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To examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates. Panel regression methods. 812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017. The study used US mortality data from the Centers for Disease Control and Prevention combined with US census data and data from Weedmaps.com on storefront dispensary operations. Data were analyzed at the county lev