Opioid Usage in the PACU Following Operative Distal Radius Fracture Repairs in Marijuana Users

Widespread legalization of marijuana in the United States has brought the implications of marijuana use on medicine into question. Of interest is cannabis’ utility as an alternative to opioids in the management of surgical pain. However, limited research on the effects of perioperative cannabis use has been conducted. A retrospective cohort study was conducted, examining morphine milliequivalents (Meq) administered post-operatively for patients undergoing distal radius fracture fixation. One to one propensity matching was performed between marijuana users and non-users to isolate the effect of marijuana usage. Four hundred and two patients were identified for inclusion, 35 of which reported use of marijuana. Following matching, marijuana users were found to require 94 fewer Meq to manage post-operative pain (p = 0.041) and achieved comparable pain scores despite receiving fewer opioids. The findings illustrate a potential connection between marijuana use and decreased opioid requirements for pain control, thus encouraging a lessened reliance on opioids to manage surgical pain. (Journal of Surgical Orthopaedic Advances 35(1):045 – 048, 2026)

Key words: cannabis, opioids, postoperative pain, distal radius fractures