Cannabis and interaction with other drugs

[Crow River]

Came across this thread and thought I would share my recent experience.

 

I've suffered anxiety and depression for most of my life, but for decades I just dealt with it in my own ways. Sometimes self-medicating with booze, also healthier stuff like fresh air, sunshine, exercise, good food. 

 

Six years ago started having panic attacks, some sort of reaction to stress, overworked, life stuff. Nervous breakdown but with weird rage incidents. Was off work for a while, sent to psychiatrist, maybe they were worried I'd be dangerous to others. Anyway, they must have decided I wasn't sufficiently ill to justify spending their limited budget on. I got better, went back to work.

 

Then a few years ago I lost my Dad. With my siblings sorted out all the arrangements, clearing and selling the house and all that. Took six months, then Covid and first lockdown. Didn't really get a chance to grieve properly, but was sort of okay until 2021 when I started to get really depressed. There was work issues too, a lot of politics and nasty stuff. Colleagues were all stressed and taking it out on others including me. I got worse, and in early 2022 got so unwell I couldn't work. 

 

This time around my GP put me on medication, to see if it would help. Bear in mind I was already growing by this point and self-medicating with weed and a bit of booze to help my anxiety. So I've been on SNRIs for over a year now. Can't really come off them: couple of times I forgot to take them, or there was a mixup with my prescription running out. That was really unpleasant. Mood swings, angry, aggressive, I was a fucking nutter basically. So I have stuck with it. 

 

The good points: I'm no longer depressed, and the anxiety attacks have mostly disappeared. I coped better with losing my Mum last year (to Covid) than I ever imagined I could. Lots of older relatives dying nowadays, it's grim. But the medication means I'm not as depressed as I might have been otherwise.

 

The bad points: side effects include sweating like a pig at the slightest exertion, and insomnia. I've had problems with insomnia for many years anyway, but the SNRIs seem to have made it a lot worse.

 

I still vape weed, and drink alcohol in moderation. The weed and booze help me to get to sleep. Only problem is, though I can get a good sedative effect from edibles or vaping strong weed, I don't really get high. This could be partly my tolerance going through the roof of course, that's a familiar issue to many growers I suspect. But I think it's also the medication. I read up on it, and while SNRIs don't target cannabinoid receptors, they do seem to reduce the euphoric effects. And when I take a tolerance break (like this weekend just past) I can't sleep! I stay awake all night until I collapse from exhaustion.

 

Given my long history of anxiety and depression, and the fact it affected my ability to do my job in recent years, I can't see me coming off SNRIs any time soon. I am really glad I can grow my own and counteract some of the side effects of the meds. I can still get a heavy sedative stone, especially from edibles, which is a very welcome aid to restful sleep. But I'm a bit sad that I can't seem to get high like in the old days. And it's not that my weed is crap, I'm growing stronger strains these days.

 

Anyway, dunno why I'm telling you all this, but maybe it might help others in a similar situation. Cannabis really does have beneficial medical effects for me, I just don't get those recreational effects I used to enjoy...

 

Reckon I'm going to apply for a CanCard, because I will probably need to keep on growing for a long while yet. If I get busted, it might come in handy.

 

Edited June 26, 2023 by Crow River

[ArnoldSW]

On 6/4/2005 at 4:16 PM, DANZIG said:

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.

Having read through your post, i realized Leo Hollister and Franjo Grotenhermen talked about using medical cannabis for different health problems. They mentioned studies on cannabis and how it interacts with other drugs like D9-THC. Even though people use cannabinoids to treat things like throwing up during chemotherapy and losing weight with AIDS, both writers mention that there are no reported bad reactions. The growth of our knowledge is still needed because things are changing all the time around the medical use of cannabis.