Anesthesia May Not Work as Well on Marijuana Users, Doctors Now Say
New guidelines highlight a growing problem as legalization becomes more widespread.
If you're a regular cannabis user, it's a good idea to let your anesthesiologist know before your next medical procedure. According to new guidelines by the American Society of Regional Anesthesia and Pain Medicine (ASRA), anesthesia may not be as effective on heavy marijuana users. That means these patients have an increased likelihood of more pain than usual while recovering from surgery. Even more concerning, the guidelines state that getting high right before an operation can spike your risk of heart complications, including heart attack.
Read on to learn more, and to find out what you can do to help ensure that your next medical procedure goes smoothly.
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Marijuana use can leave patients in more pain than usual following surgery.
If you regularly use marijuana, you could be in a world of pain after your next operation, suggest the ASRA's new guidelines.
While many people use marijuana to help with pain management, experts say high doses can actually increase pain and counteract the effects of anesthesia. So whether you use it recreationally or for medicinal purposes, consider cutting back before going under.
"Even though some people use cannabis therapeutically to help relieve pain, studies have shown regular users may have more pain and nausea after surgery, not less, and may need more medications, including opioids, to manage the discomfort," Samer Narouze, MD, PhD, senior author of the guidelines and ASRA Pain Medicine president, said in a statement. "We hope the guidelines will serve as a roadmap to help [provide] better care for patients who use cannabis and need surgery."
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Edibles have a stronger effect than smoking marijuana.
According to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), roughly 10 percent of Americans use marijuana monthly, and it's the most commonly used psychotropic substance behind alcohol. In addition, more people than ever are opting for marijuana edibles. This is likely due to the growing awareness of the harmful effects of smoking cannabis, such as the increased risk of cancer and lung disease, according to the National Institutes of Health (NIH).
Unfortunately, while choosing marijuana edibles over smoking will reduce your chronic disease risk, they come with their own health risks. According to the NIH, edibles take longer to digest and produce a high which often causes people to consume more to feel the effects faster, leading to potentially dangerous results. Additionally, taking high THC doses from edibles regularly may increase the risk of addiction.
Marijuana use can increase nausea and interfere with painkillers after surgery.
Besides increasing the need for powerful and addictive painkillers, ASRA's guidelines also indicate that heavy marijuana use may worsen nausea and interfere with the efficacy of painkillers following an operation.
Scientific research supports the guidelines. For example, a 2018 study published in Patient Safety in Surgery looked at 261 patients across four trauma centers and found that cannabis users had higher pain scores and consumed higher quantities of painkillers than non-users.
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Disclose your marijuana use before surgery.
The main takeaway from the guidelines is to disclose your cannabis use to your doctor or anesthesiologist before medical procedures. Doing so could mean the difference between a quick, healthy recovery versus a long and painful one.
"Before surgery, anesthesiologists should ask patients if they use cannabis—whether medicinally or recreationally—and be prepared to possibly change the anesthesia plan or delay the procedure in certain situations," said Narouze. "They also need to counsel patients about the possible risks and effects of cannabis."
