HomeCannabis MedicinePostoperative Opioid Use Among Opioid-Naive Cannabis Users Following Single-Level Lumbar Fusions

Postoperative Opioid Use Among Opioid-Naive Cannabis Users Following Single-Level Lumbar Fusions

April 20, 2023

World Neurosurg. 2023 Apr 6:S1878-8750(23)00475-8. doi: 10.1016/j.wneu.2023.04.001. Online ahead of print.

ABSTRACT

BACKGROUND: As the literature grows on opioid use, the impact of simultaneous cannabis use has hitherto been mostly unexplored. In this study, we assessed the effects of cannabis use on postoperative opioid utilization in opioid-naive patients undergoing single level fusions of the lumbar spine.

METHODS: Using an all-payer claims database, the medical records of 91 million patients were analyzed to identify patients who had undergone single level lumbar fusions between January 2010 and October 2020. Rates of opioid utilization at 6 months following index procedure (morphine milligram equivalents/day), the development of opioid use disorder, and the rates of opioid overuse were assessed.

RESULTS: Following examination of 87,958 patient records, 454 patients were matched and distributed equally into cannabis user and non-cannabis user cohorts. At six months following index procedure, cannabis users were equal to non-users in their rates of prescribed opioid utilization (49.78%, p>.99). Cannabis users used smaller daily dosages compared to non-users (51.1±35.05 vs. 59.72±41, p=.003). On the other hand, the proportion of patients diagnosed with opioid use disorder was found to be significantly higher among patients using cannabis (18.94% vs. 3.96%, p<.0001).

CONCLUSION: Compared to non-cannabis users, opioid-naive patients who are cannabis users undergoing lumbar spinal fusions are at a higher risk of developing opioid dependence following surgery, despite having decreased daily dosages of opioids overall. Further studies should explore the factors associated with the development of opioid use disorder and the details of concurrent marijuana use to effectively treat pain while limiting the potential for abuse.

PMID:37030484 | DOI:10.1016/j.wneu.2023.04.001

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About The Author

Patrick Blanchard MD

Meet Dr. Blanchard Dr. Blanchard’s medical practice is an embodiment of Integrative health which brings conventional and complementary approaches together in a coordinated way. Conveniently located in sunny Florida and over the internet with ValiseMD’s secure HIPPA compliant telXmed servers. Since 1994, patients with a wide range of challenging medical problems have achieved optimum health using the best of natural medicine, judiciously combined with high-tech innovations. Breakthroughs are often achieved even after patients have consulted mainstream specialists and holistic practitioners. Dr. Blanchard is founder and CEO of ValiseMD, Inc. He is board certified in Family Medicine since 1994 and awarded Fellow of the American Academy of Family Physicians in 2001. He received the ‘Teacher of the Year’ award from the University of Kansas School of Medicine at completion of his residency in Family Medicine. He completed a fellowship at Wake Forest University in the field of vascular neurosonology. He holds a medical patent in the field of Gastroenterology. He holds an unrestricted license to practice medicine and surgery in Florida. He started his medical career as a Emergency Medical Technician, then as a Paramedic and later a Medical Doctor.