Cannabis research has effectively been banned in the United States since the passage of the Marihuana Tax Act of 1937. This prohibition not only hindered our knowledge about cannabinoids’ effects, but also how it interacts with other drugs. This poses some very serious consequences owing to the fact that there are significantly more drugs, both licit and illicit, available now compared to the 1930s. The two major cannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD), have been shown to interact with hundreds of prescription medications. It is essential for cannabis users to understand any possible side effects of combining cannabinoids with other drugs.
Sedatives and Cannabis
Cannabis is often used as a natural sleep-aid by both medicinal and recreational users. CBD holds promise in treating insomnia, but THC, in large doses, has the potential to limit REM quality. Since cannabinoids can influence sleep in different ways, how do they interact with other drugs designed for sedation? One 2019 study found that anesthetics doses required for endoscopic surgery were “significantly higher” for regular cannabis users than for non-users. This study is not definitive, but it does imply an overlap between cannabinoids and sedatives. Those who use cannabis for other reasons besides sleep may find that the sedatives they use slowly become less affective. This means they may have to up the dosage in the future.
For individuals who combine cannabis and sedatives, the risks may be even more dire. If cannabis is used in tandem with medications like Ambien, Lunestra, and Benadryl, the effect can combine into an overwhelming sedation that could result in serious health risks like heart failure or asphyxiation.
Cannabis and Anxiety Medication
In a similar vein to sedatives, cannabis has also been touted as an alternative to antianxiety medication like Xanax or Valium. While the science is still developing, the research indicates that CBD may relieve anxiety, while THC, in large doses, may exacerbate it. Cannabinoid ratios impact the interaction with anxiety meds, adding ambiguity to strain effects. THC-rich strains may increase paranoia and anxiety, requiring higher doses of anti-anxiety medication.CBD heavy strains may supplement the medication, causing users to take less. To a lesser extent, anti-anxiety medications also can have a sedative effect. Combining them with cannabis may be similar to sedatives.
Pain Medication and Opioids
There is some early evidence that cannabis may serve as a useful replacement in dealing with opioid addiction. This is because cannabis not only has the potential to ease withdrawal symptoms, but has also been shown to be beneficial in replacing opioids for pain relief as well. In one proven area of pain management, cannabis has been shown to be effective in treating neuropathic pain, making it a valuable alternative to other pain medications like Percocet, codeine, Vicodin in addition to opioids. This does present an additional risk, though, as the combination of these medications with cannabis leads to a magnification of both. Cannabis is not lethal, but combining it with opioids can have disastrous consequences.
Anticoagulants and Anticonvulsants
THC and CBD interact similarly with prescription drugs despite differing functions in the body. In the case of anticonvulsants, which treat seizures, one study found that CBD can reduce serum levels of various antiepileptic drugs within the blood stream. In the case of anticoagulants, or blood thinners, THC has been demonstrated to limit warfarin absorption of various medications. This means that in both cases, cannabinoids limit the effectiveness of each medication in quantifiable ways. The risk here is that both of these drugs can influence not only quality of life, but also safety. Additional risks of blood clots or seizures can be very dangerous. Cannabis may reduce the effectiveness of certain medications, requiring higher doses to be effective.
Antidepressants With Cannabinoids
Antidepressants treat mental and emotional disorders, but they could also induce strong physical side effects. Both THC and CBD can affect selective serotonin reuptake inhibitors (SSRI), which can help regulating mood and happiness. Combined with antidepressants, may increase physical risks like cough, influenza, dizziness, palpitations, panic attacks, and even hallucinations. hallucinations. Some of these side effects may be minor, but with heart palpitations and panic attacks the risks are apparent. Depression is a serious condition to treat, and cannabis use may worsen depression and increase associated risks.
Cannabis Risks for Diabetics
While the data is limited, there is some evidence that suggests cannabinoids could interfere with insulin in certain diabetic patients. For type 1 diabetic patients, there is evidence that cannabis can cause ketoacidosis in certain individuals. Additional studies indicate that cannabis increases the risk of peripheral arterial occlusion and myocardial infarction for those with type 2 diabetes. Cannabis and glycemic levels may be linked in diabetic patients, but the cause and effects are unclear. It may also be due to some corollary effect of cannabis use as well.
Alcohol and Other Intoxicants
Cannabis on its own is considered to be a relatively safe drug. However, when combined with other substances individuals must take their own possible intoxication into account. On the plus side, CBD may help to prevent certain risks associated with alcohol, including limiting brain and liver damage and possibly even lowering blood alcohol levels. In the long term, though, evidence suggests cannabis can contribute to substance abuse disorder, especially when combined with stimulants and opioids.