Study: THC May Reduce Opioid Use in Trauma Patients

According to a new study published in the journal Trauma Surgery & Acute Care, trauma patients who are administered THC capsules consume fewer opioids than do similarly matched control subjects. The study is titled Matched pilot study examining cannabis-based dronabinol for acute pain following traumatic injury.

For the study researchers examined the off-label use of dronabinol (which is an FDA-approved synthetic oral THC) on opioid consumption patterns in trauma patients with acute pain. 66 patients participated in the study: Half received THC, and the other half did not.

According to researchers, patients who were administered oral THC experienced a “nine-fold greater reduction in opioid consumption” compared to controls. These effects were most pronounced among participants who had prior marijuana experience

The study concludes by stating that “The addition of dronabinol resulted in reduced opioid consumption, … suggesting a beneficial opioid-sparing effect of dronabinol in acutely painful conditions.. Because our study showed that the opioid-sparing effect of dronabinol may be greatest in patients who use marijuana, use of dronabinol adjunctively may benefit nearly half of [Colorado’s] population.”

Below is the study’s full abstract:

Background To determine whether adjunctive dronabinol, a licensed form of delta-9-tetrahydrocannabinol, reduces opioid consumption when used off-label for managing acute pain following traumatic injury.

Methods This matched cohort study included patients who were admitted with a traumatic injury between 1 March 2017 and 30 October 2017. The hospital pharmacy database was used to identify patients who received dronabinol (cases), and they were matched 1:1 to patients who did not receive dronabinol (controls) using age, cause of injury and hospital length of stay. The primary outcome, change in opioid consumption, was calculated using morphine milligram equivalents (MME). The change in MME was calculated for cases as total MME over 48 hours with adjunctive dronabinol minus 48 hours prior to dronabinol, and for controls as total MME 48–96 hours from admission minus 0–48 hours from admission. Data are presented as mean and SE or median and IQR. Statistical analysis was performed using paired t-tests and McNemar’s tests.

Results There were 66 patients included: 33 cases and 33 matched controls. Dronabinol was initiated 55 (28–107) hours from admission. Cases and controls were well matched. Cases had a significant reduction in opioid consumption with adjunctive dronabinol (−79 (20) MME, p<0.001), while opioid consumption was unchanged for controls (−9 (20) MME, p=0.63). This resulted in a ninefold greater reduction in opioid consumption for cases versus controls that was statistically different between pairs (p=0.02). Nineteen (58%) cases reported using marijuana; in this subset, opioid consumption was reduced with adjunctive dronabinol (−97 (24) MME, p<0.001) versus a non-significant increase in opioid consumption in matched controls (11 (29) MME, p=0.70); difference between groups, p=0.01.

Conclusions The results of this study suggest adjunctive dronabinol reduces opioid consumption following traumatic injury. The opioid-sparing effect of dronabinol may be greater in patients who are marijuana users.

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