The effects of relaxing state laws related to marijuana use on adolescent opioids use and treatment admissions

Research question: Does legalizing the use of marijuana (recreationally and/or medically) affect the use of opioids and treatment admissions for opioids among adolescents?

Background and motivation:

Opioids misuse and related overdose deaths has been rapidly increasing in the U.S over the recent decades. Compared to adults, past year or month misuse of prescription opioids have dropped over the last 5 years among 12^thgraders, according to the 2017 Monitoring the Future data. According to the 2017 Youth Risk Behavior Surveillance System, 14% of 9 to 12^thgraders reported that they used prescription pain medicine differently than doctor’s instructions. Compared to 2003, admission due to opiates other than heroine among 12 to 17-year-olds increased from 39 percent in 2003 to 48 percent in 2013 (Treatment Episode Data-A), while the opposite trend holds true for marijuana during the same period.

Many studies have linked the relationship between laws allowing the use of recreational and medical marijuana use and prescription opioid use or overdose outcomes, finding evidence of substitutability between marijuana and opioids. However, studies on teenager’s misuse or treatment on opioid use are difficult to find. For teenagers the primary reasons for misuse of opioids may differ from adults in that it may be more driven by reasons other than relieving pain. This would be an important policy question to examine as it is important to reduce opioid dependence and misuse from early adolescence and to investigate whether there is a significant relationship between opioid misuse and relaxing the state laws related to marijuana use.

Data and Methods:

For this study, I plan to use two (and possibly three different data sets). I plan to use the restricted-use National Survey of Drug Use and Health (NSDUH) data, which contains detailed questionnaires related to prescription opioid use for those of age 12 and higher. Another data set that I will use for this study is Treatment Episode Data Set-A (TEDS-A) data from 1992 to 2015. TEDS-A contains admission to substance abuse treatment facilities in the US and has information on admission demographics and substance use characteristics.

I will use a difference-in-difference model and propensity score matching to answer this research question. Given that previous studies have found that treatment admissions related to marijuana has decreased after the implementation of medical marijuana laws among adolescents (Pacula et al., 2013; Pacula et al., 2013; Anderson et al., 2015), whether the same pattern holds true for opioid-related admissions remains an empirical question to investigate.

Anderson D. M., Hansen B., Rees D. I. Medical marijuana laws and teen marijuana use. Am Law Econ Rev 2015;17;4950528

Pacula R., Powell D., Heaton P., Sevigny E. L. Assessing the effects of medical marijuana laws on marijuana and alcohol use: the devil is in the details. Report no.: Working Paper 9302 Cambridge, MA: National Bureau of Economic Research; 2013

Pacula R. L., Powell D., Heaton P., Sevigny E. L. Assessing the effects of medical marijuana laws on marijuana use: the devil is in the details. J Policy Anal Manage2015; 34 :7–31.