Cannabis use before and after metabolic and bariatric surgery and its association with alcohol use.

BACKGROUND

Research on changes in cannabis use prevalence from pre- to postmetabolic and bariatric surgery (MBS) is limited.

OBJECTIVES

To assess the change in legal cannabis use prevalence from pre-to post-MBS and the association between postoperative alcohol and cannabis use.

SETTING

Single Michigan health system.

METHODS

Patients who received MBS between 2018 and 2021 were invited to participate. The analytic sample included 612 participants who completed online surveys regarding cannabis, alcohol, and other substance use, psychiatric symptoms, and demographic information.

RESULTS

Findings indicate a 52.4% relative increase in cannabis use prevalence from pre-to post-MBS (P = .0001). Specifically, 16% of participants reported postoperative cannabis use of which 45.9% were new initiates. Among initiates, 11.8% screened positive for hazardous cannabis use while 19.2% who used cannabis pre- and post-MBS screened positive for hazardous cannabis use. Of 61.9% participants who reported past year alcohol use, 41.4% screened positive for hazardous alcohol use. Those who screened positive were more likely to initiate cannabis use post-MBS (odds ratio [OR]adj = 2.8; 95% CI: 1.4, 5.4) and more likely to persist cannabis use post-operatively (ORadj = 3.0; 95% CI: 1.6, 5.8).

CONCLUSIONS

Cannabis use initiation post-MBS is not uncommon. The increase in cannabis use prevalence might be explained by its use as a coping mechanism and cannabis legalization, though most participants underwent MBS after legalization. Results suggest a significant association between past year hazardous alcohol use and higher odds of persistent and new initiate post-MBS cannabis use. MBS programs might consider monitoring patients for cannabis use, particularly among patients using alcohol.