This original study examines whether the use of medically prescribed cannabis (MC) for the management of dysuria is associated with an increased incidence of substance use disorders (SUD). While MC is often considered a viable alternative for pain management, its long-term impact on substance dependence remains unclear. This study seeks to assess the risks associated with MC use in patients diagnosed with dysuria.

A retrospective cohort analysis was conducted using a large claims database to identify adult patients diagnosed with dysuria between 2003 and 2024. Patients were stratified into two cohorts: those receiving any therapy for dysuria (general dysuria cohort, GD) and those specifically using MC for dysuria (MC cohort). Propensity score matching (PSM) was performed in a 1:1 ratio to adjust for age, gender, and race. Risk ratios (RR), odds ratios (OR), and Kaplan-Meier survival analysis were used to assess the incidence of cannabis abuse/dependence, opioid abuse/dependence, and cocaine abuse/dependence among the two cohorts.

Following PSM, 86,089 patients were included in the analysis, with a mean age of 37.3 ± 16.4 years, of whom 63.7% were female. In the MC cohort, 5,798 of 49,861 patients (11.63%) developed SUD, compared to 2,322 of 82,773 patients (2.81%) in the GD cohort. The calculated RR was 0.241 (95% CI: 0.23 to 0.253), and the OR was 0.219 (95% CI: 0.209 to 0.23), indicating a more than 76% increased risk of SUD in patients using MC. Kaplan-Meier analysis over a 20-year follow-up demonstrated that 64.97% of patients in the MC cohort remained free from SUD compared to 88.18% in the GD cohort (p < 0.001), further supporting the increased risk associated with MC use.

These findings suggest a significant association between medically prescribed cannabis for dysuria and an elevated risk of developing SUD. While MC may offer symptomatic relief, its potential to contribute to substance dependence raises critical concerns. The long-term impact of MC use on substance dependence requires further investigation, and clinicians should exercise caution when prescribing cannabis for dysuria management.

This study highlights the need for careful evaluation of the risks and benefits of MC in the treatment of dysuria. While MC may provide pain relief, its association with increased SUD incidence warrants further clinical and policy considerations. Future research should explore potential mitigation strategies to reduce the risk of substance dependence among MC users.