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Opioids, Blood Thinners, and Other Drugs that May Interact with Cannabis

Posted on May 03 2019

Like all medications, medical marijuana should be used with care. Like all chemicals, THC, CBD, and all the other cannabinoids and terpenes in the cannabis plant have the potential to react with other chemicals. For this reason, and the many healthful effects cannabis may have on your body, cannabis products may interact with some medications. This is true both for some over-the-counter remedies as well as some prescription medications. While there are a few medications that may not mix well with cannabis, some of them may actually work alongside cannabis to provide boosted effects. The research is limited, but some experts have identified many instances where cannabis may interact with common substances and medications. If you’re concerned about cannabis drug interactions, or are new to medical marijuana and curious about how it could interact with your medication routine, take a look at these findings.


What Drugs Interact with Cannabis?

Due to the way that cannabis metabolizes and impacts the body, as well as its natural chemical structure, it may interact with a variety of other chemicals and medications. Some of these reactions could produce negative effects, and medical marijuana may not be right for all people. In other cases, though, cannabis may increase the effects of medication, or have synergistic effects that give it a super-boost. Cannabis could also affect the way that medications are absorbed by the body to make them more or less effective. Because of cannabis’ schedule 1 status in the United States, we are still lacking necessary research to identify every single potential drug interaction for cannabis products. However, there are a few medications that we know react differently when used with cannabis, and other medications that should only be combined with cannabis when recommended and overlooked by a doctor. Here are some medications that we know interact with cannabis and cannabis products:


Medications That Thin the Blood

One of the most common concerns with medical marijuana drug interactions is the possibility of adverse reactions with blood thinning medications, like Warfarin. This is because cannabis is a known anticoagulant, which means it may thin the blood just like similar anticoagulant medications. People who regularly use blood thinners often show concern about also using cannabis for this reason, worrying that the two may combine and produce stronger effects. In most cases, the two can be used together without ill effects, but should only be combined with a doctor’s guidance. Sometimes, just adjusting the doses so that the two don’t pair negatively is enough, but your doctor will know best. Drug interactions like this seem scary, but remember that blood thinners can react with several different common substances, even menthol cough drops.


Blood Pressure Medication

Cannabis’ impact on blood pressure is still scientifically unsettled, and there is a bit of confusion among experts, mostly due to the poor representation of many of the existing tests. Studies have shown that cannabis could excite cardiac oxygen consumption, which may increase the risk of heart attack and other cardiac issues for some people. The same can be said for other activities, like exercise or sexual activity, which is why they aren’t recommended for patients considered at high risk for cardiac complications. Other evidence shows that cannabis may actually help lower blood pressure, which may help patients taking medication for high blood pressure. It is unclear, however, how the two medications will react. Using cannabis with blood pressure medications could be fine (even beneficial) on a case by case basis, but should be closely monitored by your doctor.


Medications for Stabilizing Blood Sugar

Often, people who use insulin or other medications to lower or regulate blood sugar are concerned about interactions between their medications and cannabis. Although there is very little evidence to help understand the potential reactions between cannabis and blood sugar medication, some research does show that cannabis may have a positive impact on insulin resistance. It is possible that cannabis is a tool for diabetics and that it may even have positive effects when combined with glucose regulating medications, but there’s also a chance that combining the two lowers glucose levels too much, which could be dangerous. It’s always best to consult your doctor about combining regular prescriptions with cannabis.


Sedatives

Many sedatives, antidepressants, and similar medications activate GABA neurotransmitters to help emit a calm feeling, and cannabis may stimulate the same receptors to produce the same effect. For this reason, using cannabis alongside some sedatives can be risky, resulting in increased effects. However, cannabis seems to have no effect on the effects of the sedatives themselves, so they are unlikely to provide the added boost. On its own, cannabis has been identified as a potential treatment for anxiety and depression, but it shouldn’t be combined with sedatives taken for the same cause unless otherwise recommended by a doctor.


Pain Killers

Certain pain killers, mainly opiates, may react with cannabis, too. However, evidence seems to show a beneficial relationship between the two, and theories suggest that the body’s natural opioid system and the endocannabinoid system are connected. One study shows that patients experienced up to 27% greater pain relief when combining medical cannabis with their normal opioid medications. Other experts have suggested that cannabis is a great alternative to opioids in many cases. Further evidence suggests that cannabis may be useful for combating an opioid dependence, too.


Can CBD Oil Interact with Medications?

Just like whole plant cannabis, there have been some CBD hemp oil drug interactions reported as well. CBD oil inhibits the cytochrome P450 enzyme, which is needed to metabolize many common medications. For reference, grapefruit is also known to inhibit this enzyme, which is why many prescription medications warn on the label not to eat grapefruit within an hour of taking the medication. Generally, the way that CBD interacts with these medications is by lowering the body’s ability to absorb them and therefore making them less effective. More research is needed to identify if there are other possible interactions for CBD products, but you should consult your doctor before starting a CBD regimen, especially if you are already taking one or more prescription medications.


Can I Smoke While on Medication?

Many new cannabis users are rightfully concerned about how their new whole-plant medication can interact with other pharmaceuticals they may take regularly. Even regular cannabis users should be concerned when incorporating a new medication alongside their regular cannabis routine, as complications and interactions are always possible, even if they are unlikely. Before combining cannabis with any medications, you should talk to your doctor. Even if you are cleared by your doctor, you should watch for any adverse reactions when using cannabis and report them immediately. Most people have no issue using medical marijuana while taking other medication, so long as they are properly informed and have a doctor’s guidance.

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