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Drug Interactions
with Cannabis
Some drug interactions can be positive — others not so much ...
by Peter Kershaw , contributing writer
Big Pharma has achieved astonishing success ( for them , not so much for us ). As of 2019 , over 131 million Americans were taking one or more pharmaceutical drugs . This includes 66 % of all adults and an alarming 85.0 % of older adults ( aged 60 +). The more pharmaceuticals one takes , the more one is subject to experiencing drug interactions . These are known as “ drug-drug interactions .” A drug-drug interaction can delay , decrease , or enhance the absorption of either drug . This can decrease or increase the action of either or both drugs or cause adverse and potentially harmful effects . Some of the common symptoms of drug interactions can include : h Medications may not work as well h Drowsiness h Dizziness h Nausea or vomiting h Abnormal heart rate h Diarrhea h Muscle aches or pains h Depression h Anxiety or restlessness h Increased bruising or bleeding h Skin rash
The packaging of many pharmaceutical drugs contains a warning label not to consume the drug in combination with alcohol ( which itself is a drug ). It ’ s well-known that certain drugs when combined with alcohol can be risky ( e . g ., alcohol and sleeping pills , Xanax , etc .). Certain drug labels even contain a warning label not to consume grapefruit juice as it ’ s known to interfere with them (“ drug-drink interaction ”).
Drug interactions can even occur when combining certain foods , supplements , and herbs with certain drugs . This is known as “ drugfood interaction .” For example , the herbal supplement St . John ’ s Wort became wildly popular in the 1990s for treating depression and menopausal symptoms . However , doctors and pharmacists soon noticed it had a negating effect on certain heart medications . Since that time , at least a dozen more pharmaceuticals have been identified as having reduced effectiveness when combined with St . John ’ s Wort . When taken on their own , virtually any herbal and natural supplement is safe and effective to combine with any other . However , combining natural with synthetic may have unintended consequences . Thankfully , in most cases , the result isn ’ t injurious ; but rather , the supplement only reduces the effectiveness of the pharmaceutical .
Though they often forget to do so , doctors should recommend that patients consult them before taking any supplements in combination with the pharmaceuticals they prescribe . As such , it ’ s always a good idea to inform your doctor of what else you are taking . However , doctors are often not the best source of information on drug interactions , nor are they likely to take the time to do much research . Your pharmacist is generally far better informed , and for good reason . Pharmacists must acquire a four-year Doctor of Pharmacy degree ( PharmD ). They are considered experts in their field . A competent pharmacist enjoys doing research . When they don ’ t immediately know the answer , they ’ ll likely have access to medical reference databases , such as Epocrates .
Cannabis and Drug Interactions
Cannabis is an inherently complex plant containing hundreds of molecules , including around 80-100 cannabinoids and 300 non-cannabinoid chemicals . The more drug molecules one consumes at a time , the more likely there is to be a drug interaction . Some of these drug interactions can be positive — others not so much .
Anyone who has ever consumed cannabis with alcohol will be familiar with the interaction : the intoxicating effects are amplified , and the effects will be longer-lasting . Even on its own , alcohol carries considerable risks , especially impairment of judgment , which can too easily lead to over-consumption . Among other things , combining cannabis with alcohol runs the risk of incurring a DUI . If you plan on consuming both while out on the town , be sure to have a designated driver or call an Uber .
Combining pain meds ( opioids , in particular ) and cannabis can have significant benefits . “ Cannabinoids may provide a therapeutic strategy to enhance the analgesic effects of opioids while mitigating their serious adverse effects . Smoked cannabis combined with an ineffective [ suboptimal ] analgesic dose of oxycodone produced analgesia comparable to an effective opioid analgesic dose without significantly increasing cannabis ’ s abuse liability . Yet the combination did increase opioid-related positive subjective ratings .” 1 As such , the patient is able to consume much lower doses of their pain meds to achieve optimal results . So effective is cannabis that many pain patients have found that , over a period of weeks , they will further reduce their prescription pain meds and sometimes even curtail them altogether .
Studies have shown that cannabis users often require greater doses of anesthesia when being put under for surgery , sometimes up to 10 times as much . 2 It is therefore extremely important to inform your surgeon and , more importantly , the anesthesiologist that you consume cannabis — how much and how often . Nothing is more horrifying than to become conscious halfway through surgery but unable to open your eyes and communicate with the surgeon that you ’ re not out completely and can feel everything ! Though you may find it calming to use cannabis before surgery — don ’ t , especially edibles . Avoid consuming cannabis at least 72 hours before surgery .
24 July 2024