Patients with cannabis-related disorders received significantly more opioid prescriptions and had more ER visits after carpal tunnel surgery compared to matched controls.
Hand surgeons, pain management specialists, and perioperative care teams.
30.9% of patients with cannabis disorders received opioids after carpal tunnel surgery vs 25.6% of matched controls
What the researchers found
Among 1,850 propensity-matched patients undergoing open carpal tunnel release, those with cannabis-related disorders (CRD) had higher rates of opioid prescriptions within 2 weeks (30.9% vs 25.6%, p=0.011), lower rates of outpatient follow-up within 6 weeks, and higher ER visits between 6-12 weeks (11.0% vs 8.0%, p=0.027).
Why it matters
Understanding how cannabis use disorders affect postoperative pain management and healthcare utilization helps surgeons set expectations and plan appropriate follow-up for these patients.
The numbers in context
925 CRD patients matched to 925 controls. Opioid prescriptions 0-2 weeks: 30.9% vs 25.6% (p=0.011). ED visits 6-12 weeks: 11.0% vs 8.0% (p=0.027). NCRD patients had higher outpatient follow-up rates within 6 weeks.
How the study worked
Retrospective cohort study using the TriNetX Research Network (2010-2022). 925 CRD patients propensity-matched 1:1 with 925 non-CRD patients on 7 characteristics. Outcomes tracked at 0-2, 2-6, and 6-12 weeks postoperatively.
What this study cannot tell us
Retrospective database study cannot determine causation. CRD diagnosis in medical records may not capture all cannabis users. Cannot distinguish between cannabis use for pain relief versus recreational use. Propensity matching does not eliminate all confounders.
How to read the evidence
Large propensity-matched cohort from a multi-institutional database, but retrospective design and database limitations constrain causal inference.
When this study was published
2025 publication with data from 2010-2022.
The bigger picture
The pattern of higher opioid prescribing, lower outpatient follow-up, and delayed ER presentations in CRD patients suggests these patients may have different pain management trajectories and healthcare engagement patterns that require tailored approaches.
Questions still open
- Do patients with CRD have higher baseline pain sensitivity, or do prescribers give them more opioids due to perceived need?
- Would preoperative cannabis cessation programs reduce postoperative opioid requirements?
Read the original research
Cannabis-Related Disorders Are Associated With Increased Early Postoperative Opioid Prescriptions and Delayed Emergency Department Visits Following Open Carpal Tunnel Release.
Hand (New York, N.Y.), 20(8), 1232-1236
Citation
Humble, Kirstin A; Vatsia, Sohrab K; Monahan, Peter F; Taylor, Kenneth F. (2025). Cannabis-Related Disorders Are Associated With Increased Early Postoperative Opioid Prescriptions and Delayed Emergency Department Visits Following Open Carpal Tunnel Release.. Hand (New York, N.Y.), 20(8), 1232-1236. https://doi.org/10.1177/15589447241284788
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