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

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.

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.

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 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.

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.