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Pancreatitis in Cannabis Users

Pancreatitis is a severe and potentially life-threatening inflammation of the pancreas. Doctors at the Cleveland Clinic Foundation recently examined how cannabis users faired through pancreatitis compared to the general population. They surveyed records of 2.8 million acute pancreatitis patients over 10 years, and the results were dramatic. People with cannabinoids in their bloodstream were 3-4x less likely to die in the hospital. On average, they stayed in the hospital for about one fewer day and saved the hospital around $5,000 on additional interventions. Those using cannabis were also less likely to have a heart attack or to need mechanical ventilation. This highlights the importance of the public health benefits of cannabis use. Interestingly, preclinical research seems to indicate that THC would be harmful in pancreatic inflammation, and some case reports have linked pancreatitis to cannabis use. But we’ve seen a similar paradox with obesity. It could be that using cannabis chronically downregulates CB1 activity in the pancreas. Or maybe the anti-inflammatory effect of CB2 is more significant. The effect may also be partly due to demographic differences, as the authors highlight. Cannabis users are different from the general population not only because of their use. In this study, they were also 10 years younger and more often male. The lower mortality could be due to these differences, so the researchers re-weighted their data with a statistical method to match the demographics of the cannabis users and the population. This adjusted model attributed a smaller effect to cannabis, but most benefits remained statistically significant. (The numbers above are from this adjusted model.) The authors hypothesize that (1) lower weight and age among cannabis users could explain lower mortality, or (2) the anti-inflammatory effect of cannabis may protect people from inflammation in pancreatitis.

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Doctors at the Cleveland Clinic Foundation recently examined how cannabis users faired through pancreatitis compared to the general population. They surveyed records of 2.8 million acute pancreatitis patients over 10 years, and the results were dramatic.

Cannabis: a rare cause of acute pancreatitis

Affiliation

  • 1 Gastroenterology department, Charles Nicolle’s Hospital, Medicine faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia. [email protected]
  • PMID: 22749694
  • DOI: 10.1016/j.clinre.2012.05.004

Cannabis: a rare cause of acute pancreatitis

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Authors

Affiliation

  • 1 Gastroenterology department, Charles Nicolle’s Hospital, Medicine faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia. [email protected]
  • PMID: 22749694
  • DOI: 10.1016/j.clinre.2012.05.004

Abstract

Context: Drugs of all types are related to the etiology of pancreatitis in approximately 2% of cases. However, there have been very few reports of acute pancreatitis associated with cannabis use in the general population.

Case report: This report is the first such case in our country, and involves a 22-year-old North African man who presented to our emergency department with transfixiant epigastric abdominal pain, nausea and vomiting. The patient denied any past or familial medical history, was taking no medications chronically and had no history of trauma. The patient admitted to smoking one pack of cigarettes a day and occasional cannabis use, and no alcohol consumption. Biological and morphological explorations found Balthazar grade-A acute pancreatitis with no biliary dilatation or obstruction. The etiological workup was normal and, on repeat questioning, the patient admitted to being a regular and excessive user of cannabis, and to having done so 2 days before the abdominal pain.

Conclusion: The use of cannabis is frequently seen worldwide and even in North Africa, and regular users, especially young adults, should be informed of the risk of this possible cannabis-induced pancreatic disease. This case should also be borne in mind, although the association of cannabis with pancreatitis is problematic because of the difficulty in monitoring cannabinoids in the body and the illegality of cannabis use and, consequently, getting patients to admit to using it.

Copyright © 2012 Elsevier Masson SAS. All rights reserved.

The use of cannabis is frequently seen worldwide and even in North Africa, and regular users, especially young adults, should be informed of the risk of this possible cannabis-induced pancreatic disease. This case should also be borne in mind, although the association of cannabis with pancreatitis i … ]]>