Association of Cannabis Use with Pancreatitis

Abstract

Introduction: Acute and chronic pancreatitis (AP and CP) are painful inflammatory disorders causing substantial public health burden. The etiology of pancreatitis is clustered into three groups: alcohol, gallstones, and others (non-gallstones-non-alcohol). Containing potent anti-inflammatory cannabinoids, cannabis use (CU) could suppress pancreatitis, has shown in murine models. Furthermore, conflicting results are reported in other studies where cannabinoids have aggravated pancreatitis. However, human data are lacking, besides few reported cases. Therefore, we conducted a more extensive and detailed assessment of the impact of CU on pancreatitis. Methods: We collected data from 2012-2014 of the Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (NIS) discharge records of patients 18-years and older, and identified three populations: those with gallstones (379,125); abusive alcohol drinkers (762,356); and non-gallstones-non-alcohol users (15,255,464). Within each population, CUsers were identified and matched by age, race, and gender to records without CU. Adjusted Odds Ratio (AOR) of having AP and CP were measured with conditional logistic models (SAS 9.4). Results: Concomitant cannabis among abusive alcohol use was associated with reduced odds of AP and CP (aOR: 0.50[0.48-0.53] and 0.77[0.71-0.84]). Strikingly, for individuals with gallstones, additional CU did not impact the incidence of AP or CP. Amongst non-gallstones-non-alcohol users, CU was associated with increased likelihood of CP, but not AP (1.28[1.14-1.44] and 0.93[0.86-1.01]). Conclusion: Our findings suggest reduced odds of only alcohol-associated pancreatitis with CU. Our results emphasize the urgent need for further studies to elucidate the modulatory effect of cannabis on pancreatitis among different risk groups.