Marijuana Drug Interaction
Do Doctors Know?
Nebraskans overwhelmingly view marijuana as a drug which is why Nebraskans widely voted for medical marijuana (https://ballotpedia.org/Nebraska_Initiative_438,_Medical_Marijuana_Regulation_Initiative_(2024)).
I was not surprised. People want their doctors to have access to a broad level of medications to deal with various conditions (https://www.wowt.com/2024/12/17/questions-arise-over-nebraskas-medical-marijuana-laws/). This is also why President Trump's Right To Try advocacy became law (https://righttotry.org/president-trump-signs-right-to-try-act-into-law/). People have a right to healthcare, (but not medical entitlements or government funding). Omaha has to croak on its own hypocrisy for supporting medical marijuana while heavily opposing Trump.
However, all sorts of institutions have to adjust so please share this article far and wide. I mentioned this previously regarding marijuana edibles (https://andrewlsullivan.substack.com/p/nebraska-marijuana-problems). For the medical community and patients, this means coming to terms with negative drug interactions with marijuana, including anesthesia (https://drugfree.org/article/marijuana-and-anesthesia/).
Of course, Americans are already taking too many medications which increases the chances of negative drug interactions (https://www.consumerreports.org/prescription-drugs/too-many-meds-americas-love-affair-with-prescription-medication/). People should take a list of all their medications and supplements to their doctor to find out how to reduce the number of drugs being taken. Often, a modest change in diet can eliminate numerous drugs from being used.
Also, people know alcohol has a negative interaction with many drugs. Yet, marijuana has a host of negative drug interactions which few people are aware of. So, I went to the Grok AI and asked (https://grok.com/share/c1a27ff0-eab9-4037-9a8e-3ea950380019).
And the result:
Marijuana, or cannabis, can interact with various medications, potentially leading to adverse effects. Here are some notable interactions:
1. **Sedatives and CNS Depressants**:
- **Examples**: Benzodiazepines (e.g., Xanax, Valium), opiates (e.g., morphine, oxycodone), alcohol.
- **Effect**: Increased sedation, dizziness, drowsiness, and risk of respiratory depression. Combining these can dangerously enhance the depressant effects on the central nervous system.
2. **Antidepressants**:
- **Examples**: SSRIs (e.g., fluoxetine, sertraline), tricyclic antidepressants.
- **Effect**: There's limited research, but some users report increased anxiety, irritability, or the opposite - enhanced effects of both drugs. SSRIs might reduce the psychoactive effects of THC.
3. **Antipsychotics**:
- **Examples**: Clozapine, olanzapine.
- **Effect**: THC might counteract the therapeutic effects of antipsychotics, potentially worsening psychiatric symptoms like psychosis. There's also a risk of increased sedation.
4. **Blood Thinners (Anticoagulants)**:
- **Examples**: Warfarin.
- **Effect**: Cannabis might increase the blood-thinning effect, potentially leading to an increased risk of bleeding. However, research is not conclusive.
5. **Antihypertensive Drugs**:
- **Examples**: Beta-blockers, ACE inhibitors.
- **Effect**: Marijuana can lower blood pressure, which when combined with antihypertensive drugs, might cause too much hypotension (low blood pressure), leading to dizziness or fainting.
6. **Antiepileptic Drugs**:
- **Examples**: Phenytoin, carbamazepine.
- **Effect**: There's some evidence suggesting that cannabis might lower seizure thresholds, potentially reducing the efficacy of antiepileptic medications.
7. **HIV Protease Inhibitors**:
- **Examples**: Ritonavir, indinavir.
- **Effect**: These drugs can inhibit the metabolism of THC, leading to prolonged and increased effects of marijuana.
8. **Immunosuppressants**:
- **Examples**: Cyclosporine.
- **Effect**: There could be an interaction where marijuana affects the metabolism of these drugs, potentially altering their effectiveness or toxicity.
9. **Theophylline** (for asthma):
- **Effect**: Cannabis smoking might increase the risk of theophylline toxicity by altering its metabolism.
It's important to note:
- **Individual Variability**: Responses to drug interactions can vary widely between individuals.
- **Lack of Comprehensive Research**: Many of these interactions are based on anecdotal evidence or small studies, as comprehensive research on marijuana interactions is still developing due to its legal status in many places.
- **Medical Supervision**: If you're considering using marijuana alongside any medication, it's crucial to consult with a healthcare provider. This is especially true for those with pre-existing conditions or those on multiple medications.
Always inform your healthcare provider about all substances you use, including marijuana, to manage potential interactions effectively.
What you don't know really can hurt you. It can even kill you. Thank you for sharing this info, Andrew.
Oh, and for the record, long-term use of marijuana, can, with a significant subset of the population, result in violent psychosis, especially, schizophrenia.
I do not say this to upset anyone, only as a warning to the wise.
Another little-known fact that more physicians really ought to discuss with their patients: opiates can jumpstart latent OCD and send it into overdrive.
Anytime you can avoid messing around with drugs, avoid them. If you can't avoid them, discuss your family history with your prescribing physician and do some research before taking them and take only enough to gain the benefit and then--no more.
All I can say is drug companies shouldn't be involved in anything, as big pharma is the most corrupt establishment there is, marijuana is a controlled substance, not a drug.