OBJECTIVE In this study we assess whether changes in ZIP code-level density of medical marijuana facilities are related to changes in rates of opioid poisonings and opioid use disorder hospitalizations in California. METHOD A panel study using California hospital discharge data was conducted to assess the relationship between density of medical marijuana dispensaries and opioid poisonings and use disorder. There were 8,536 space-time units at the ZIP code level. Outcome measures included ZIP code counts of opioid poisonings and opioid use disorder; independent variables were local- and adjacent-area medical marijuana dispensaries and demographic and economic characteristics. RESULTS Independent of effects for covariates, densities of medical marijuana dispensaries were positively related to opioid use disorder (RR = 1.05, CI [1.03, 1.06]) and opioid poisonings (RR = 1.04, CI [1.02, 1.05]) in local areas, but negatively related to opioid misuse in spatially adjacent areas (RR = 0.91, CI [0.88, 0.94] for opioid use disorder, RR = 0.89, CI [0.86, 0.93] for opioid poisonings). CONCLUSIONS Although state-level studies suggest that more liberal marijuana policies may result in fewer opioid overdose deaths, our results within one state suggest that local availability of medical marijuana may not reduce those deaths. The relationship appears to be more complex, possibly based on socioeconomic conditions within and adjacent to areas with higher densities of medical marijuana dispensaries.

中文翻译：

---

阿片类药物滥用和通过药房提供的医用大麻

目的在这项研究中，我们评估了加利福尼亚医用大麻设施的邮政编码水平密度的变化是否与阿片类药物中毒率和阿片类药物使用障碍住院率的变化有关。方法使用加利福尼亚州医院出院数据进行小组研究，以评估医用大麻药房的密度与阿片类药物中毒与使用障碍之间的关系。邮政编码级别有8,536个时空单位。结果措施包括阿片类药物中毒和阿片类药物使用障碍的邮政编码计数；自变量是局部和邻近区域的医用大麻药房以及人口和经济特征。结果独立于协变量的影响，医用大麻药房的密度与阿片类药物使用障碍呈正相关（RR = 1.05，CI [1.03，1。06]）和局部地区的阿片类药物中毒（RR = 1.04，CI [1.02，1.05]），但与阿片类药物滥用在空间上相邻的区域呈负相关（RR = 0.91，阿片类药物使用障碍的CI [0.88，0.94]，RR =阿片类药物中毒为0.89，CI [0.86，0.93]。结论尽管州一级的研究表明，更宽松的大麻政策可能导致更少的阿片类药物过量死亡，但我们在一个州内的研究结果表明，当地可获得的医用大麻可能无法减少这些死亡。这种关系似乎更加复杂，可能是基于医用大麻药房密度较高的区域内及其附近的社会经济状况。93]。结论尽管州一级的研究表明，更宽松的大麻政策可能导致更少的阿片类药物过量死亡，但我们在一个州内的研究结果表明，当地可获得的医用大麻可能无法减少这些死亡。这种关系似乎更加复杂，可能是基于医用大麻药房密度较高的区域内及其附近的社会经济状况。93]。结论尽管州一级的研究表明，更宽松的大麻政策可能导致更少的阿片类药物过量死亡，但我们在一个州内的研究结果表明，当地可获得的医用大麻可能无法减少这些死亡。这种关系似乎更加复杂，可能是基于医用大麻药房密度较高的区域内及其附近的社会经济状况。