Cannabis Use Reduces Opioid Consumption in Neck Fusion Surgery Recovery
Numerous studies have already demonstrated the potential of cannabis use in reducing opioid consumption for various ailments and conditions. A new study from the University of Connecticut School of Medicine adds to this body of research by exploring the impact of cannabis use on recovery from a major neck surgery.
The study, published in the North American Spine Society Journal, focuses on anterior cervical discectomy and fusion (ACDF) surgery. This procedure involves removing or repairing damaged discs in the spine to alleviate pressure on the spinal cord or nerves in the neck and alleviate related pain, weakness, numbness, and tingling.
The researchers acknowledged the “growing evidence to suggest that cannabis use may positively impact opioid consumption.” They also highlighted the increasing amount of literature on cannabis and its potential medical benefits, although there are only a few studies that specifically explore its potential in orthopedics.
Using a retrospective case-control design, researchers analyzed opioid use following ACDF surgery. They used PearlDiver to examine patients who underwent a single-level ACDF between January 2020 and October 2020.
Patients with a previous diagnosis of cannabis use, dependence, or abuse were placed in the study group. Patients under 18 years old or those who had filled an opioid prescription within three months before their procedure were excluded. The control group was formed to match on age, gender, Charlson comorbidity index (which predicts mortality for patients with various diseases), and had no diagnosis of cannabis use.
A total of 1,339 patients were included in each group.
The findings revealed that fewer patients in the cannabis group filled their opioid prescriptions within three days after surgery, aligning with previous studies on cannabis use and the need for opioids. Only 2.7% of patients in the cannabis group filled their initial prescription within three days post-operation, compared to over 7% in the control group. There were no significant differences in prescription rates at 30 and 60 days after the procedure. Notably, no patients in the cannabis group filled their initial prescriptions 90 days after the surgery.
At 60 days post-operation, the control group required higher doses of opioids compared to the cannabis group. The authors noted that daily morphine milliequivalent (MME) doses in the cannabis group were below 50 MME for prescriptions filled within 60 days postoperatively, while the control group reached the 60 MME level. Studies have indicated that opioid doses above 50 MME per day are significantly associated with an increased risk of opioid-related death or hospitalization, suggesting that cannabis users may be at reduced risk of opioid dependence.
When looking at the total number of patients, 1.8% of the cannabis group and 3.1% of the control group filled additional opioid prescriptions. However, this difference was not statistically significant when considering only patients who filled an initial prescription. There were no differences in prescription rates at both 60 and 90 days after the procedure.
The study concludes that cannabis use may reduce opioid requirements in patients undergoing ACDF procedures. However, further studies are needed to investigate the effect of cannabis use on postoperative pain control.
The researchers acknowledged limitations in their study, including reliance on a large insurance claims database and potential selection bias due to inaccurate diagnosis codes for cannabis use. Moreover, the database did not differentiate between CBD and THC usage, which could impact general health and opioid needs. The changing landscape of cannabis laws across states during the study period also adds complexity to data collection.
As marijuana usage and perceptions evolve, future research may benefit from improved data collection as patients become more open about their cannabis use, gain better access to medical and recreational products, and receive better education about the advantages and risks associated with marijuana. These ongoing changes will undoubtedly affect the reliability of data in this field.
In conclusion, this study adds to the growing body of evidence suggesting that cannabis use can reduce opioid consumption during recovery from neck fusion surgery. While further research is needed, these findings contribute to the expanding literature on cannabis, pain management, and orthopedics.
