Inpatient outcomes of rheumatoid arthritis in hospitalized patients using cannabis: data from the National Inpatient Sample

Baylor University Medical Center Proceedings
2025
Karun Shrestha, Prakriti Subedi, Anil Regmi, Manoj Ghimire, Sajana Poudel, Mahmoud Hashim, Mohammed Hasan, & Clement Tagoe

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Abstract

Background

Despite advancements in rheumatoid arthritis (RA) treatment, effective pain management remains challenging, with many patients also experiencing insomnia, anxiety, and depression. Cannabis, with its analgesic properties, offers a promising nonopioid alternative. This study evaluated outcomes in hospitalized RA patients using cannabis through the National Inpatient Sample (NIS) database.

Methods

This retrospective study analyzed NIS data (2016–2021) using ICD-10 codes to identify RA patients. Demographic and clinical characteristics and inpatient outcomes were compared between cannabis users and nonusers.

Results

RA patients using cannabis (n = 42,415) were younger (mean age 51.8 vs 67.8 years), less likely to be female (60.65% vs 73.71%), and more likely to be African American (24.02% vs 12.86%) and Native American (2.25% vs 0.86%). Cannabis use was associated with lower mortality (0.98% vs 2.71%) and hospital charges ($57,773 vs $63,681). After adjusting for age, gender, race, and comorbidities, cannabis use was linked to decreased mortality (odds ratio [OR]: 0.50), depression (OR: 0.47), chronic pain (OR: 0.45), and anxiety (OR: 0.55). Conversely, cannabis use increased the risk of opioid use (OR: 1.10), nicotine dependence (OR: 1.35), and alcohol use (OR: 1.35).

Conclusion

RA patients using cannabis had lower mortality, depression, chronic pain, and anxiety, but higher risks of opioid, nicotine, and alcohol use. Further research is needed on the long-term effects of cannabis in RA management.

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