# Linking local variation in marijuana and opioid policies to health outcomes

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $201,354

## Abstract

PROJECT SUMMARY
We propose an Exploratory/Developmental Research Grant (R21) in response to “Public Policy Effects, on
Alcohol-, Marijuana-, and Other Substance-Related Behaviors and Outcomes” (PA-17-132) which calls for
studies of local implementation of state marijuana and opioid policies and their impacts on substance use
outcomes. Across the US, there is a trend toward liberalizing marijuana policy and addressing the opioid crisis.
The effects of cannabis legalization on health outcomes are not clear and preliminary evidence suggests this
may be due in part to local heterogeneity. Our work aims to develop a classification of local substance use
policies in California. California provides an ideal context for this study because its laws regarding cannabis
grant enormous latitude to localities to tax, limit, or ban retail and commercial businesses; unlike in other
states, there is no cap on local cannabis tax rates. Further, California is one of 16 states authorizing syringe
exchange programs (SEPs); as a result over 20 counties and cities have passed, opposed, and passed and
rescinded SEPs. We propose a developmental R21 study that will map heterogeneity in the implementation of
cannabis policies in 12 California counties, controlling for opiate policies, and then explore associations with
health outcomes related to cannabis and prescription opioid use. We hypothesize that: (a) local substance use
policies vary significantly and can be meaningfully classified by the degree to which they comprehensively
regulate cannabis and opiates; and (b) that more comprehensive local policies are associated with reduced
marijuana and prescription opioid use. Aim 1 will map and classify local substance use policies by scope. We
will collect written policy data and conduct key informant interviews with policymakers in 12 California counties.
We will then classify local policies to determine whether they are more or less comprehensive, for both
cannabis and opioids. Aim 2 will analyze the association between local policies and cannabis outcomes
including: 1) retail outlets (both storefront and online) identified through Weedmaps; 2) retail marijuana sales
from the California Board of Equalization; and 3) past-month cannabis use and modes of use from the
California Health Interview Survey. Aim 3 will explore the relationship between local policies and prescription
opioid use, using data from the California Controlled Substance Utilization Review and Evaluation System.
Studying local substance use policy within the large and diverse state of California will build understanding of
how local policies may influence broader trends in drug use.

## Key facts

- **NIH application ID:** 9852434
- **Project number:** 5R21DA046051-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Dorothy Elinor Apollonio
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $201,354
- **Award type:** 5
- **Project period:** 2019-02-01 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9852434

## Citation

> US National Institutes of Health, RePORTER application 9852434, Linking local variation in marijuana and opioid policies to health outcomes (5R21DA046051-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9852434. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*