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Comment & Response
September 2018

Opioid Death Rate Acceleration in Jurisdictions Legalizing Marijuana Use—Reply

Author Affiliations
  • 1Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, Georgia
  • 2National Bureau of Economic Research, Cambridge, Massachusetts
  • 3Department of Health Management and Policy, University of Kentucky College of Public Health, Lexington
JAMA Intern Med. 2018;178(9):1282. doi:10.1001/jamainternmed.2018.3894

In Reply Both our study1 and that of Bradford and colleagues2 have been called into question by the analysis of Bleyer and Barnes.3 However, their statistical treatment of states with regard to states’ policies is misleading. Rather than use the longitudinal data at their disposal to examine the changes in states’ cannabis policies over the 2010-2016 period and evaluate whether these changes affected opioid outcomes, Bleyer and Barnes assigned states a cannabis policy for the entire period based on the policy in effect in the state as of 2016.3 For example, in their analysis, Florida was considered as having a cannabidiol extract law from 2010 through 2016, even though the law was not in place until August 2016. Thus in their study, opioid deaths in Florida in 2010 are attributed to the 2016 law change.

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