Wikipedia says, “Interaction is a kind of action that occurs as two or more objects have an effect upon one another.” Understand this makes drug interactions a bit easier to break down. Not every interaction is a ‘bad thing.’ Sometimes, when we combine two drugs/medications, they help each other…sometimes not. The discussion becomes a good or safe interaction versus a harmful or unsafe interaction.
It is important to note that the information 2 Leaf Nurses provides here is only for education and information purposes. It is not medical advice in any way. Before starting any new medication or supplement, you should talk with your physician.
The short answer to interactions between medications and cannabis is YES. There will be an interaction because two or more substances are entering the body, so there will be some type of interaction. But that is not to say it is harmful or unsafe. Research studies have found and continue to find that various cannabinoids are not only not dangerous but are good and interact well. “In comparison with other drugs used for the treatment of certain medical conditions, CBD has a better side effect profile. This could improve patients’ compliance and adherence to treatment. CBD is often used as adjunct therapy” (Iffland, 2017).
Given about half of Missouri medical cannabis patients are over 50, and on an average of 5 prescriptions and the national average of all American adults is 4prescriptions, it is essential to break this down. First, anything we can do clinically to improve a patient’s adherence/compliance with treatment is good. Second, fewer side effects are always good – no one likes to feel ill from their medications. And third, the research cited refers to CBD, which is a cannabinoid just like THC, CBG, CBN, and the other 100 plus cannabinoids found in cannabis. However, because CBD is found in both hemp and marijuana plants, the point is relevant. lEach of the cannabinoids can interact differently depending on the medication, so one needs to know what they are taking and why. For example, there are many CBD-type receptors in the gut, so someone taking medicine for digestive issues is more likely to encounter interactions between CBD-dominant cannabis. Whereas someone taking an opioid for nerve pain is more likely to encounter interactions with a THC dominant cannabis because the brain and central nervous system receptors are more receptive to THC. Do you see why it is essential to talk to a healthcare professional about your specific medications? To say ‘It’s complicated’ can be an understatement.
As a cannabis nurse, I conduct a thorough medication interaction search with clients and talk in-depth about the interaction findings. This provides them something to share with their physician in their quest to medicate responsibly. There are some medications that most of us recognize need thoughtful consideration before mixing with cannabis. One is warfarin and other blood clotting prevention medications because of the potential to increase the bleeding time that could be harmful. Chemotherapy agents must be looked at individually because some interactions enhance the effects of the chemo when combined with cannabis, while others can negatively interfere. THC can enhance the effects of drugs that cause sedation and depress the central nervous system, such as benzodiazepines, barbiturates, and alcohol. The good news is that these interactions clinically are not commonly seen when patients are micro-dosing or using lesser amounts of cannabis. Precisely what constitutes a small amount is different for everyone. Still, usually, less than 20mg of THC or less than 100mg of CBD per day is considered a small amount.
I could talk for hours about all the different medications and the potential for positive or negative interactions.
Still, it all boils down to this… speak to your physician or with a cannabis nurse. At 2 Leaf Nurses, this is a passion-filled aspect of education, and we are happy to help.
Dedee Culley, RN, is the founder of 2 Leaf Nurses, an educational consultancy working with both patients and facilities.Reference:
Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and Cannabinoid Research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034
What do you think?