Cannabis use in IBD patients was linked to more ER visits, hospitalizations, and opioid use but not more surgeries or deaths

In a propensity-matched population study, IBD patients who used cannabis had significantly more ER visits (2.1x), hospitalizations (1.9x), corticosteroid use, and opioid use compared to non-users, though surgery and death rates were not different.

Glickman, Danny et al.·Inflammatory bowel diseases·2024·Moderate EvidenceObservational
RTHC-05343ObservationalModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

After propensity score matching, cannabis-using IBD patients had increased risk for ER visits (RR 2.143), hospitalizations (RR 1.925), corticosteroid use (RR 1.095), and opioid use (RR 1.35). No increased risk of IBD-related surgery or death. Crohn's disease patients specifically showed increased corticosteroid and opioid use, while ulcerative colitis patients showed similar patterns for ER visits and hospitalizations.

Key Numbers

ER visits: RR 2.143 (95% CI 2.034-2.257). Hospitalizations: RR 1.925 (95% CI 1.783-2.079). Corticosteroid use: RR 1.095 (95% CI 1.021-1.174). Opioid use: RR 1.35 (95% CI 1.14-1.6). All p<0.05. No significant difference for surgery or death.

How They Did This

Retrospective propensity score-matched study using the TriNetX Diamond Network. Separate analyses for IBD overall, Crohn's disease, and ulcerative colitis. Baseline differences controlled through matching.

Why This Research Matters

Many IBD patients use cannabis for symptom relief, but this large population study suggests cannabis use is associated with markers of worse disease management, raising questions about whether cannabis helps or hinders IBD outcomes.

The Bigger Picture

The paradox of increased healthcare utilization without increased surgery or death suggests cannabis users may have more poorly controlled disease (or seek care more often) without necessarily having worse long-term structural outcomes.

What This Study Doesn't Tell Us

Cannot determine whether cannabis use causes worse outcomes or whether sicker patients are more likely to use cannabis. Administrative data cannot capture disease severity, cannabis dose, or symptom burden. Propensity matching may not capture all confounders.

Questions This Raises

  • ?Are cannabis-using IBD patients sicker to begin with?
  • ?Could cannabis be masking symptoms that delay appropriate treatment?

Trust & Context

Key Stat:
2x more ER visits and 1.9x more hospitalizations in cannabis-using IBD patients
Evidence Grade:
Large propensity-matched database study with disease-specific subanalyses, though retrospective design cannot establish causation.
Study Age:
2024 study
Original Title:
The Impact of Cannabis Use on Clinical Outcomes in Inflammatory Bowel Disease: A Population-based Longitudinal Cohort Study.
Published In:
Inflammatory bowel diseases, 30(7), 1055-1061 (2024)
Database ID:
RTHC-05343

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Should people with IBD avoid cannabis?

This study shows associations, not causation. Cannabis users may have more severe disease that drives both cannabis use and healthcare utilization. The absence of increased surgery or death suggests cannabis is not causing catastrophic harm.

Why might cannabis users have more ER visits?

Possible explanations include that cannabis users have more severe baseline disease, that cannabis may mask symptoms leading to delayed treatment, or that cannabis users may have lower thresholds for seeking emergency care for other reasons.

Read More on RethinkTHC

Cite This Study

RTHC-05343·https://rethinkthc.com/research/RTHC-05343

APA

Glickman, Danny; Dalessio, Shannon; Raup-Konsavage, Wesley M; Vrana, Kent E; Coates, Matthew D. (2024). The Impact of Cannabis Use on Clinical Outcomes in Inflammatory Bowel Disease: A Population-based Longitudinal Cohort Study.. Inflammatory bowel diseases, 30(7), 1055-1061. https://doi.org/10.1093/ibd/izad151

MLA

Glickman, Danny, et al. "The Impact of Cannabis Use on Clinical Outcomes in Inflammatory Bowel Disease: A Population-based Longitudinal Cohort Study.." Inflammatory bowel diseases, 2024. https://doi.org/10.1093/ibd/izad151

RethinkTHC

RethinkTHC Research Database. "The Impact of Cannabis Use on Clinical Outcomes in Inflammat..." RTHC-05343. Retrieved from https://rethinkthc.com/research/glickman-2024-the-impact-of-cannabis

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.