# The Impact of Preoperative Cannabis Use on Postoperative Pain and Opioid Use in Orthopaedic Surgery Patients: A Scoping Review

> **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637)
> **Publisher:** CED Clinic (https://cedclinic.com)
> **Canonical URL:** https://cedclinic.com/research/opioid-for-postoperative-pain-scoping-review/
> **Published:** 2026-10-14T18:51:07-04:00 | **Last Modified / Clinically Audited:** 2026-10-20T13:33:39-04:00
> **Clinical Summary:** This study looked at how using cannabis before surgery might affect pain and the need for painkillers after surgery.

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Background: The use of cannabis for medical and recreational purposes has become increasingly prevalent. Emerging evidence suggests that postoperative cannabis-based medications influence postoperative opioid use for analgesia, although the impact of preoperative cannabis use on acute orthopaedic surgical outcomes remains unclear. The purpose of this study was to explore current literature regarding the associations of preoperative cannabis use with pain and opioid requirements after undergoing orthopaedic surgery. Methods: A scoping review was conducted through a search of the PubMed, EMBASE, and Scopus databases. Two independent reviewers extracted information on population, measure of cannabis use, and postoperative outcomes, including Patient-Reported Outcomes Measurement Information System scores, pain, and morphine milligram equivalents. Results: We identified 1,025 studies for potential inclusion. After screening all abstracts and titles, 19 orthopaedic studies were included, comprising 19,719 patients. Most were retrospective cohort studies, with 11 evaluating opioid use, three evaluating postoperative pain outcomes, and five evaluating both. Among the pain-related studies, three reported higher pain scores in their cannabis-user cohorts, one reported lower pain scores among cannabis users, and the remaining found no differences in pain. The studies evaluating opioid use found no notable difference in morphine milligram equivalent consumption between cannabis users and nonusers. Discussion: Most evidence suggests that preoperative cannabis use has no effect on opioid use after orthopaedic surgery. Few articles investigated the associations of preoperative cannabis use with postoperative pain, and results were mixed, with only one study evaluating cannabis use in upper extremity surgical patients, suggesting the need for further exploration in some fields. No studies were able to measure duration of cannabis use, method of consumption, or potency because the use was either self-reported or based on a diagnosis of cannabis use disorder, indicating the need for future studies to stratify preoperative cannabis use by methods of ingestion and amount consumed.

 

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### 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).