Cannabis Use Linked to Shorter Hospital Stays and Lower Costs for IBD Patients After Legalization | Research

The takeaway

After recreational cannabis legalization in Colorado and Washington, reported cannabis use among hospitalized IBD patients tripled, and cannabis users had shorter hospital stays and lower charges than non-users.

Gastroenterologists managing IBD; patients with Crohn's or UC considering cannabis; cannabis legalization researchers.

$8,418 lower hospital charges for cannabis-using IBD inpatients

What the researchers found

Reported cannabis use among IBD inpatients increased from 1.2% to 4.2% after legalization (p<0.05). In 2015, cannabis-using IBD patients had shorter hospital stays and $8,418 less in hospital charges (p=0.024) compared to non-users.

Why it matters

IBD patients frequently use cannabis for symptom management, and there is preclinical evidence for anti-inflammatory effects of cannabinoids in the gut. This study provides preliminary real-world data suggesting cannabis use does not worsen and may improve inpatient outcomes.

The numbers in context

Cannabis use: 1.2% (2011) vs 4.2% (2015, post-legalization). In 2015: shorter hospital stays (p=0.038) and $8,418 lower charges (p=0.024) for cannabis users. Analysis adjusted for demographic data.

How the study worked

Retrospective analysis comparing hospitalized IBD patients in Colorado and Washington before (2011) and after (2015) recreational cannabis legalization. Used chi-square and t-tests for comparisons, with multivariable regression adjusting for demographics.

What this study cannot tell us

Retrospective design with potential confounders. Cannabis use was likely underreported, especially pre-legalization. The "cannabis use" category does not capture dose, frequency, or product type. Lower charges might reflect less severe disease in cannabis users rather than a treatment effect.

How to read the evidence

Preliminary: retrospective analysis with limited ability to control for confounders and likely underreporting of cannabis use.

When this study was published

Published in 2022, comparing 2011 vs 2015 data.

The bigger picture

This is one of the few studies linking cannabis legalization to specific disease outcomes beyond general population health metrics. The improved inpatient outcomes in cannabis-using IBD patients are intriguing given the known anti-inflammatory properties of cannabinoids.

Questions still open

Does cannabis genuinely reduce IBD inflammation, or are cannabis-using IBD patients simply less severely ill? Would a prospective study of cannabis use in IBD patients confirm shorter hospital stays? Which cannabinoid components might benefit IBD most?

Common questions

Does cannabis help with inflammatory bowel disease?

This study found cannabis-using IBD patients had shorter hospital stays and lower charges, but it cannot determine whether cannabis caused the improvement. Cannabis users might have had less severe disease to begin with.

Did legalization increase cannabis use among IBD patients?

Yes. Reported cannabis use among hospitalized IBD patients rose from 1.2% to 4.2% after recreational legalization, though actual use was likely higher given underreporting in both periods.

Read the original research

Impact of Cannabis Use on Inpatient Inflammatory Bowel Disease Outcomes in 2 States Legalizing Recreational Cannabis.

Crohn's & colitis 360, 4(2), otac015

View on PubMed ↗Publisher’s paper ↗

Citation

Pusateri, Antoinette; Anaizi, Ahmad; Nemer, Laura; Hinton, Alice; Lara, Luis; Afzali, Anita. (2022). Impact of Cannabis Use on Inpatient Inflammatory Bowel Disease Outcomes in 2 States Legalizing Recreational Cannabis.. Crohn's & colitis 360, 4(2), otac015. https://doi.org/10.1093/crocol/otac015