Association for Public Policy Analysis & Management

In the past 20 years, state laws regulating the sale and possession of marijuana have undergone significant changes. To date, 28 states and the District of Columbia have passed laws that formally recognize the medical value of marijuana. At the same time, there has been a significant increase in opioid use and abuse within the United States. According to the Centers for Disease Control and Prevention, the number of opioid prescriptions have quadrupled since 1999, along with the rate of opioid related deaths, which reached just over 33,000 in 2015.

Recently, the Associated Press and the Center for Public Integrity concluded that opioid manufacturers and related interest groups spent over $880 million between 2006 and 2015 in an effort to block policies aimed at controlling opioid abuse, including state adoption of medical marijuana laws (MMLs). For example, Insys Therapeutics Inc. (a producer of Fentanyl) donated $500,000 towards defeating Arizona’s medical marijuana ballot in 2016. Recent evidence by Bradford and Bradford (2016) found that when MMLs are implemented spending on pain medications in Medicare Part D falls substantially. More recent evidence suggests that the effect is even larger when states allow dispensaries to be a mechanism for medical marijuana distribution.

Currently, 20 of the 28 states and D.C. include a dispensary system as part of their MML. However, there can be significant delays between when a state’s governor signs an MML into effect and when the state actually permits dispensaries to open. One question that has not been studied is whether political contributions by pharmaceutical companies influence the delay before a state adopts any MML and then the length of time between passage of an MML and the opening of a dispensary. In order to explore this relationship, we will use the “Politics of Pain” political contribution data from 2000 to 2015 and state-level demographic and political attitude data to estimate linked mixed proportional hazard models that predict the duration to adoption of an MML and then the subsequent duration between adoption and the opening a the first dispensary in a state. The implications for the political economy of opioid and marijuana related polices will be discussed.