Cannabis Use, Dependence Linked to Worse Clinical Outcomes in Chronic Pancreatitis

Cannabis use, particularly abuse and dependence, is linked to worse clinical outcomes in patients with chronic pancreatitis, according to findings from a recent study.1

The research was presented at Digestive Disease Week (DDW) 2025 by Muhammad Hassaan Arif Maan, MD, Rutgers New Jersey Medical School, and revealed overuse of cannabis was linked to a heightened risk of acute pancreatitis flare, pancreatic cancer, and all-cause mortality compared with non-cannabis users.1

According to the US Centers for Disease Control and Prevention, cannabis is the most commonly used federally illegal drug in the United States, with 52.5 million people, or about 19% of people in the US, having used it at least once in 2021. An estimated 3 in 10 people who use cannabis have cannabis use disorder, raising concerns about the potential health risks associated with cannabis use.2

“Whereas studies have explored the relationship between cannabis use and acute pancreatitis, data is scarce on its impact on chronic pancreatitis,” Maan and colleagues wrote.1

To address this gap in research, investigators conducted a prosperity-matched multicenter cohort study using data from the TriNetX health research network for adults with chronic pancreatitis, excluding those with pancreatic cancer. They divided patients into 2 groups based on the presence of cannabis abuse or dependence.1

1:1 propensity score matching was applied to adjust for demographic factors, behavioral factors, and comorbidities, including cholelithiasis, obesity, type 2 diabetes, hypertension, hyperlipidemia, chronic kidney disease, and systemic connective tissue disorders.1

The primary outcome was acute pancreatitis flare, while secondary outcomes included pancreatic necrosis, pancreatic cancer, and all-cause mortality.1

Before matching, the cannabis use cohort consisted of 9268 patients, while the comparison cohort included 5,261,368 patients. After propensity score matching, each cohort was reduced to 9062 patients, achieving adequate balance for all baseline characteristics.1

The mean follow-up was 824 ± 388 days for the cannabis use cohort and 936 ± 341 days for the control cohort. Following matching, the cannabis use cohort showed a significantly greater risk of acute pancreatitis flare (hazard ratio [HR], 22.353; 95% CI, 19.528–25.587; P <.001), pancreatic cancer (HR, 25.676; 95% CI, 9.436–69.864; P <.001), and all-cause mortality (HR, 1.430; 95% CI, 1.283–1.594; P <.001). Cannabis use was also significantly associated with pancreatic necrosis (P <.001), with no cases in the control group.1

Investigators noted these outcomes remained unchanged following sensitivity analysis with adjustment for opioid use disorder.1

“Our study shows that cannabis use, particularly abuse and dependence, is linked to worse clinical outcomes in chronic pancreatitis patients, including a significantly higher risk of acute pancreatitis flare, pancreatic cancer, and all-cause mortality,” investigators concluded.1 “These findings underscore the detrimental effects of cannabis use disorder on complications of chronic pancreatitis, highlighting the urgent need for further investigation into the long-term consequences of cannabis use in this population and its potential role in exacerbating pancreatic diseases.”

References

1. Maan MHA, Maan S, Ahmad MM, et al. IMPACT OF CANNABIS USE ON CLINICAL OUTCOMES IN CHRONIC PANCREATITIS: A PROPENSITY-MATCHED MULTICENTER COHORT STUDY. Abstract presented at Digestive Disease Week 2025 in San Diego, CA from May 3 - May 6, 2025.

2. US Centers for Disease Control and Prevention. Cannabis Facts and Stats. March 7, 2025. Accessed May 3, 2025. https://www.cdc.gov/cannabis/data-research/facts-stats/index.html