Cannabis Abuse Linked to More ER Visits and Pain Across 10 Neurological Conditions | Research

The takeaway

Among patients with 10 different neurological conditions, cannabis abuse was consistently associated with higher emergency department utilization and pain prevalence, though mortality and stroke recurrence were not significantly different.

neurologists, pain management specialists, emergency physicians, patients with neurological conditions

What the researchers found

Across all 10 neurological conditions studied (cluster headache, neuropathy, MS, stroke, TIA, Parkinson's, Alzheimer's, vascular dementia, migraine, tension headache), cannabis abuse was consistently linked to significantly higher ED visits and pain prevalence. For example, neuropathy patients with cannabis abuse had 25.8% ED visits vs. 19.3% in non-users. Mortality and recurrent cerebrovascular events trended higher but were generally not statistically significant.

Why it matters

This is the first study to systematically compare cannabis abuse outcomes across multiple neurological conditions using a unified methodology. The consistent pattern of increased ED visits and pain across all conditions suggests cannabis abuse may worsen clinical management regardless of the specific diagnosis.

The numbers in context

143 healthcare organizations. 10 neurological conditions. Consistently higher ED utilization and pain prevalence across all conditions. Neuropathy example: 25.8% vs. 19.3% ED visits. Mortality and stroke recurrence trended higher but generally not significant. 3-year follow-up.

How the study worked

Retrospective analysis using TriNetX global federated health research network (143 healthcare organizations). Propensity score matching balanced demographics and clinical characteristics for each of 10 neurological conditions. Up to 3-year follow-up comparing cannabis abuse vs. no cannabis abuse.

What this study cannot tell us

Cannabis abuse identified by ICD codes, which captures only diagnosed problematic use. Cannot determine causation or temporal sequence. Propensity matching cannot control for unmeasured confounders. Cannabis abuse diagnosis may be a marker for overall health behavior rather than a direct cause.

How to read the evidence

Large multi-center propensity-matched analysis with consistent findings across conditions, but observational design and ICD-code identification of cannabis abuse limit causal inference.

When this study was published

2025 publication with up to 3-year follow-up.

The bigger picture

The paradox of increased pain in cannabis users who often report using cannabis for pain management deserves attention. It may reflect a cycle where cannabis provides temporary relief but worsens long-term pain outcomes, or it may reflect that people with worse pain are more likely to use cannabis.

Questions still open

Does cannabis use cause worse pain outcomes or do patients with worse pain use more cannabis?
Would medical cannabis users show different patterns than those with diagnosed cannabis abuse?

Common questions

Does cannabis make neurological conditions worse?

This study found cannabis abuse was associated with more ER visits and higher pain prevalence across all 10 neurological conditions studied, including stroke, MS, migraine, and Parkinson's disease. However, the study cannot determine if cannabis caused worse outcomes or if sicker patients were more likely to use cannabis.

Does cannabis help with neurological pain?

Paradoxically, this study found patients with cannabis abuse had higher pain prevalence across all neurological conditions, despite cannabis being commonly used for pain. This may reflect a cycle of temporary relief and long-term worsening, or that people with more pain are more likely to develop problematic cannabis use.

Read the original research

Differential impact of Cannabis abuse on neurological disorders.

Journal of the neurological sciences, 474, 123527

View on PubMed ↗Publisher’s paper ↗

Citation

Tabi, Younes Adam; Meyer, Eva Christina. (2025). Differential impact of Cannabis abuse on neurological disorders.. Journal of the neurological sciences, 474, 123527. https://doi.org/10.1016/j.jns.2025.123527