Cannabis-using IBD patients received more opioids during hospitalization
Among 423 hospitalized inflammatory bowel disease patients, preadmission cannabis use was associated with higher inpatient opioid exposure even after controlling for disease severity and prior opioid use.
Quick Facts
What This Study Found
Preadmission cannabis use was significantly correlated with higher inpatient opioid exposure (coefficient = 12.1 IV morphine mg equivalents/day; 95% CI: 2.6-21.5) after adjusting for IBD severity, pain scores, and preadmission opioid use.
Key Numbers
423 IBD patients studied; cannabis use coefficient = 12.1 IV morphine mg equivalents/day (95% CI: 2.6-21.5); first pain score coefficient = 1.3 (95% CI: 0.6-2.0); preadmission opioid use coefficient = 22.3 (95% CI: 17.0-27.6)
How They Did This
Retrospective cohort study of 423 adults hospitalized for IBD at a large academic health system from March 2017 to April 2018. Opioid exposure was calculated as total IV morphine milligram equivalents divided by length of stay. Multivariable linear regression adjusted for confounders including disease severity and preadmission opioid use.
Why This Research Matters
Opioid use in IBD patients is associated with excess mortality, and inpatient opioid exposure predicts post-discharge opioid use. If cannabis-using patients receive more opioids during hospitalization, it raises questions about pain management strategies for this population.
The Bigger Picture
This finding complicates the narrative that cannabis can serve as an opioid substitute. In this hospital setting where patients lacked access to cannabis, those who used it before admission ended up receiving more opioids, not fewer.
What This Study Doesn't Tell Us
Retrospective design from a single institution. Cannabis use was self-reported and binary (yes/no) without dosage or frequency details. Cannot determine causation. Patients lacked cannabis access during hospitalization, which may have affected pain management needs.
Questions This Raises
- ?Would providing cannabis access during hospitalization reduce opioid requirements?
- ?Does regular cannabis use alter pain perception or tolerance in ways that increase opioid needs when cannabis is unavailable?
Trust & Context
- Key Stat:
- 12.1 additional IV morphine mg equivalents/day associated with cannabis use
- Evidence Grade:
- Retrospective cohort with appropriate statistical controls, but single-center design and binary cannabis use measurement limit conclusions.
- Study Age:
- Published in 2021 using 2017-2018 hospital data.
- Original Title:
- Preadmission Cannabis Use Is Positively Correlated With Inpatient Opioid Dose Exposure in Hospitalized Patients With Inflammatory Bowel Diseases.
- Published In:
- Inflammatory bowel diseases, 27(4), 500-506 (2021)
- Authors:
- Dalal, Rahul S, Palchaudhuri, Sonali, Snider, Christopher K, Lewis, James D, Mehta, Shivan J, Lichtenstein, Gary R
- Database ID:
- RTHC-03083
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Did cannabis use cause higher opioid needs?
The study found an association, not causation. Cannabis-using patients may have had higher pain levels, different pain thresholds, or withdrawal effects from losing cannabis access during hospitalization.
How strong was the cannabis effect compared to prior opioid use?
Preadmission opioid use had a stronger association (coefficient = 22.3) than cannabis use (coefficient = 12.1), but both were independently significant predictors of inpatient opioid exposure.
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Cite This Study
https://rethinkthc.com/research/RTHC-03083APA
Dalal, Rahul S; Palchaudhuri, Sonali; Snider, Christopher K; Lewis, James D; Mehta, Shivan J; Lichtenstein, Gary R. (2021). Preadmission Cannabis Use Is Positively Correlated With Inpatient Opioid Dose Exposure in Hospitalized Patients With Inflammatory Bowel Diseases.. Inflammatory bowel diseases, 27(4), 500-506. https://doi.org/10.1093/ibd/izaa104
MLA
Dalal, Rahul S, et al. "Preadmission Cannabis Use Is Positively Correlated With Inpatient Opioid Dose Exposure in Hospitalized Patients With Inflammatory Bowel Diseases.." Inflammatory bowel diseases, 2021. https://doi.org/10.1093/ibd/izaa104
RethinkTHC
RethinkTHC Research Database. "Preadmission Cannabis Use Is Positively Correlated With Inpa..." RTHC-03083. Retrieved from https://rethinkthc.com/research/dalal-2021-preadmission-cannabis-use-is
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.