CBD for Pain Reduction and Opioid Use After Ankle and Tibia Fracture ORIF

Inclusion Criteria: * Patients undergoing an ankle fracture open reduction and internal fixation (medial malleolus, lateral malleolus, posterior malleolus, and/or syndesmosis repair), tibial plafond (pilon) open reduction and internal fixation, tibial shaft repair (open reduction internal fixation and intramedullary nail fixation), or tibial plateau open reduction and internal fixation * Patients ages 18-75, inclusive * Female patients must be currently practicing effective forms of two types of birth control, which are defined as those, alone or in combination, that result in a low failure rate (less than 1% per year) when used consistently and correctly * Male patients must be using an effective form of contraception Exclusion Criteria: * Legally incompetent or mentally impaired (e.g., minors, Alzheimer's subjects, dementia, etc.) * Younger than 18 years of age * Older than 75 years of age * Any patient considered a vulnerable subject: pregnant women or fetuses, children, cognitively impaired adults, prisoners * History of cannabis abuse or dependence * History of coagulation abnormalities and thromboembolic disease or current abnormal coagulation test values * History of stroke or acute coronary syndromes within 3 months before surgery * Abnormal coagulation profile * Renal failure (serum creatinine \> 250 μmol/L \[2.83 mg/dL\]) or liver cirrhosis * Patients that have been on pre-operative opioid management for any reason * Patients meeting the DSM-V for major psychiatric illness, such as bipolar disorder * Patients diagnosed with major depression, psychosis, or substance abuse disorder * Patients with current or a history of suicidal ideation * Breastfeeding females * Patients with clinically significant illness, including cardiovascular disorders * Clinically significant lab abnormalities * Abnormal LFTs * Patients with major neurological disorders, such as dementia, Parkinson's disease, cognitive impairment, epilepsy, history of traumatic brain/head injury, or seizures * Patients with moderate (Child-Pugh B) and severe hepatic impairment (Child-Pugh C). * Patients taking moderate or strong inhibitors of CYP3A4 and CYP2C19 concomitantly * Patients taking strong CYP3A4 and CYP2C19 inducers concomitantly