Can I Use Cannabis Before and After Surgery?

Marijuana and health are becoming more and more intermixed as time goes on. People are beginning to realize the physical and mental benefits medical marijuana can offer in day-to-day life and have started using it to help themselves in ways traditional pharmaceuticals have been previously unsuccessful.

Since medical cannabis is now legalized in most American states, patients wonder if cannabis use is an alternative for postoperative pain control. Could patient outcomes improve with the non-traditional use of cannabis as a pain medicine following elective surgery?

At DocMJ, we’ve been caring for patients in Florida since 2016. We provide thirty convenient clinic locations, including a Fort Lauderdale medical marijuana doctor.

While some patients feel uncomfortable discussing medical marijuana with their doctor, if you have an upcoming surgery, you want to make sure that whatever pain medicine you are provided will not conflict with cannabis.

Can Patients Use Medical Cannabis in a Hospital?

Imagine a world where patients could choose the type of pain relief they wanted for post-surgical pain control. After you have recovered from the regional anesthesia, a nurse could provide you with a cannabis capsule or edible as an alternative method to relieve pain.

As awareness about the adverse side effects of prescription pain medications grows, patients should be given the option, particularly if they have faced a severe complication after using opioids or NSAID drugs.

Unfortunately, patients cannot be administered or use medical cannabis in a healthcare facility. That includes long-term care and nursing homes. There are two reasons cannabis healthcare remains off the table; first, it is an insurance liability for providers to dispense medical cannabis.

The second reason is that hospitals receive funding from both state and federal governments. While cannabis remains illegal according to federal law, institutions risk losing funding if they allow cannabis use.

If you have a medical card, nothing can stop you from using medical cannabis to help with your postoperative recovery at home. But discuss your prescription medications and plan to use medical cannabis with your primary care physician.

The First-Pass Effect of Marijuana and Prescription Medications

When ingested, marijuana undergoes quite a bit of change as it is absorbed into the body. Edibles, for example, pass through the digestive tract before being absorbed, resulting in many significant changes to the chemistry.

Similarly, when other drugs pass through the body, they are changed themselves. This is vital to the science of pharmaceuticals. After all, what good is a drug that is active outside the body but changes to an inactive form when ingested?

In marijuana’s case, there are many different forms and methods that are all changed in different ways. Whether it is through inhalation, sublingual application, or ingestion, there are many possible places marijuana can interact with other drugs.

Notably, these drug interactions can have many different results and may not just add together or cancel each other out. As a general example, marijuana may interact with any drugs processed within the li; these include acetaminophen, alcohol, and anesthetics.

There is an effect in drug metabolism known as the “first pass effect.” The first-pass effect occurs when a drug’s concentration is lowered before reaching the bloodstream. Essentially, it means that if you take 100mg of a drug, it doesn’t necessarily mean that 100mg ends up circulating in your body.

Specific methods of application bypass first-pass metabolism, including the previously mentioned inhalation and sublingual methods. In such cases, it may be interesting to compare the oral and sublingual doses, as in most cases, the sublingual form will have a much lower concentration with drugs susceptible to the first-pass effect.

 

Can I Use Medical Marijuana Before Surgery?

The interactions we have looked at up until now have all occurred when the drugs are introduced concurrently, but what about hours, days, or weeks later? In these cases, there may not be any immediate drug interactions, but long-term use of marijuana can change the way pharmaceuticals react in the body.

Specifically, regarding surgery, it was found that marijuana use resulted in both airway obstruction and an increase in anesthetic doses needed. This correlates with previous findings regarding marijuana use and surgical outcomes. Furthermore, it was found that marijuana smoke was correlated with both airway inflammation and increased risk of respiratory illness.

Another thing to consider is the effect of marijuana on the heart and vascular system. Some studies have shown that marijuana can have adverse effects on the heart. In the short-term, marijuana has been shown to both increase heart rate and lower blood pressure.

For those with hypertension, this can be beneficial. Before surgery, however, this can cause problems both with anesthesia dosage and the physical aspect of the surgery as well. In some cases, heavy marijuana users require more anesthesia, which can impact the safety of the surgical procedure.

Surgeons and anesthesiologists are aware of the physical effects caused by marijuana, along with the previously mentioned drug interactions. The increased tolerance of marijuana smokers in regard to common anesthetics, citing possible side effects due to their higher doses, including even lower blood pressure and lessened cardiac efficiency.

That is why it is crucial to your safety to have an honest discussion about medical cannabis use before surgery. If your prescribed pain medicine conflicts with cannabis, you could find yourself in more pain. Effective pain management is critical to healing.

Using Medical Marijuana After Surgery to Help With Recovery

The effects of marijuana after surgery are even less researched than their effects beforehand. In some cases, it seems to be beneficial, while in others, it can cause problems. For example, those who have had surgery near the abdomen should avoid smoking marijuana due to the risk of a cough, which could cause further damage to the area.

Some people, though, have successfully used marijuana as a pain or inflammation reducer after surgery. In these cases, marijuana can offer some relief though it is highly recommended to speak with a physician before using it.

During surgery specifically, marijuana can react with many common anesthetics, raise the necessary amount of anesthetic for surgery, and lower blood pressure. All of these can cause problems for both the physician and the patient.

Post-surgery, marijuana may cause problems in certain cases or raise the risk of injury due to misuse, but it may also provide relief to some users.

In some cases, postponing elective surgery may be required if a patient has moderate to heavy marijuana use. That is to protect patient safety and minimize possible risks. Remember, if you are undergoing surgery in the near future, to have a conversation with your care team about medical cannabis use before surgery and after.