Cannabis users needed nearly twice as many opioids after spinal fusion surgery

Opioid-naive cannabis users consumed significantly more prescription opioids after posterior lumbar spinal fusion surgery than non-users, despite having fewer comorbidities.

Moon, Andrew S et al.·Global spine journal·2024·Moderate EvidenceRetrospective Cohort
RTHC-05565Retrospective CohortModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Among 220 opioid-naive patients, 29 cannabis users consumed significantly more postoperative prescription opioids (2,545 vs 1,380 morphine equivalent doses, p=.019) than 191 non-users. Cannabis users were younger (56 vs 65, p<.001), had more depression (31% vs 14%, p=.017), and lower comorbidity (1.38 vs 2.49, p=.002).

Key Numbers

220 opioid-naive patients. 29 (13%) cannabis users. Post-discharge opioids: 2,545 vs 1,380 morphine equivalent doses (p=.019). Cannabis users younger (56 vs 65), more depression (31% vs 14%), lower comorbidity (1.38 vs 2.49).

How They Did This

Retrospective review of 220 opioid-naive patients who underwent one- or two-level posterior lumbar fusion surgery, categorized by preoperative cannabis use diagnosis.

Why This Research Matters

Cannabis is often promoted as an opioid alternative for pain, but this study found the opposite in surgical patients: cannabis users needed more opioids postoperatively.

The Bigger Picture

Cross-tolerance between cannabinoid and opioid systems may explain why regular cannabis use raises rather than lowers postoperative opioid requirements.

What This Study Doesn't Tell Us

Small cannabis user group (n=29). Retrospective design. Cannabis use identified by diagnosis codes, not objective testing. Single surgical procedure type.

Questions This Raises

  • ?Does preoperative cannabis cessation normalize opioid requirements after surgery?
  • ?Is the increased opioid need due to pharmacological cross-tolerance or differences in pain perception?

Trust & Context

Key Stat:
morphine equivalent doses used post-discharge by cannabis users versus non-users after spinal fusion
Evidence Grade:
Retrospective cohort from a single center with small cannabis user group, but the magnitude of the opioid difference is clinically meaningful.
Study Age:
2024 publication.
Original Title:
Cannabis Use Is Associated With Increased Use of Prescription Opioids Following Posterior Lumbar Spinal Fusion Surgery.
Published In:
Global spine journal, 14(1), 204-210 (2024)
Database ID:
RTHC-05565

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Does cannabis reduce the need for opioids after surgery?

This study found the opposite: cannabis users who were opioid-naive needed significantly more opioids after spinal fusion surgery.

Why would cannabis users need more opioids?

Possible explanations include cross-tolerance between cannabinoid and opioid receptor systems, differences in pain processing, or the higher depression rates seen in the cannabis group.

Read More on RethinkTHC

Cite This Study

RTHC-05565·https://rethinkthc.com/research/RTHC-05565

APA

Moon, Andrew S; LeRoy, Taryn E; Yacoubian, Vahe; Gedman, Marissa; Aidlen, Jessica P; Rogerson, Ashley. (2024). Cannabis Use Is Associated With Increased Use of Prescription Opioids Following Posterior Lumbar Spinal Fusion Surgery.. Global spine journal, 14(1), 204-210. https://doi.org/10.1177/21925682221099857

MLA

Moon, Andrew S, et al. "Cannabis Use Is Associated With Increased Use of Prescription Opioids Following Posterior Lumbar Spinal Fusion Surgery.." Global spine journal, 2024. https://doi.org/10.1177/21925682221099857

RethinkTHC

RethinkTHC Research Database. "Cannabis Use Is Associated With Increased Use of Prescriptio..." RTHC-05565. Retrieved from https://rethinkthc.com/research/moon-2024-cannabis-use-is-associated

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.