ArticlePatient safety in surgery2018
The grass is not always greener: a multi-institutional pilot study of marijuana use and acute pain management following traumatic injury.
Article in Patient safety in surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 60 citations in OpenAlex.
- Cannabis Use Disorder and Postoperative Pain: Elevated Analgesic Requirements After Surgical Repair of Hand Fractures.Plastic and reconstructive surgery. Global open · 2026Article
- Cannabis and liver transplant in the era of legalization: Effects of pretransplant cannabis use on postoperative opioid use and transplant outcomes.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
- Cannabis use and acute postoperative pain outcomes in older adults: a propensity matched retrospective cohort study.Regional anesthesia and pain medicine · 2025Article
- Impact of Preexisting Substance Use Disorders on Prolonged Opioid Use and Postoperative Complications After Burns.Journal of burn care & research : official publication of the American Burn Association · 2025Article
- Considerations for Anesthesia in Older Adults with Cannabis Use.Drugs & aging · 2024Review
- Cannabis smoking and abdominal wall reconstruction outcomes: a propensity score-matched analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Preoperative Cannabis Use Did Not Increase Opioid Utilization After Primary Total Knee Arthroplasty in a Propensity Score-Matched Model.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2024Article
- Marijuana Use is Not a Contraindication for Tranexamic Acid Utilization in Lumbar Spine Surgery.Global spine journal · 2023Article
- Patterns of Opioid Demand after Operative Treatment of Distal Radius Fractures.Plastic and reconstructive surgery. Global open · 2023Article
- Hand Surgery Patient Perspectives on Medical Cannabis: A Survey of Over 600 Patients.Journal of hand surgery global online · 2023Article
- Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report.Journal of cannabis research · 2022Article
- Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices.Journal of pain research · 2022Article
- Perioperative Pain Management and Opioid Stewardship: A Practical Guide.Healthcare (Basel, Switzerland) · 2021Review
- Cannabinoids for fibromyalgia pain: a critical review of recent studies (2015-2019).Journal of cannabis research · 2020Review
- Efficacy of Dronabinol for Acute Pain Management in Adults with Traumatic Injury: Study Protocol of A Randomized Controlled Trial.Brain sciences · 2020Article
- A review of the anesthetic implications of marijuana use.Proceedings (Baylor University. Medical Center) · 2019Review
- Outcomes, Registries and Medical Marijuana: Towards Establishing Dispensary Monitoring and Reporting Standards.Innovations in pharmacy · 2018Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWidespread legislative efforts to legalize marijuana have increased the prevalence of marijuana use and abuse. The effects of marijuana on pain tolerance and analgesic pain management in the acute pain setting have not been reported. Although marijuana has been shown to have antinociceptive effects and is approved for medical use to treat chronic pain, anecdotal evidence suggests marijuana users admitted with traumatic injuries experience poorer pain control than patients who do not use marijuana. We hypothesized that marijuana users would report higher pain scores and require more opioid analgesia following traumatic injury.
methodsThis retrospective pilot study included all patients involved in motor vehicle crashes, consecutively admitted to four trauma centers from 1/1/2016-4/30/2016. Marijuana status was examined as non-use and use, and was further categorized as chronic and episodic use. We performed a repeated measures mixed model to examine the association between marijuana use and a) average daily opioid consumption and b) average daily pain scores (scale 0-10). Opioid analgesics were converted to be equianalgesic to 1 mg IV hydromorphone.
resultsMarijuana use was reported in 21% (54/261), of which 30% reported chronic use (16/54). Marijuana use was reported more frequently in Colorado hospitals (23-29%) compared to the hospital in Texas (6%). Drug use with other prescription/street drugs was reported in 9% of patients. Other drug use was a significant effect modifier and results were presented after stratification by drug use. After adjustment, marijuana users who did not use other drugs consumed significantly more opioids (7.6 mg vs. 5.6 mg,
conclusionThese preliminary data suggest that marijuana use, especially chronic use, may affect pain response to injury by requiring greater use of opioid analgesia. These results were less pronounced in patients who used other drugs.
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