Effect of cannabis use history on postoperative opioid utilization in lumbar fusion patients: an American retrospective study
- Author:
Pranav MIRPURI
1
;
Syed Ibad KHALID
;
Patrick KING
;
Joanna Mary ROY
;
Aladine ELSAMADICY
;
Ankit Indravadan MEHTA
;
Owoicho ADOGWA
Author Information
- Publication Type:Clinical Study
- From:Asian Spine Journal 2024;18(5):639-646
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:In this database study, medical coding was used to identify patients who had undergone one- to three-level lumbar fusions between 2012 and 2021. Propensity score matching was used to create two equal cohorts with respect to cannabis use history. Opioid utilization rates (morphine milligram equivalents [MME]/day) and overuse rates at 6 months post-index procedure were assessed. All pvalues <0.05 were considered statistically significant.
Results:Following examination of 153,500 patient records, 1,216 patients were matched into cannabis user and non-cannabis user cohorts. Cannabis users had lower rates of opioid utilization compared to non-cannabis users as early as 2 months after fusion (47.7% vs. 41.1%, p <0.05), a relationship which persisted at 6 months (46.2% vs. 37.7%, p <0.01). Additionally, cannabis users had lower rates of high-dose opioid utilization (≥100 MME per day) during the initial 14–30 days following surgery (6.91% vs. 3.79%, p <0.05).
Conclusions:Patients with a history of cannabis use were less likely to be using opioids as early as 2 months postoperatively and had lower rates of high-dose opioid utilization in the immediate postoperative period. Physicians operating on these patients should consider their cannabis use patterns to provide appropriate titration of pain medication over time.
