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We examined associations between prescription monitoring programs with access mandates (must-query PDMPs), legalization of medical and recreational cannabis supply, and opioid overdose deaths in United States counties in 2013-2020. Using data on overdose deaths from the National Vital Statistics System, we fit Bayesian spatiotemporal models to estimate risk differences and 95% credible intervals (CrIs) in county-level opioid overdose deaths associated with enactment of these state policies. Must-query PDMPs were independently associated with on average 0.8 (95% CrI, 0.5-1.0) additional opioid-involved overdose deaths per 100\u2009000 person-years. Legal cannabis supply was not independently associated with opioid overdose deaths in this time period. Must-query PDMPs enacted in the presence of legal (medical or recreational) cannabis supply were associated with 0.7 (95% CrI, 0.4-0.9) more opioid-involved deaths relative to must-query PDMPs without any legal cannabis supply. In a time when overdoses are driven mostly by nonprescribed opioids, stricter opioid prescribing policies and more expansive cannabis legalization were not associated with reduced overdose death rates.<\/jats:p>\n               <jats:p>This article is part of a Special Collection on Mental Health.<\/jats:p>","DOI":"10.1093\/aje\/kwae210","type":"journal-article","created":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T04:54:00Z","timestamp":1721451240000},"page":"791-801","source":"Crossref","is-referenced-by-count":6,"title":["The role of prescription opioid and cannabis supply policies on opioid overdose deaths"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8441-7046","authenticated-orcid":false,"given":"Magdalena","family":"Cerd\u00e1","sequence":"first","affiliation":[{"name":"Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine , New York, NY ,","place":["United 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