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Digestive Diseases and Sciences

, Volume 63, Issue 10, pp 2786–2791 | Cite as

Is There an Effect of Cannabis Consumption on Acute Pancreatitis?

  • C. Roberto Simons-Linares
  • Jodie A. Barkin
  • Yuchen Wang
  • Palashkumar Jaiswal
  • William Trick
  • Michael J. Bartel
  • Jamie S. Barkin
Original Article
First Online:
Received:
Accepted:

Abstract

Background and Aim

Twenty-percentage of acute pancreatitis (AP) cases is labeled as idiopathic. Cannabis remains the most frequently used illicit drug in the world. The aim of this study was to identify the prevalence of cannabis use among all patients with a first episode of AP, particularly in those labeled as idiopathic etiology, and determine any effect on AP severity.

Methods

Retrospective cohort of all consecutive patients admitted with a first episode of AP at a large tertiary referral hospital from 01/2013 through 12/2014. AP was identified by ICD9 code, or lipase ≥ 3 times the upper limit of normal and abdominal pain consistent with AP. Cannabis users (CU) were identified via history or urine toxicology.

Results

Four hundred and sixty patients were included. 54% were men, with a mean age of 48 years (range 17–89 years). Forty-eight patients (10%) were identified as CU. After adjusting for admission SIRS, age, and gender, cannabis use was not found to be an independent risk factor for persistent SIRS, AKI, ARDS, pancreatic necrosis, mortality, ICU admission, length of stay, in-hospital infections, nor recurrent AP. Of note, AKI was least common among non-CU compared to CU (OR 0.4; p = 0.02; CI 0.2–0.9) and non-CU had a higher admission BISAP score (≥ 2) compared to CU (OR 2.5; p = 0.009; CI 1.2–4.9).

Conclusion

This is the largest study to date examining cannabis use in AP. Cannabis use was found across almost all etiologies of AP with a prevalence of 10% (48 cases), and in 9% (9 cases) of so-called idiopathic AP cases in this cohort, which could account as an association for approximately 2% of all AP cases. Cannabis use did not independently impact AP severity or mortality.

Keywords

Cannabis Marijuana Acute pancreatitis Diagnosis Prevalence 
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Notes

Acknowledgments

Dr. Jodie Barkin is supported by the Louis Fortunoff Pancreas Fellowship at the University of Miami.

Compliance with ethical standards

Conflict of interest

C. Roberto Simons-Linares MD MSc, Yuchen Wang MD, Palash Jaiswal MD, William Trick MD MPH, Michael J. Bartel MD PhD, Jamie S. Barkin have no conflicts of interest to disclose.

References

  1. 1.
    Fagenholz PJ, Fernandez-del Castillo C, Harris NS, et al. Direct medical costs of acute pancreatitis hospitalizations in the United States. Pancreas. 2007;35:302–307.CrossRefGoogle Scholar
  2. 2.
    Whitcomb DC. Value of genetic testing in the management of pancreatitis. Gut. 2004;53:1710–1717.CrossRefGoogle Scholar
  3. 3.
    Grant P, Gandhi P. A case of cannabis-induced pancreatitis. JOP. 2004;5:41–43.PubMedGoogle Scholar
  4. 4.
    Degenhardt L, Chiu WT, Sampson N, et al. Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO World Mental Health Surveys. PLoS Med. 2008;2008:7.Google Scholar
  5. 5.
    Gerich ME, Isfort RW, Brimhall B, et al. Medical marijuana for digestive disorders: high time to prescribe? Am J Gastroenterol. 2015;110:208–214.CrossRefGoogle Scholar
  6. 6.
    Naftali T, Bar-Lev Schleider L, Dotan I, et al. Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. Clin Gastroenterol Hepatol. 2013;11:1276–1280.CrossRefGoogle Scholar
  7. 7.
    Kim HS, Hall KE, Genco EK, et al. Marijuana tourism and emergency department visits in Colorado. N Engl J Med. 2016;374:797–798.CrossRefGoogle Scholar
  8. 8.
    Barkin JA, Nemeth Z, Saluja AK, et al. Cannabis Induced Acute Pancreatitis: A Systematic Review. Pancreas. 2017;In Press.Google Scholar
  9. 9.
    Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–111.CrossRefGoogle Scholar
  10. 10.
    KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012;2(Suppl 1):1–138.Google Scholar
  11. 11.
    Members_of_the_American_College_of_Chest_Physicians/Society_of_Crit_Care_Med_Consensus_Conference_Committee. American College of Chest Physicians/Society of Crit Care Med Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 1992;20:864–874.Google Scholar
  12. 12.
    Wu BU, Johannes RS, Sun X, et al. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57:1698–1703.CrossRefGoogle Scholar
  13. 13.
    Hasin DS, Saha TD, Kerridge BT, et al. Prevalence of marijuana use disorders in the United States between 2001–2002 and 2012–2013. JAMA Psychiatry. 2015;72:1235–1242.CrossRefGoogle Scholar
  14. 14.
    Gubatan J, Staller K, Barshop K, et al. Cannabis abuse is increasing and associated with increased emergency department utilization in gastroenterology patients. Dig Dis Sci. 2016;61:1844–1852.  https://doi.org/10.1007/s10620-016-4090-9.CrossRefPubMedGoogle Scholar
  15. 15.
    Wargo KA, Geveden BN, McConnell VJ. Cannabinoid-induced pancreatitis: a case series. JOP. 2007;8:579–583.PubMedGoogle Scholar
  16. 16.
    Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–245.CrossRefGoogle Scholar
  17. 17.
    Culetto A, Bournet B, Haennig A, et al. Prospective evaluation of the aetiological profile of acute pancreatitis in young adult patients. Dig Liver Dis. 2015;47:584–589.CrossRefGoogle Scholar
  18. 18.
    Dembiński A, Warzecha Z, Ceranowicz P, et al. Cannabinoids in acute gastric damage and pancreatitis. J Physiol Pharmacol. 2006;57:137–154.PubMedGoogle Scholar
  19. 19.
    Koliani-Pace J, Gordon SR, Gardner TB. The effect of medical cannabis on pain and opioid use in chronic pancreatitis. Gastroenterology. 2017;152:S673.CrossRefGoogle Scholar
  20. 20.
    Culetto A, Bournet B, Buscail L. Clinical profile of cannabis-associated acute pancreatitis. Dig Liver Dis. 2017;49(11):1284–1285. Epub 9/30/2017.  https://doi.org/10.1016/j.dld.2017.08.040. PubMed PMID: 28958411.CrossRefGoogle Scholar
  21. 21.
    Charilaou P, Agnihotri K, Garcia P, Badheka A, Frenia D, Yegneswaran B. Trends of cannabis use disorder in the inpatient: 2002–2011. Am J Med. 2017;130(6):678–687.e7. Epub 2/6/2017.  https://doi.org/10.1016/j.amjmed.2016.12.035. PubMed PMID: 28161344.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Gastroenterology and Hepatology Department, Digestive Disease InstituteCleveland Clinic FoundationClevelandUSA
  2. 2.Division of Gastroenterology, Department of Medicine, Leonard M. Miller School of MedicineUniversity of MiamiMiamiUSA
  3. 3.John Stroger Hospital of Cook CountyChicagoUSA
  4. 4.Section of GastroenterologyFox Chase Cancer Center, Temple HealthPhiladelphiaUSA

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