Cannabis use is rapidly increasing in North America, particularly following the legalization of medical and recreational cannabis use in many states in the United States and Canada. Additionally, opioid use has become a public health crisis, and there remains little data on the impact of cannabis use on postoperative opioid use. We hypothesized that cannabis use would not result in different postoperative opioid use or cost of hip arthroscopy.
Data was collected from a large commercial insurance database (PearlDiver, USA) between the years 2010-2019. Patients who underwent hip arthroscopy with reported cannabis use were identified using Common Procedural Terminology (CPT) codes and the appropriate International Classification of Diseases (ICD) codes. This group was then matched by age, procedure, gender, Charleston Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), obesity, tobacco use, diabetes to a group of similar patients without self-reported cannabis use. Opioid use over the episode of care, evaluated by morphine milligram equivalents (MME), and 30-day cost were compared between groups using unequal variance t-test.
Of our population of patients, 360 (0.71%) had a diagnosis of preoperative cannabis
use, abuse, or dependence within five years prior to their hip arthroscopy. A total of
300 patients (172 female, 128 male) were matched into each hip arthroscopy group,
with and without cannabis. Of those patients, 171 without cannabis use and 174 with
cannabis use had full financial and opioid use data for analysis. Prescription opioid use was not significantly different over the episode of care in patients with reported
cannabis use (1840 +/- 2743 MME) than those without reported cannabis use (2129 +/- 3383 MME)(p=0.3848). Additionally, episode of care reimbursement cost following hip arthroscopy did not differ significantly between patients with cannabis use ($2957 +/- $4428) and those without reported cannabis use ($2651 +/- $3762)(p=0.0956).
Following hip arthroscopy, patients with reported cannabis use did not have significantly different postoperative opioid use or cost of hip arthroscopy episode of care compared with patients without reported cannabis use.