Differential impact of Cannabis abuse on neurological disorders

Cannabis abuse is increasingly linked to adverse neurological and cerebrovascular outcomes, yet its impact on diverse neurological conditions remains unclear. We evaluated clinical outcomes of cannabis abuse across ten disorders: cluster headache, neuropathy, multiple sclerosis, stroke, transient ischemic attack (TIA), Parkinson's disease, Alzheimer's disease, vascular dementia, migraine, and tension-type headache. Using data from the TriNetX global federated health research network (143 healthcare organizations), we identified patients with and without cannabis abuse for each disorder. Propensity score matching balanced demographic and clinical characteristics. Patients were followed for up to three years post-index event, and outcomes were compared by assessing emergency department (ED) visits, pain prevalence, mortality, and cerebrovascular events using risk ratios. Cannabis abuse was consistently linked to significantly higher ED utilization and pain prevalence across all conditions. For example, neuropathy patients with cannabis abuse experienced 25.8 % ED visits compared to 19.3 % in non-users. Although trends toward increased mortality and recurrent stroke/TIA were noted, these differences were generally not statistically significant. Our findings demonstrate a differential impact of cannabis abuse across neurological disorders, markedly elevating acute care needs and pain burden. These results highlight the need for tailored management and additional research.