Cannabis Users Were Less Likely to Go Opioid-Free After Colorectal Surgery

Among 344 colorectal surgery patients, 51% used no opioids after discharge. Cannabis use was one of the strongest predictors of NOT achieving opioid-free recovery (OR = 0.09, posterior effect probability = 96%). Other predictors of opioid-free recovery included older age and fewer prescribed opioid pills.

Prospective cohort of 344 adults undergoing elective colorectal surgery at 2 academic hospitals. Self-reported analgesic consumption was assessed weekly for 1 month after discharge. Bayesian model averaging identified predictors.

Finding that half of patients can go opioid-free after major abdominal surgery is encouraging for reducing opioid prescribing. However, the strong association between cannabis use and opioid consumption raises important questions about whether cannabis users have different pain experiences or pain management needs.

This finding is consistent with other research showing cannabis users report more postoperative pain and use more opioids. Whether this reflects cross-tolerance, different pain sensitivity, or confounding factors remains an important clinical question.

Observational design cannot determine causation. Self-reported cannabis use and analgesic consumption. Cannabis use was a relatively small subgroup. The association may reflect underlying differences in pain tolerance or reporting rather than a direct cannabis effect.