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Cannabis may be a substitute for prescription opioids in the treatment of chronic pain. Previous studies have assessed recreational cannabis laws' effects on opioid prescriptions financed by specific private or public payers or dispensed to a unique endpoint. Our study adds to the literature in three important ways: by (1) examining these laws' impacts on prescription opioid dispensing across all payers and endpoints, (2) adjusting for important opioid\u2010related policies such as opioid prescribing limits, and (3) modeling opioids separately by type. We implement two\u2010way fixed\u2010effects regressions and leverage variation from eleven U.S. states that adopted a recreational cannabis law (RCL) between 2010 and 2019. We find that RCLs lead to a reduction in codeine dispensed at retail pharmacies. Among prescription opioids, codeine is particularly likely to be used non\u2010medically. Thus, the finding that RCLs appear to reduce codeine dispensing is potentially promising from a public health perspective.<\/jats:p>","DOI":"10.1002\/hec.4652","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T04:04:02Z","timestamp":1674101042000},"page":"747-754","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Recreational cannabis and opioid distribution"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5984-5417","authenticated-orcid":false,"given":"Shyam","family":"Raman","sequence":"first","affiliation":[{"name":"Jeb E. Brooks School of Public Policy Cornell University  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8581-0672","authenticated-orcid":false,"given":"Johanna Catherine","family":"Maclean","sequence":"additional","affiliation":[{"name":"Schar School of Policy and Government George Mason University NBER IZA  Fairfax Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8173-1168","authenticated-orcid":false,"given":"W. David","family":"Bradford","sequence":"additional","affiliation":[{"name":"School of Public and International Affairs University of Georgia  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0618-0626","authenticated-orcid":false,"given":"Coleman","family":"Drake","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3386\/w28471"},{"key":"e_1_2_8_3_1","volume-title":"Provisional drug overdose death counts","author":"Ahmad F.","year":"2022"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3386\/w29087"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.05266"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1661"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.1135"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.0266"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1257\/app.20190176"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/qje\/qjz014"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.3254"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S134330"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeconom.2021.03.014"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6199"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","unstructured":"Hollingsworth A. Wing C. &Bradford A.(2020).Comparative effects of recreational and medical marijuana laws on drug use among adults and adolescents.","DOI":"10.31235\/osf.io\/drx9f"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13548"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-025331"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.01.011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4190"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2019.102273"},{"key":"e_1_2_8_21_1","unstructured":"National Academies of Sciences E. 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