Self-Reported Marijuana Use Is Associated With Increased Narcotic Prescribing Following Hip and Knee Arthroplasty

Opioid-related deaths continue to rise annually in the United States, prompting a search for alternative or adjunct pain management strategies. Concurrently, marijuana has become increasingly legal, widely used, and culturally accepted. Within orthopedic surgery, there is growing interest in exploring the potential role of marijuana as a component of multimodal pain control. This study aimed to evaluate the impact of self-reported marijuana use on postoperative opioid prescribing patterns in patients undergoing hip and knee arthroplasty.

This retrospective study reviewed the medical records of patients treated by a single hip and knee arthroplasty surgeon. Patients were divided into two cohorts based on self-reported marijuana use: those who reported use and those who denied use. The primary outcome was the total morphine milligram equivalents (MME) prescribed within the first 90 days following surgery. Statistical analysis was conducted to compare prescribing patterns between the two groups.

97 patients were surveyed with a mean age of 64 years old. There were 61 females (62.9%) and 26 (37.1%) males. There were 39 (40.2%) primary total hips and 58 (59.8%) primary total knees. Patients who self-reported marijuana use were prescribed significantly higher MMEs within the 90-day postoperative period compared to those who denied marijuana use (983 MME vs. 501 MME, p=0.019). The difference in opioid prescribing patterns suggests that marijuana use may not mitigate postoperative opioid requirements and could potentially be associated with higher opioid consumption.

Self-reported marijuana use was associated with increased opioid prescribing in the early postoperative period following hip and knee arthroplasty. These findings highlight the need for further investigation into the relationship between marijuana use and postoperative pain management to better inform clinical practice and optimize multimodal analgesic strategies. Level of Evidence: III.