Cannabis Use Disorder and Perioperative Outcomes in Major Elective Surgeries
A Retrospective Cohort Analysis
Although cannabis has been used in the United States since the 1800s, recent changes regarding the legality of its recreational and medical use have led to an increase in its consumption. The 2016 American National Survey on Drug Use and Health showed that among the 7.4 million individuals with an illicit drug use disorder, the most common substance used was cannabis (4.0 million people). An estimated 24.0 million Americans aged 12 or older in 2016 reported using cannabis in the last month. Medical cannabis is currently legal in the District of Columbia and 33 states. Given that the prevalence of cannabis use is expected to continue to grow, healthcare providers are likely to encounter the sequelae associated with its use.
Recent literature has highlighted potential detrimental effects associated with cannabis use such as increased bronchial reactivity, cerebrovascular accidents, and myocardial infarctions (MI).[2–8] Surgical patients with an active cannabis use disorder may be at an increased risk of adverse outcomes given the potential for psychoactive and hemodynamic effects within the perioperative setting. No large cohort study has yet evaluated the perioperative outcomes of patients with cannabis use disorder. To anticipate and prevent postoperative complications, perioperative healthcare providers need to be aware of the associated risks of cannabis to ensure that appropriate counseling, safeguards, and monitoring can be applied.
We therefore conducted a retrospective cohort study to (1) identify whether patients with an active cannabis use disorder experienced worse postoperative outcomes and (2) describe national trends in the prevalence of cannabis use disorders in patients presenting for major elective operations. We hypothesized that patients with an active cannabis use disorder have a higher risk of postoperative complications and higher resource utilization.