Patient Safety in Surgery

Featured article: The grass is not always greener

The rapid expansion of THC legalization at the state-level in the United States has led to an increased consumption of cannabis across the country. Currently, 29 states allow the medical use of cannabis, while 9 states also legalize its recreational use. The potential negative fall-out related to an increased risk of traffic accidents from drivers under the influence of THC has not been investigated in a scientific setting. This featured article reports the insights form a retrospective multicenter observational cohort study on 261 trauma patients assessed for the prevalence of pre-injury marijuana use.
After adjustment for confounding variables, marijuana users who did not use other drugs or pain medication were shown to consume significantly more opioids during their hospital stay and reported higher pain scores than non-marijuana users. These insights may affect the pertinent discussion around the “opioid crisis” by unveiling a previously unrecognized negative effect of marijuana consumption on pain tolerance and on narcotic requirement for post-injury pain control.
In addition, these data demonstrate for the first time an impressive and previously unreported prevalence of 21% marijuana use among motor vehicle accident victims admitted to four different trauma centers in Colorado and Texas. The three hospitals in Colorado, a state with liberal legalization of cannabis for recreational use, reported a high prevalence of up to 29% THC consumption, compared to just 6% in the Texas hospital, a state with restricted legislation allowing the exclusive use for medical purposes with limited THC content. The data from this pilot study should be taken into consideration when discussing the impact of cannabis legalization on public health.