01 DA048860
6 · The paper itself

Abstract

backgroundThrough increasing cannabis availability, state cannabis legalization has been posited as one potential solution to the opioid crisis by providing an alternative to long-term opioid use for treating chronic pain. Forty U.S. states have legalized cannabis for medical use and 25 for recreational use. We systematically reviewed the literature to investigate the relationship of state medical and recreational cannabis legalization (MCL and RCL, respectively) to rates of opioid prescriptions, nonmedical use, opioid use disorder (OUD), opioid-related hospitalizations and emergency department visits, and overdose deaths.

methodsWe searched EconLit, EMBASE, MEDLINE, and Web of Science Core Collection for English-language studies published through 10/21/25 that estimated MCL or RCL enactment effects on opioid outcomes compared to states that did not enact such laws. This study is registered with PROSPERO, CRD42023416119.

findingsOf 43 eligible studies, 18 investigated MCL, 11 investigated RCL, and 14 investigated both. Findings on MCL, RCL and opioid prescribing were mixed. No study found decreases in non-medical opioid use after MCL enactment; only one study found decreased non-medical use after RCL enactment. No studies found that MCL or RCL decreased OUD. MCL enactment was associated with lower opioid overdose mortality rates in earlier but not more recent studies; studies of RCL and opioid overdose fatalities had inconsistent results. INTERPRETATIONS: The mixed study findings suggest that MCL and RCL are just two factors in a complex set of influences on opioid outcomes that require further study. Meanwhile, cannabis legalization should not be considered an effective policy for curbing the opioid epidemic.

Indexed as

Analgesics, OpioidLegislation, DrugMedical MarijuanaOpioid-Related DisordersHumansUnited StatesAnalgesics, OpioidMedical MarijuanaCannabis legislationChronic painOpioid, prescriptionsOpioid useOpioid use disorderSystematic Review

Identifiers

PMID42061001
PMCPMC13214325

What Socratic holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.