The evidence for a widely-held theory is thin
WEEDMAPS, an app that allows cannabis users to find sellers and review their wares, advertises its services through “Weedfacts”—marijuana-promoting factoids on bus stops and billboards in Washington, DC, where recreational use has been decriminalised. The signs proclaim that the legalisation of cannabis improves property values and decreases teenage use and crime. Harmless advertising perhaps.
The idea that cannabis legalisation—for both medical and recreational purposes—could seriously make a dent in America’s opioid crisis is common. This month, the state health commissioner of New York issued emergency regulations allowing anyone with an opioid addiction to obtain medical marijuana, calling it “a critical step in combating the deadly opioid epidemic affecting people across the state”. Illinois has introduced a similar programme.
A recent paper by Chelsea Shover, an epidemiologist and a postdoctoral fellow at Stanford University, showed that this was a mistake. By simply extending the study period up to 2017—the time period during which the opioid crisis accelerated—she shows that the association between opioid deaths and medical marijuana legalisation flipped from strongly negative to strongly positive.
The flawed interpretations of the original paper fell afoul of what statisticians call the ecological fallacy, when an inference is made about an individual based on statistical data for a group. Poorer states may be more likely to vote for Republicans, but that does not mean that poorer people are more likely to vote for the party, for example.
There is danger in haste. Opioid addiction is a chronic disorder characterised by repeated relapses. It is exceptionally hard to kick. People who receive medically-assisted treatment—generally methadone, buprenorphine or naltrexone—are much less likely to relapse than those who try mere abstention. But only one in five Americans with an opioid use disorder—the medical term for addiction—are currently receiving treatment.
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