Over the last two decades, the drug overdose crisis—driven by opioids—has taken an unimaginable toll on American families and communities.
Yet the data suggest progress is being made in combating this epidemic. In 2024, opioid overdose deaths in the U.S. were nearly 27 percent lower than they had been in 2023—the first time that national opioid overdose deaths have decreased since 1999. In new research, we find that part of this decline can be explained by how states regulate the use of recreational marijuana.
Our failure to combat America’s deadly relationship with opioids is not from a lack of trying. Politicians and policymakers have tried seemingly every angle to save lives. Restricting opioid prescriptions, improving access to anti-overdose drugs, and tightening border security have not had a significant effect.
The opioid crisis has gotten so out of hand that many states will give people possessing heroin and engaged in other crimes complete legal immunity if they call 911 when witnessing an opioid overdose. While well-intended, these so-called Good Samaritan Laws have also done little to curb the opioid epidemic’s death toll.
Although these efforts have come up short, our research, now published in the Southern Economic Journal, examines how recreational marijuana legalization affects opioid overdose deaths. Analyzing trends in state laws and opioid deaths from twenty years of data, we find that states that legalized recreational marijuana experienced significantly fewer overdose deaths.
We also found that states that legalized recreational marijuana earliest (for example, in the early 2000s) experience larger decreases in opioid deaths. Early adopters, such as Colorado and Washington state, continued to see fewer opioid-related deaths a decade after the policy took effect. Our results even held up during the COVID-19 pandemic, when heartbreakingly many people turned to substance abuse to cope with unprecedented times.
Intuitively, this makes sense. Like opioids, marijuana has long been recognized as an effective pain reliever. It is also much less habit-forming than opiates and does not pose a risk of fatal overdose. When marijuana is legal and accessible, drug users are less likely to turn to life-threatening alternatives like fentanyl. With nearly 53 million self-reported recreational marijuana users nationally, greater access through state-level policy reform has the potential to reduce opioid use and its potential harm dramatically.
Despite widespread concerns that marijuana use leads to harder drugs, there is little evidence that it is a so-called “gateway drug.” In general, countries with decriminalized marijuana seldom have high rates of hard drug use.
Currently, 24 states and the District of Columbia have legalized recreational marijuana use. Current legislation proposed in Hawaii, Pennsylvania, and Virginia could soon tip the scales and make it legal in the majority of states. National reconsideration of marijuana’s drug scheduling could prompt more even more states to join the list.
Even Nebraska—a historically hostile place for liberalized marijuana policy—recently passed a law allowing for medicinal marijuana use with overwhelming support. Similarly, Texas has also moved to expand medicinal marijuana access dramatically.
As the tides move intensely in favor of legalization, allowing greater access to marijuana depends heavily on the public’s perception of how to balance its potential harms against its benefits. Our research provides strong evidence that recreational marijuana legalization can help combat the opioid crisis and prevent opioid misuse. The recent decline in opioid overdose deaths is an encouraging sign. Continuing that trend will require policymakers to abandon ideas that don’t work and focus on reforms that have a real impact.
Legalizing recreational marijuana is a step in the right direction.