Medical students do not get an education in the endocannabinoid system, which is a shame. Most doctors have a firm understanding about pharmaceuticals and other traditional Western medicinal therapies. You might get lucky and have a personal physician who has a basic knowledge about holistic medicine, herbal therapies and other integrative health techniques. Sadly, this lack of information puts patients at risk and encourages some to self-diagnose and self-medicate. If you are consuming cannabis — for medicinal, recreational, spiritual, wellness or any other purpose — it is vitally important to share this information with your doctor. While cannabis is a safe drug, you need to be careful when you mix these drugs with marijuana.
Don’t be afraid to share; there is a thing called doctor-patient confidentiality. Besides, eight states have already legalized recreational marijuana and 29 states allow some form of medicinal use.
Why is it vital? Even though cannabis is considered to be a fairly safe psychoactive substance — and there has never been a documented case of fatal overdose — there can be medical issued when mixed with some prescription medications.
According to Dr. Sarah T. Melton, associate professor of Pharmacy Practice at the Gatton College of Pharmacy at East Tennessee State University:
“Marijuana has potentially serious drug interactions with prescription and over-the-counter medications. By sharing details of marijuana use, the prescriber can best make decisions about medication choices and educate the patient about any potential contraindications or need for monitoring.”
Since science regarding the interaction of pharmaceuticals and cannabis — still a Schedule I drug, which means research is difficult — there is no definitive list of what medications are unsafe to use in combination with marijuana. To be clear, this is true for most herbal medications, which are tested by the FDA under a different protocol than pharmaceuticals.
According to the Mayo Clinic, cannabis may adversely interact with:
- anabolic steroids
- barbiturates
- benzodiazepines
- central nervous system depressants
- corticosteroids
- dopamine antagonists
- nicotine
- nonsteroidal anti-inflammatories
- opioid receptor antagonists
- pain relievers
- phytoestrogens
Another trusted source is Drugs.com, an independent medicine information site that provides “independent, objective, comprehensive and up-to-date information for both consumers and healthcare professionals.”
According the Drugs.com, definitely check with your physician before combining cannabis and these pharmaceutical medicines:
Benztropine
Using cannabis together with benztropine can increase nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment.
Buprenorphine and cannabis
Using buprenorphine together with cannabis can lead to serious side effects such as respiratory distress, coma, or even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Levomethadyl acetate
Using levomethadyl acetate together with cannabis may increase side effects such as drowsiness, dizziness, lightheadedness, confusion, depression, low blood pressure, slow or shallow breathing, and impairment in thinking, judgment, and motor coordination.
Propoxyphene
First some good news: Propoxyphene hasn’t been on the market since 2o1o after the FDA issued a warning. If you come across some in the back of your medicine closet, toss him out.
Using propoxyphene together with cannabis may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should take propoxyphene exactly as prescribed by your doctor.
Sodium oxybate
Using sodium oxybate together with cannabis may increase side effects such as drowsiness, dizziness, lightheadedness, confusion, depression, low blood pressure, slow or shallow breathing, and impairment in thinking, judgment, and motor coordination.
SSRIs
Using cannabis together with SSRI’s such as escitalopram may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications.
Alcohol
Using cannabis together with alcoholic beverages may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with cannabis. Do not use more than the recommended dose of cannabis, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
Yes, booze and buds can be a dangerous concoction. If you enjoy a craft beer with your joint or a chardonnay with your vape, use caution and know your limit!
This is not a complete list. It is vitally important for you to have the conversation with your doctor. And do a little homework on your own. It’s better to be safe than sorry.
