# Impact of Combined Cannabinoids and Cocaine on Trauma Outcomes > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/combined-cannabinoids-cocaine-trauma-outcomes/ > **Published:** 2026-04-23T10:08:57-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T10:14:41-04:00 > **Clinical Summary:** Explore the combined cannabinoids cocaine trauma outcomes in trauma patients and their impact on clinical care and mortality risk. --- CED Clinical Relevance  #56Monitored Relevance  Early-stage or contextual signal requiring further evidence before action. 🔬 Evidence Watch  |  CED Clinic TraumaCannabisPolydrug UseClinical OutcomesRegistry Study Journal Surgery in practice and science Study Type [Clinical Study](https://cedclinic.com/cannabis-hyperemesis-syndrome-psychiatric-risk/) Population Human participants Why This Matters This retrospective analysis of trauma registry data addresses a critical gap in understanding how concurrent cannabis and cocaine use affects trauma outcomes. With increasing [cannabis legalization](https://cedclinic.com/the-forgotten-history-of-hemp-in-america/) and polydrug use patterns, trauma teams need evidence-based insights about how these substances individually and collectively impact [patient care](https://cedclinic.com/cannabis-cardiovascular-risk-impact/) and recovery. Clinical Summary Using the Trauma Quality Improvement Program database from 2019-2023, researchers compared outcomes between trauma patients testing positive for both cannabinoids and cocaine versus cannabinoids alone, employing propensity score matching to control for confounding variables. The study included 120,951 qualifying patients, with 12,116 matched pairs analyzed for in-hospital mortality and other clinical endpoints. While the abstract indicates baseline characteristic matching was successful, the specific mortality findings and clinical outcomes are not detailed in this summary, limiting interpretation of the clinical significance. Dr. Caplan’s Take “This type of registry analysis provides valuable real-world data, though I remain cautious about drawing definitive clinical conclusions without seeing the actual mortality rates and confidence intervals. The propensity matching methodology is appropriate, but residual confounding from unmeasured variables like dosing, timing of use, and underlying medical complexity remains a concern.” Clinical Perspective 🧠 Trauma clinicians should continue comprehensive [substance use](https://cedclinic.com/stroke-risk-assessment-substance-use/) screening and consider polydrug interactions in care planning, regardless of these specific findings. Patients using cannabis should receive counseling about potential interactions with other substances, and trauma teams should maintain awareness that [substance use](https://cedclinic.com/stroke-risk-assessment-substance-use/) patterns are complex and evolving in clinical populations. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/forum/cannabis-industry/) Have thoughts on this? Share it: [𝕏 Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Combined%20Impact%20of%20Cannabinoids%20and%20Cocaine%20on%20Outcomes%20of%20Trauma%20Patients.%20%40drcaplan&url=https%3A//pubmed.ncbi.nlm.nih.gov/42022774/)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A//pubmed.ncbi.nlm.nih.gov/42022774/)[🦥 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Combined%20Impact%20of%20Cannabinoids%20and%20Cocaine%20on%20Outcomes%20of%20Trauma%20Patients.%20--%20via%20%40drcaplan.bsky.social%20https%3A//pubmed.ncbi.nlm.nih.gov/42022774/)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan/)[📝 Read more on Substack](https://substack.com/@doctorapproved)[🔔 Subscribe via RSS](https://cedclinic.com/category/cannabis-news/feed/) 📰 Source: [https://pubmed.ncbi.nlm.nih.gov/42022774/](https://pubmed.ncbi.nlm.nih.gov/42022774/) Table of Contents - [FAQ](#FAQ)[Does combined cannabis and cocaine use increase mortality risk in trauma patients compared to cannabis alone?](#Does_combined_cannabis_and_cocaine_use_increase_mortality_risk_in_trauma_patients_compared_to_cannabis_alone) - [How common is polydrug use involving cannabis and cocaine in trauma patients?](#How_common_is_polydrug_use_involving_cannabis_and_cocaine_in_trauma_patients) - [Should emergency physicians modify trauma care based on cannabis and cocaine co-use?](#Should_emergency_physicians_modify_trauma_care_based_on_cannabis_and_cocaine_co-use) - [What are the limitations of using toxicology screening to assess drug impact on trauma outcomes?](#What_are_the_limitations_of_using_toxicology_screening_to_assess_drug_impact_on_trauma_outcomes) - [How reliable is this evidence for clinical decision-making in trauma care?](#How_reliable_is_this_evidence_for_clinical_decision-making_in_trauma_care) - [Related](#Related) ## FAQ #### Does combined cannabis and cocaine use increase mortality risk in trauma patients compared to cannabis alone? This study examined whether trauma patients testing positive for both cannabinoids and cocaine had different in-hospital mortality compared to those testing positive for cannabinoids only. Using propensity score matching on over 120,000 patients from the TQIP database (2019-2023), the study found no statistically significant difference in mortality between the two groups. #### How common is polydrug use involving cannabis and cocaine in trauma patients? The study identified a substantial number of trauma patients with positive drug screens for both substances, with 12,116 matched pairs available for analysis from the initial cohort. This suggests polydrug use involving cannabis and cocaine is a clinically relevant phenomenon in trauma populations requiring further investigation. #### Should emergency physicians modify trauma care based on cannabis and cocaine co-use? Based on this study’s findings of no increased mortality risk with combined use versus cannabis alone, routine trauma care protocols may not need modification solely based on this drug combination. However, clinicians should still consider individual patient factors and potential complications from polydrug use during assessment and treatment. #### What are the limitations of using toxicology screening to assess drug impact on trauma outcomes? Positive drug screens indicate recent use but don’t establish causation for trauma outcomes or specify timing, dosage, or impairment level at time of injury. The study’s observational design using registry data cannot determine whether drug use directly influenced injury mechanisms or recovery processes. #### How reliable is this evidence for clinical decision-making in trauma care? While this large registry study provides valuable epidemiological data, it represents early-stage evidence requiring validation through additional research. The study’s propensity score matching helps control for confounders, but clinicians should interpret findings cautiously and consider them alongside other clinical factors when managing trauma patients. [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. Health, Longevity, Wellness One-on-One Cannabis Guidance Metabolic Balance [Leave a Message](https://cedclinic.com/contact/) [Metabolic Care](https://cedclinic.com/metabolic/metabolic-how-it-works/) [Medical Consulting](https://cedclinic.com/book/) [Cannabis Care](https://cedclinic.com/book/) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) RELATED READING AT CED CLINIC Continue exploring the evidence [Opioids and Cannabis: An Uncertain Combination?](https://cedclinic.com/opioid-cannabis-interactions-risks-clinical-insights/) Explore the complexities and clinical considerations of combining opioids with cannabis in [patient care](https://cedclinic.com/cannabis-cardiovascular-risk-impact/). [Read More](https://cedclinic.com/opioid-cannabis-interactions-risks-clinical-insights/) [Cannabis Use Patterns and Perception of Acute Pain During Brief Abstinence: Sex-Dependent Associations with Circulating Cannabinoid Levels.](https://cedclinic.com/acute-pain-cannabinoid-withdrawal-sex-dependent-cannabis-study/) This study examines how [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) patterns affect acute pain perception, highlighting sex differences in cannabinoid levels. [Explore Study](https://cedclinic.com/acute-pain-cannabinoid-withdrawal-sex-dependent-cannabis-study/) [Substance Use and Suicide Attempts in Adolescents: A Comparative Analysis of Clinical and Psychosocial Risk Factors.](https://cedclinic.com/adolescent-substance-use-suicide-risk-analysis/) A detailed analysis of how substance use correlates with suicide attempts among adolescents, focusing on clinical and psychosocial risks. [Learn More](https://cedclinic.com/adolescent-substance-use-suicide-risk-analysis/) ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).