Cannabis and interaction with other drugs

[Mrs Cannabisology]

• There is evidence that there may be an interaction with levodopa and similar anti-parkinsonism drugs. Therefore use of this group of drugs is currently considered to be an absolute contraindication.

Hi, I'm totally new to this forum but my other half has recommended that I do a bit more research for my dad into the use of cannabis to help with his parkinson's. As I am completely clueless on most things medical, i figured, this may be the best place to ask for people's opinion.

I have just about convinced my mom that Cannabis definitely has a lot more pros than cons (if any cons at all!), and she has agreed to let me look into more ways of helping my dad as his parkinsons is starting to get a lot worse. Would anyone be able to tell me if there are any particular strains which could be best for him to take (he won't agree to smoking but I can try to make oil and cook with it), or if he should not mix cannabis with his medication at all...

for his Parkinsons, he is using:

Lannsopazole 15mg

Sinemet plus

Epanutin

Requip-Prolib (ropinirole)

As his parkinsons is getting a lot worse, his sleep is being affected because his body is getting really tense at night which is stopping him from moving round, I'm guessing having a bit of cannabis to relax him would help him, but just wanted to make sure (as I saw the quote above) that he doesn't get any reactions which could make him worse off.

would really appreciate your help and advise

[asboferret]

I have had a dual diagnosis worker for the past years as I have tried to battle with drink and drugs that I used to self medicate. Speed when I was down, weed if I'm too "up", drink always. Dual diagnosis means that you have both a drug dependency and a mental health problem, for me specifically Borderline Personality Disorder and Post Traumatic Stress disorder, and cannabis dependency which has crippled me for the past 7 years. I have been trying to quit weed for a few years, but could never understand why my illness got worse when I did. For years I got sick of being told that the weed was the problem, however I recently saw the Head Psychiatrist who has said that cannabis helps to subdue the underlying emotional instability and high anxiety state, not to mention the nightmares and flashbacks (I never dream on pot). She asked me why I wanted to quit weed if it helped that much, but it is not the magic bullet as there are drawbacks for me (Apathy, tiredness, paranoia - although I get that even without smoking, lower mood). On weed I was a bit paranoid all the time but it was low level and consistent and I kind of preferred it to suddenly being shit scared out of nowhere and its right in your face. Also when I have smoked weed it gives me thinking time before acting, and things seem to stay in my head more rather than spilling out and possibly doing something stupid.

After 3 1/2 weeks of no pot I couldn't tell real from unreal, I was having unplaced rage, panic attacks, irritability very little sleep due to flashbacks and nightmares even with the temazapam I was prescribed. I self harmed twice in that time due to being in such a massively overwhelming hit of emotions (cannabis blocks the physical side of emotions that I find overwhelming and makes me think about things in a more logical way which I can deal with better)

I made the concious decision that life without pot was going to get me into trouble as I became worse not better when I stopped, and it is the lesser of two evils so went straight back to it. Hey presto the next day I was still feeling the effects from last nights joint and had a feeling of calm that was a million miles away from when I was in crisis. I can feel the calming effects of pot for up to 18 hours after a spliff.

I am on olanzapine and mirtazapine and the psycs have always been aware of my usage of cannabis - they never made an issue of it, although the tablets alone are enough to kick you comatose into next week until your body adjusts.

I would love to grow again, I'm sick of passing 60gbp a week to anyone, and would like to stay out of the circles that congregate at my dealers house (like I said I'm paranoid anyway. Have to wait till I can move somewhere without a shared entrance hall - don't want to make myself homeless again getting caught growing.

Cannabis is thought to contain an antilpsychotic element which definitely helps me level out. Lifes still tough, but not as tough as when I stop smoking and lose the plot.

Just my experiences thought I'd share.

[purpleperil]

OK I am not using medical cannabis but now I have learnt the hard way as I have got Multiple Sclerosis I use it for that and occassionally my GP gives me Diazapam well after chucking 2 whites I now knaow that cannabis and Diazapam don't mix.

I am terriffied if I chuck another.

[purpleperil]

I have got MS so I am on a cocktail of drugs but the one thing it doesn't mix with is Diazapam I chucked 2 whities a couple of times so I never mix the 2 but Cannabis works but I don't smoke it any more so I eat them in cookies I never got stoned but it helps with the pain and helps me sleep.

[CrookedJack]

I was prescribed fentanyl 50mg on the patches.. changed every three days.. that drug was uselss..

Breaking that habit was nowhere near as bad as the oxicondone hydrochiride to come off next. This was offered as a substitute for the Fentanyl

The contradicications of the oxy were horrendous.. two months of feeling I was on speed.. no sleep.. oedema in my feet..

Now, my pain clnician has me on is Sevredol.. a coated morphine sulphate.. extremelt addictive and damages the entire renal system over time..I'm waiting for an appontment with yet another pain clinician.. thise one has the nous to a least prescribe Satvex.. but it's exceeding dubious as to long it will take to wean me off the morphene.. It could be a matter of months.. one of the problems of taking addictive compounds..

It literally blows my mind, that a drug which I've smoked for 43 years and have stopped several times without any adverse affects.. which alleviates more than one of the worst of my symptoms, the electic spasm which inevidablt turns into a full-blown cramp.. Cannot be prescribed on the NHS..

It might be an idea to contact one's MP and here in Scotland, your member of the National Assembly, and determine their stance on the decriminalisation of cannabis for medicial use..

In fact, it might be worth a series of calls to those in the Cabinet(s).. perhaps emails might be better.. suggesting perhaps that such legislation would work well at breaking the income of those who currenly are selling and getting.. £10 per gram..

Those who use it for medicinal use are a far greater majority than might be thought. It could be a 'voting' issue if enough made their voices heard..

In some 5 years or so to go with an SNP majority.. one would think enough signatures could be raised over that time, to bring the issue into prominence.. Time enough for the positve to be accentuared, such as those seen in States the likes of Minnesota.. Oregon.. California.. The Laws in the Netherlands.. in Portgugal.. in Italy..

And the more of those who are credible.. erudite.. well versed in both the drug's efficacy.. and it's contraindications as well, the better..

As mentioned, we have 5 years to develop a full scale lobby.. this would be our chance to tip scales..

Edited July 11, 2011 by CrookedJack

[Arnold Layne]

I was prescribed fentanyl 50mg on the patches.. changed every three days.. that drug was uselss..

Breaking that habit was nowhere near as bad as the oxicondone hydrochiride to come off next. This was offered as a substitute for the Fentanyl

The contradicications of the oxy were horrendous.. two months of feeling I was on speed.. no sleep.. oedema in my feet..

Now, my pain clnician has me on is Sevredol.. a coated morphine sulphate.. extremelt addictive and damages the entire renal system over time.

Severedol, which is Morphine Sulphate, is not likely to damage your renal system over time; where did you get that idea? Morphine, like most opioids, is considered relatively benign to one's organs, as it is well tolerated even in long term use.

I have been on Fentanyl (found it useless, TBH), Pethidine and many other opioids, now for over 15 years daily. At the moment, my prescription is for 140 mg of Oxycontin (70mg every 12 hours), and as much Sevredol as I need, daily. I've been using 20mg Sevredol and more for the last 5 or 6 years every day; I used to be on higher doses, but now my GP has switched my main analgesia to Oxy, which I find much more useful as it is much less soporific than the 90mg of Morphgesic (Morphine Sulphate, controlled release) I was on every 12 hours before that.

I'd rather be on Morphine, its a better pain control drug, but it does knock one out for the day! Oxy is like Morphine and speed mixed, it gives me the chance to stay awake more during the days.

Cannabis on its own I find redundant as a pain control drug, apart from its power to lift the mind and distract it from the pain. Even that works best in combination, Cannabis and Morphine is perhaps as good an analgesic as you are every likely to find.

I'm sorry you reacted to the Oxy like that. For me, it has proved a godsend.

[mactheman]

arnold laynes right.as mutch as hate taking oxy it kills the pain dead.the only trouble is getting to sleep oxy is very speedy .so agood smoke is a must for me.William Burroughs says its an evil drug that only the germans invent.under the nameof eucodol in 1930s.mac

[ABull2Grow]

I am on many prescribed drugs, like Mirtazapine for Depression,Prochlorperazine for Nausia, Amitriptyline for nerve pain, i find when combined with cannabis the reaction is very much improved, i also have found that Chronic hepatitis C treatment rises from 20% succesful to over 50% succesful when combined with cannabis,

[doriangray]

This would have been a really interesting post but there were just too many long words that had to be looked up nearly every sentence and seeing as this is a cannabis forum and not a medical journal I think this may have ruined it somewhat.

So in a nutshell, I stopped reading.

Maybe next time edit for stoners:)

Have a good day

DG

[Arnold Layne]

This would have been a really interesting post but there were just too many long words that had to be looked up nearly every sentence and seeing as this is a cannabis forum and not a medical journal I think this may have ruined it somewhat.

So in a nutshell, I stopped reading.

Maybe next time edit for stoners:)

Have a good day

DG

C'mon chap - its not so hard to look things up in these days of instant knowledge, is it?

What words in particular were causing you problems? Most of us are not medical, but I guess we use technical terminology because we can't really do anything else. I could say, for example, that I have bad back pains. But its not so clear what that might entail, is it? In the end, we can't do anything else but use technical terms sometimes, we are dealing with technical subjects.

So instead of saying that I have "back ache", I speak of "Degenerative Spinal Stenosis with sciatica, brachalgia and other stenosis related/caused pains". It might sound horribly technical, but to anyone else in the same boat it is a vital description, because it helps them see it is exactly the same diagnosis as theirs. It defines what kind of back pain I am talking about, and it also indicates why I am having the pain, and what is causing it.

But as I said, let us know which terms your struggling with. I'm sure someone will help you understand them better

Peas.

[toolrthebest]

I like those pieces.

There's no reason to suspect that cannabis doesn't interact with other substances.

Who hasn't had a (good) few drinks and then toked on a fat spliff and thrown a whitey?

Woof

Would have to agree

[HealthSeeker]

Cannabis and interaction with other drugs

Leo Hollister

Although medical cannabis is not officially approved, cannabis has been tried empirically for treating a variety of medical disorders, such as nausea and vomiting associated with cancer chemotherapy, weight loss associated with AIDS, and spasticity from neurological diseases.

In each instance, other drugs are also present. So far, no adverse interactions from such use have been reported. However, this might not reflect the true frequency. Unless one looks for something, one is not likely to find it. The published literature, at least in regard to studies with humans, has been rather silent. Usually this silence indicates that no meaningful interactions have been observed in the real life use of marijuana as compared with experimental studies

One of the most reasonable therapeutic uses of cannabis and THC has been to ameliorate the nausea and vomiting associated with cancer chemotherapy. Thus, cannabinoids will be used simultaneously with many highly toxic cancer drugs. In none of the reports of use of THC or marihuana in patients simultaneously undergoing cancer chemotherapy has there been any mention of increased toxicity of anticancer drugs.

In one animal study in which THC was given with muscle relaxants, it was found to increase the desired effect of the latter drugs. In this case, the interaction might be advantageous.

(Please note: This text has been taken from a scientific article. Some sentences have been changed to improve understandability.). Interactions of cannabis and D9-THC with other drugs. In: Nahas G, Sutin KM, Harvey DJ, Agurell S, eds. Marihuana and medicine. Totowa, NJ: Humana Press, 1999

Franjo Grotenhermen

Cannabis and dronabinol (THC) have been used in combination with a multitude of medications without significant deleterious drug interactions. Clinical studies in the beginning of the 20th century often demonstrated mutual enhancement of therapeutic effects of cannabis preparations and other drugs. In modern therapeutic concepts a combination of cannabis/THC with other medications could also be of benefit for many indications. Cannabis has been used illegally by individuals suffering from many diseases concomitantly with numerous prescription medicines

No unwanted side effects of clinical relevance have been observed to date. Other medicines may enhance or attenuate certain actions of cannabis/THC or certain actions of these medicines may be enhanced or attenuated by cannabis/THC. Moreover, it is possible that certain effects are enhanced and others reduced, as is the case with phenothiazines applied against side effects of cancer chemotherapy. Of greatest clinical relevance is reinforcement of the sedating effect of other psychotropic substances,

Pharmacology, toxicology, and therapeutic potential. Haworth Press, Binghamton/New York 2001, in press

The Medicinal Uses of Cannabis and Cannabinoids, published by Ph Press

Advises the following

Contraindications

Cannabis and cannabinoids. seem to have a very low physical toxicity. As yet there is limited knowledge on the contraindications to the use of cannabinoids as almost all information is derived from anecdotes and from studies on recreational users. As experience grows these may change. Our current contraindications are as listed below.

Absolute contraindications

• There is evidence that cannabis might precipitate a psychotic illness, particularly in those who are at risk of developing such a disorder in the future. Therefore until there is sufficient evidence, a history of psychosis should remain an absolute contraindication (Hall, 1999).

• There is evidence that there may be an interaction with levodopa and similar anti-parkinsonism drugs. Therefore use of this group of drugs is currently considered to be an absolute contraindication.

• Drugs using cytochrome P450 3A4 enzyme as their exclusive mode of metabolism (theoretically fentanyl could be a problem), until further expedience is gained

Relative contraindications

• The effects on the cardiovascular system are varied and cannot be reliably predicted. While this may be of minor importance to a healthy person there may be a risk in the presence of significant hypertension or ischaemic heart disease.

• Many patients are on a range of drugs that may affect both the CNS and the cardiovascular system. As yet we have little knowledge about the interaction of most drugs or herbal medicines with cannabinoids. The metabolism of anticoagulants such as warfarin may be affected.

• Assessing the effects of CBME on patients presenting with a complex range of symptomatology (physical, psychological and social) can present almost impossible problems. Frail and elderly patients may prove extremely sensitive to the side-effects.

• Patients who are intolerant of a wide range of psychoactive drugs. Currently it is impossible to separate the therapeutic from the psy¬choactive effects. Therefore extreme caution and slow titration is essential for this group.

• We already have concerns on the use of morphine and other psychoactive drugs in patients with actual or suspected substance misuse. Control of the use of such drugs is usually very difficult. Some too will have a history of recreational use of cannabis and may see the prescribing of CBME as a route to a regular source of high-grade material. The physician has the responsibility here in ensuring that the prescribed medicine will be used for its specified purpose. The presence in a patient's household of an individual who is a substance misuser/recreational user should also be taken into account. The presentation of the medication in a package which is tamper evident and not easy to divert for illicit use is therefore crucial.

What type of side effects could occur if suffering from ishemic heart disease and heart failure. NOT taking any meds. Vits, supps and diet.

Why CYP is metabolized by Hemp Oil? I know that my CYP 3A4 is dysfunctional. (shown on Genomix test) I take no meds. I started on Indica Hemp Oil today, a tiny pin prick dosage. If no reaction in the next few days at this dosage, is it safe to assume that I can continue to very slowly up the dosage?

My blood pressure is on the low side, but I do suffer from arrythmias, could be the hypothryoidism, on set of diabetes, or nutritional deficiencies.

Many thanks,

HS

Edited March 9, 2013 by HealthSeeker

[HealthSeeker]

Cannabis and interaction with other drugs

Leo Hollister

Although medical cannabis is not officially approved, cannabis has been tried empirically for treating a variety of medical disorders, such as nausea and vomiting associated with cancer chemotherapy, weight loss associated with AIDS, and spasticity from neurological diseases.

In each instance, other drugs are also present. So far, no adverse interactions from such use have been reported. However, this might not reflect the true frequency. Unless one looks for something, one is not likely to find it. The published literature, at least in regard to studies with humans, has been rather silent. Usually this silence indicates that no meaningful interactions have been observed in the real life use of marijuana as compared with experimental studies

One of the most reasonable therapeutic uses of cannabis and THC has been to ameliorate the nausea and vomiting associated with cancer chemotherapy. Thus, cannabinoids will be used simultaneously with many highly toxic cancer drugs. In none of the reports of use of THC or marihuana in patients simultaneously undergoing cancer chemotherapy has there been any mention of increased toxicity of anticancer drugs.

In one animal study in which THC was given with muscle relaxants, it was found to increase the desired effect of the latter drugs. In this case, the interaction might be advantageous.

(Please note: This text has been taken from a scientific article. Some sentences have been changed to improve understandability.). Interactions of cannabis and D9-THC with other drugs. In: Nahas G, Sutin KM, Harvey DJ, Agurell S, eds. Marihuana and medicine. Totowa, NJ: Humana Press, 1999

Franjo Grotenhermen

Cannabis and dronabinol (THC) have been used in combination with a multitude of medications without significant deleterious drug interactions. Clinical studies in the beginning of the 20th century often demonstrated mutual enhancement of therapeutic effects of cannabis preparations and other drugs. In modern therapeutic concepts a combination of cannabis/THC with other medications could also be of benefit for many indications. Cannabis has been used illegally by individuals suffering from many diseases concomitantly with numerous prescription medicines

No unwanted side effects of clinical relevance have been observed to date. Other medicines may enhance or attenuate certain actions of cannabis/THC or certain actions of these medicines may be enhanced or attenuated by cannabis/THC. Moreover, it is possible that certain effects are enhanced and others reduced, as is the case with phenothiazines applied against side effects of cancer chemotherapy. Of greatest clinical relevance is reinforcement of the sedating effect of other psychotropic substances,

Pharmacology, toxicology, and therapeutic potential. Haworth Press, Binghamton/New York 2001, in press

The Medicinal Uses of Cannabis and Cannabinoids, published by Ph Press

Advises the following

Contraindications

Cannabis and cannabinoids. seem to have a very low physical toxicity. As yet there is limited knowledge on the contraindications to the use of cannabinoids as almost all information is derived from anecdotes and from studies on recreational users. As experience grows these may change. Our current contraindications are as listed below.

Absolute contraindications

• There is evidence that cannabis might precipitate a psychotic illness, particularly in those who are at risk of developing such a disorder in the future. Therefore until there is sufficient evidence, a history of psychosis should remain an absolute contraindication (Hall, 1999).

• There is evidence that there may be an interaction with levodopa and similar anti-parkinsonism drugs. Therefore use of this group of drugs is currently considered to be an absolute contraindication.

• Drugs using cytochrome P450 3A4 enzyme as their exclusive mode of metabolism (theoretically fentanyl could be a problem), until further expedience is gained

Relative contraindications

• The effects on the cardiovascular system are varied and cannot be reliably predicted. While this may be of minor importance to a healthy person there may be a risk in the presence of significant hypertension or ischaemic heart disease.

• Many patients are on a range of drugs that may affect both the CNS and the cardiovascular system. As yet we have little knowledge about the interaction of most drugs or herbal medicines with cannabinoids. The metabolism of anticoagulants such as warfarin may be affected.

• Assessing the effects of CBME on patients presenting with a complex range of symptomatology (physical, psychological and social) can present almost impossible problems. Frail and elderly patients may prove extremely sensitive to the side-effects.

• Patients who are intolerant of a wide range of psychoactive drugs. Currently it is impossible to separate the therapeutic from the psy¬choactive effects. Therefore extreme caution and slow titration is essential for this group.

• We already have concerns on the use of morphine and other psychoactive drugs in patients with actual or suspected substance misuse. Control of the use of such drugs is usually very difficult. Some too will have a history of recreational use of cannabis and may see the prescribing of CBME as a route to a regular source of high-grade material. The physician has the responsibility here in ensuring that the prescribed medicine will be used for its specified purpose. The presence in a patient's household of an individual who is a substance misuser/recreational user should also be taken into account. The presentation of the medication in a package which is tamper evident and not easy to divert for illicit use is therefore crucial.

I am a little confused by this: Relative contraindications

• The effects on the cardiovascular system are varied and cannot be reliably predicted. While this may be of minor importance to a healthy person there may be a risk in the presence of significant hypertension or ischaemic heart disease.

Does this means that if someone is NOT taking heart meds, but suffers from heart failure, and suspected coronary blockages (based on unstable angina, acute coronary sysndrome, and angina on exertion) that it could be unwise to take RSO oil? I read on another site that it causes the coronary vessels to constrict, hence, makes the heart work harder. Is this correct?

If this is the case, it could cause a heart attack.

I am unsure if the contra indications here has to do with heart meds, or heart disease? I read much the research out there, but found no evidence of it being beneficial. In one case, there was some benefits but also some downside.

This eve I upped the pin prick dose just a little. I had palpitations for over 30 mins and a little angina like type of twinge. I took liquid magnesium to calm the heart down, which it did. I am wondering the safety in view of my cardiac history.

Thank you.

Edited April 7, 2013 by HealthSeeker

[Arnold Layne]

I have ischaemic heart disease. My Cardiac chap told me smoking neat weed was fine, and to carry on.

So I've been toking every day since my heart attack some 5 or 6 years ago, and my ticker is now running at optimum.

~~~~~~~~~~~~~~

I was also on Fentanyl patches for a while. I did not note any issues with mixing this with weed. the only issue I had was with the Fentanyl not working very well as a painkiller. But that is a common observation.

Edited April 7, 2013 by Arnold Layne

[HealthSeeker]

I have ischaemic heart disease. My Cardiac chap told me smoking neat weed was fine, and to carry on.

So I've been toking every day since my heart attack some 5 or 6 years ago, and my ticker is now running at optimum.

~~~~~~~~~~~~~~

I was also on Fentanyl patches for a while. I did not note any issues with mixing this with weed. the only issue I had was with the Fentanyl not working very well as a painkiller. But that is a common observation.

Thanks, I was wondering about the oil, if its possible to cause constricting coronary vessels, and arrythmias?

This is what it is written below, and I am not sure if this is for those with cardiac issues AND taking meds, or those who have cardiac issues NOT taking meds?

• The effects on the cardiovascular system are varied and cannot be reliably predicted. While this may be of minor importance to a healthy person there may be a risk in the presence of significant hypertension or ischaemic heart disease.

If this applies to both those NOT on meds, and those TAKING meds, then, caution is advised, since it clearly says, it does not know.

Edited April 7, 2013 by HealthSeeker