While many view cannabis medication as medicine in its own right, there are many illnesses that weed can’t treat, which means trips to the pharmacy are still necessary from time to time.
Naturally, many prescription and over-the-counter drugs come with contraindications, so it’s essential to know if certain medications are safe to mix with cannabis.
Mixing Cannabis With Over-The-Counter Medications
Among the most common pharmaceutical meds are non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin, the latter of which is also a blood thinner that can be used to treat headaches. These medications are not contraindicated with cannabis, which means getting high is very unlikely to cause you any problems while using these drugs – provided you consume them as directed by a doctor or pharmacist.
However, despite a lack of evidence to suggest that there’s nothing to worry about, there is reason to be a little cautious. After all, pharmaceuticals are designed to interact with several biological functions, so it’s wise to avoid combining these with other substances if possible.
For example, many NSAIDs – including aspirin and ibuprofen – work by inhibiting an enzyme called COX-2, resulting in a decrease in inflammatory compounds such as prostaglandins. THC, however, has been shown to increase the activity of COX-2, implying that cannabis may disrupt the efficacy of these medications.
Furthermore, many meds are metabolised and cleared from the body by a liver enzyme called cytochrome P450. Cannabinoids such as CBD, however, are known to inhibit this enzyme, potentially decreasing the body’s ability to break down some pharmaceuticals. Therefore, mixing cannabis with some common medications may not be the brightest idea, although few recorded examples of significant interactions exist.
Among the few case studies that have been documented is the story of a 41-year-old man who suffered a heart attack after mixing Viagra with weed. According to the doctors who reported the incident, Viagra is broken down by P450 and therefore falls into the class of medications that doesn’t don’t with excessive cannabis use[i].
Paracetamol, meanwhile, is among the medications that are not contraindicated for cannabis. Once again, however, it’s advisable to exercise caution, especially when you consider that paracetamol is primarily produced by a metabolite called AM404, which activates cannabinoid receptors, including the CB1, CB2, and TRPV1 receptors.
Mixing Cannabis with Prescription Medicines
Prescription drugs tend to have much stronger effects than over-the-counter meds, so it makes sense to use these substances with a greater degree of caution. Opioid painkillers, for instance, profoundly depress the respiratory and central nervous systems, so they should not be consumed in combination with cannabis.
The same goes for benzodiazepines such as diazepam – also known by the brand name Valium – which are prescribed to treat conditions such as anxiety, insomnia, and restless leg syndrome. While these drugs don’t mix with the endocannabinoid system, they do reduce arousal within the central nervous and limbic systems by enhancing the activity of an inhibitory neurotransmitter called GABA. Combining these medications with cannabis is therefore highly dangerous and can result in extreme drowsiness and mental confusion.
Of course, the best way to remain safe when using pharmaceutical drugs is to always read the label and discuss any contraindications with a doctor – especially if you plan on getting high while under the influence of other medications.
If you’re on over-the-counter medication, you’re probably not going to run into any trouble. But if you’ve been prescribed something stronger that brings its own side effects, then perhaps lay off the weed until you’re feeling better. Stay safe!
[i] McLeod AL, McKenna CJ, Northridge DB. Myocardial infarction following the combined recreational use of viagra® and cannabis. Clinical Cardiology: An International Indexed and Peer‐Reviewed Journal for Advances in the Treatment of Cardiovascular Disease. 2002 Mar;25(3):133-4. – https://www.drugs.com/drug-interactions/aspirin-caffeine-propoxyphene-with-cannabis-251-0-2758-0.html