While cannabis undoubtedly has a wide range of potential benefits, including pain and anxiety relief, there are some prescription medications you should avoid using with weed, even if you are a medical marijuana patient. Cannabis may interact negatively with your medication or dull the medication’s impact, potentially creating a range of health risks.
If you’re currently prescribed any of the following medications, you should consider refraining from cannabis use until you have had an opportunity to discuss the potential outcomes and best options with your doctor.
One opioid medication worth mentioning is oxycodone. An opioid like oxycodone can be incredibly addictive on its own. Some doctors may be able to help moderate oxycodone use and ensure its use is as safe as possible. When you mix oxycodone with other drugs, like cannabis, the risks only increase. One study found that combining oxycodone and cannabis leads to an increased risk of depression and anxiety and unintentionally subdues a patient’s central nervous system to a dangerous degree.
However, there is a plus side: Medical cannabis can potentially be used to reduce prescription opioid intake, which ultimately reduces the chances of negative side effects such as dependence and overdose. Those who intend to utilize medical cannabis to reduce their opioid intake should speak to a qualified healthcare professional to get the appropriate support and tapering programs, which improves the chances of overcoming dependence.
Blood thinners, which regulate the ease of blood flow throughout the body, require incredibly careful dosages in the first place, and adding cannabis to the mix can be risky. Some blood thinners are drastically affected by cannabis use. One study found that using blood thinners and cannabis simultaneously can lead to the increased potency of certain blood-thinning medications.
Doctors prescribe people medicines at certain dosages for a reason. With some blood thinners, the potential exists, in practice, for people to essentially be taking a significantly higher amount of medication than their doctor intended. If you are on blood thinners and actively use cannabis, your doctor might recommend lowering the prescribed dose of your medicine or suggest you reduce or cease cannabis use.
SSRIs, or selective serotonin reuptake inhibitors, have a lot of potential uses but are most commonly used as antidepressants to treat conditions such as depression, anxiety or obsessive-compulsive disorder. More research is needed to determine whether patients need to avoid cannabis entirely when taking a prescribed SSRI. Still, until then, patients should be aware of potential issues, be careful, and seek their physician’s advice.
Some initial warning signs suggest that antidepressants’ effectiveness may be dulled by co-use with cannabis. Some studies also suggest that cannabinoids like CBD can prevent your body from eliminating antidepressants such as escitalopram and sertraline, which can lead to an increase of antidepressants in the body. This, in turn, can lead to an increased risk of side effects such as panic attacks.
On the other hand, some patients on SSRIs may benefit from the medical use of some marijuana products, as cannabis can have antidepressant qualities when dosed appropriately. Moreover, cannabis may be useful in reducing antidepressant intake. As always, open and honest communication with your healthcare provider is the best course of action when combining SSRIs and cannabis.
Some studies suggest that there could be potential benefits to using cannabis to aid in the withdrawal from benzodiazepines, though further research is needed. Those with forms of epilepsy like Dravet syndrome or Lennox-Gastaut syndrome may also find that CBD reduces their need for antiseizure medications, many of which are sedative and benzodiazepine-based (e.g., lorazepam, midazolam, diazepam, and clonazepam).
Combining cannabis use with active benzodiazepine use, however, could be a different story. Benzodiazepines are depressant, sedative-like drugs known for general potency. Like blood thinners, cannabis use can effectively increase the amount of benzodiazepines in the body. In other words, cannabis use can ramp up the potency of a drug like Xanax, which is already quite powerful on its own.
Those who wish to utilize cannabis to reduce their benzodiazepine intake should do so under medical supervision, especially as benzodiazepine withdrawal can be dangerous and even life-threatening.
Ritalin is a stimulant often used to treat conditions like ADHD. While CBD or low-dose THC may help manage some of Ritalin’s side effects, some studies have found that cannabis use can result in minimized effectiveness of Ritalin.
Due to its ability to potentially dull Ritalin’s effectiveness, those prescribed Ritalin should work with their doctors to determine whether they should continue using cannabis.
The Bottom Line
Several prescription drugs should not be combined with cannabis use, or at the very least, should be done so under medical supervision. With that said, it is important to remember that cannabis is not the sole, potentially problematic factor for adverse medical reactions. All potentially negative drug interactions should be taken seriously, whether cannabis is involved in any way or not.
Even grapefruit has been shown to negatively interact with some forms of medication, leading to the term ‘The Grapefruit Effect.’ This is because grapefruit can inhibit the liver enzyme, cytochrome P450 (CYP 450), which metabolizes many drugs and medications. CBD has a similar effect.
As always, you should be open and honest with your doctor so that, together, you can make informed, responsible decisions about what medications are best for your health. Medical cannabis can be an amazing tool for managing chronic pain, multiple sclerosis, and many other conditions but, like everything, it requires careful consideration and is not for everyone.