Does Cannabis Use Before Surgery Affect Pain and Opioid Needs Afterward? | Research

The takeaway

Cannabis users may experience higher postoperative pain and need more opioids, but results vary significantly by surgical type.

Surgeons, anesthesiologists, pain management specialists, patients preparing for surgery

What the researchers found

Of 42 studies, 33.3% found cannabis users reported higher postoperative pain, 23.8% found no difference, and 42.9% indicated greater postoperative opioid requirements. Results varied by surgical specialty — spine and mixed cohorts showed more opioid use, while arthroplasty studies often showed no difference.

Why it matters

With more surgical patients using cannabis, surgeons and anesthesiologists need clear guidance on how to manage perioperative pain — this review shows the answer isn't one-size-fits-all.

The numbers in context

42 studies reviewed. Pain outcomes: 33.3% found higher pain in cannabis users, 23.8% no difference, 4.8% reduced pain. Opioid use: 42.9% found greater requirements, 40.5% no difference, 7.1% reduced use. Spine populations showed increased opioid use in 55% of studies.

How the study worked

Systematic search of PubMed, CINAHL, and Embase identifying 42 studies from the past ten years examining preoperative cannabis use and its relationship with postoperative pain and opioid consumption, analyzed via narrative synthesis.

What this study cannot tell us

Heterogeneous exposure definitions and outcome metrics limit cross-study comparisons. Most studies are retrospective and observational. Cannabis potency, frequency, and method of use were rarely standardized.

How to read the evidence

Comprehensive review of 42 studies provides broad evidence base, but heterogeneity in methods and mixed results prevent definitive conclusions.

When this study was published

Reviews studies from the past ten years, published 2026.

The bigger picture

The mixed results suggest that cannabis's effect on surgical recovery may depend on factors like surgery type, cannabis use patterns, and individual biology — pointing toward personalized perioperative approaches rather than blanket policies.

Questions still open

Why do outcomes differ so much by surgical type? Would standardized cannabis use assessments improve surgical planning? Could controlled perioperative cannabis use actually benefit some patients?

Common questions

Should I stop using cannabis before surgery?

Research suggests cannabis users may experience more pain and need more opioids after surgery, particularly for spine procedures. Discussing your cannabis use with your surgical team is important for optimizing pain management.

Does cannabis use affect all surgeries the same way?

No — spine surgery patients who use cannabis more often needed extra opioids (55% of studies), while joint replacement studies mostly found no difference (62%), suggesting the impact varies by procedure type.

Read the original research

Preoperative cannabinoid exposure and postoperative pain: A narrative review.

Journal of clinical anesthesia, 109, 112097

View on PubMed ↗Publisher’s paper ↗

Citation

King, Daniel D; Temmermand, Rhea; Greenwood, Jennifer E. (2026). Preoperative cannabinoid exposure and postoperative pain: A narrative review.. Journal of clinical anesthesia, 109, 112097. https://doi.org/10.1016/j.jclinane.2025.112097