Some experts recommend people stop using cannabis at least several days before surgery. Ascent X Media/Getty Images
- Researchers say people who use cannabis tend to experience more pain after surgery than people who don’t use the drug.
- They add that cannabis users have a tendency to use more opioids after surgery.
- Experts say cannabinoid receptors in the brain may overlap with opioid receptors.
- They add that cannabis users may build up a tolerance for opioids, making those pain relievers less effective.
Cannabis is often touted for pain relief and some research supports that claim.
However, a new study finds that cannabis users may experience more pain, not less, after undergoing surgery.
The study was presented at the American Society of Anesthesiologists’ Anesthesiology 2022 annual meeting in New Orleans. The findings haven’t been published yet in a peer-reviewed journal.
In their study, researchers looked at more than 34,000 people who had elective surgery at Cleveland Clinic, including more than 1,600 cannabis users.
They reported that those who had used cannabis within 30 days of surgery experienced 14% more pain in the 24 hours after surgery. They said cannabis users also took 7% more opioid painkillers than non-users did.
The findings square with past research showing that up to 20 percent of cannabis users experience higher levels of post-surgical pain, Dr. Samer Narouze, the chairman of the Center for Pain Medicine at Western Reserve Hospital in Cuyahoga Falls, Ohio, and a member of the American Society of Anesthesiologists’ Committee on Pain Medicine, told Healthline.
The new study is more comprehensive than past research that also found associations between cannabis use, pain scores, and opioid consumption, said Dr. Elyad Ekrami, the lead author of the study and clinical research fellow of the Outcomes Research Department at Cleveland Clinic’s Anesthesiology Institute, in a press statement.
“Physicians should consider that patients using cannabis may have more pain and require slightly higher doses of opioids after surgery, emphasizing the need to continue exploring a multimodal approach to post-surgical pain control,” Ekrami said.
Narouze said that cannabinoid receptors often overlap with opioid receptors in the spine and brain. Both are involved in pain regulation.
He said that opens the door for cannabis users to develop a tolerance for opioid medications, thus limiting their effectiveness.
It also produces the possibility that cannabinoids — a less effective analgesic — could crowd out opioids at receptor sites.
Another factor could be what Narouze called the paradox of THC, the main psychoactive component of cannabis. At low doses, THC can reduce pain, but at high doses, it may amplify pain.
“Heavy users of cannabis are the ones who experience more pain after surgery, not the casual users,” said Narouze.
Published: October 23, 2022
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