Understanding Rx Drug Interactions with Cannabis: A Nurse's Perspective

In this episode, Nurse Whitt Wacker, a registered nurse in Colorado and the nurse manager at LEAF 411, joins host Steve on the podcast to discuss drug-to-drug interactions with cannabis. LEAF 411 is a national nurse hotline that provides guidance to individuals with cannabis-related questions and concerns. LEAF 411 has received over 10,000 calls from people all over the world, demonstrating the demand for cannabis education and support.

Nurse Whitt and Steve emphasize the importance of educating oneself about how cannabis may interact with prescription drugs, especially for those taking multiple medications. She highlights the safety profile of cannabis, citing research that shows it is generally safe to ingest with mild side effects such as sedation and dry mouth. Nurse Whitt also emphasizes the need to consult with healthcare providers and provides resources for further research.

CBD and pharmaceutical drug interactions.

CBD and pharmaceutical drug interactions can have significant implications for individuals who use both cannabis and prescription medications. Host Steve and Nurse Whitt shed light on the topic by discussing specific examples of drug interactions and providing guidance on how to navigate them.

They mention medications such as selective serotonin reuptake inhibitors (SSRIs) and opioids, which are commonly prescribed to individuals and the importance of being aware of potential interactions between these medications and CBD. For example, Losartan, a blood pressure medication, may have an increased effect when combined with CBD. Similarly, the SSRI Lexapro may also be affected by CBD use. However, it is noted that this interaction could potentially be advantageous, as it may allow for a reduction in the dosage of these pharmaceutical medications, and as a result a lower cost.

By highlighting these interactions, the podcast emphasizes the importance of discussing CBD and cannabis use with healthcare providers and potentially adjusting medication dosages under their guidance.

One helpful hint is to keep a journal to track the effects of both cannabis products and pharmaceutical medications. Healer, which provides journal books and inventory sheets to help individuals track their cannabis journey. By keeping a record of how you feel while using these substances, individuals can have informed and transparent conversations with their medical providers. This can help ensure the effectiveness of prescribed medications and over-the-counter cannabis products and can aid in evaluating trends and adjusting medication use under the guidance of healthcare providers.

Drug interactions with edibles.

Nurse Whitt explains that when cannabis is ingested as an edible, it goes through the stomach and undergoes first-pass metabolism in the liver, which can convert Delta 9 THC into a more potent form called Delta 11THC. This highlights the importance of a ‘start low, go slow’ approach to consuming THC edibles as it may take up to 2 hours to feel the effect. (Meaning start at a low dose, wait to feel an effect, and increase slowly, if at all).

Nurse Whitt emphasizes that the metabolism of cannabis can vary depending on an individual's metabolic rate. Fast metabolizers may feel the effects of cannabis quicker, while slow metabolizers may experience a delayed onset of effects. She reiterates that once the stomach has finished processing the cannabis, it is sent to the liver, where other medications are also processed, and this is where interactions may occur.

Specific conditions that could be affected by drug interactions with cannabis are discussed. These include statins, blood thinners, blood pressure medications, selective serotonin reuptake inhibitors (SSRIs) for depression, and opioids. Nurse Whitt also mentions that statins such as Crestor, commonly taken for cholesterol, often come with a warning about grapefruit juice. This is because grapefruit can reduce the effectiveness of the enzyme responsible for metabolizing the statin drug. Steve notes that CBD can have a similar effect.

Cannabis has a safe profile.

It is crucial to understand how cannabis is absorbed, distributed, and metabolized in the body, and how it may interact with pharmaceutical medications.

One of the main points from this episode is that cannabis has a safe profile and that there has never been an overdose death from cannabis. This is a significant statement, as it highlights the fact that cannabis is not as dangerous as some other substances, such as opioids, which can cause respiratory depression and potentially stop a person's breathing. The absence of cannabinoid receptors in the brain that affect breathing centers contributes to the higher safety profile of cannabis compared to many pharmaceutical medications.

The podcast host Steve acknowledges that more research needs to be done on the specific drug interactions with CBD and THC. However, they highlight the availability of online resources and books that provide information on potential interactions. They mention a book called "Pain Free with CBD" that includes a chart highlighting the most prescribed drugs and how they interact with cannabis. They also mention online resources like drugs.com and go.drugbank.com, which offer interaction checkers to help individuals understand potential interactions.

Education, research, and awareness are key to ensuring safe and effective cannabis use for everyone.

At key points in this episode, you will learn about:

[01:38] Drug to drug interactions.
[04:25] Cannabis safety profile and side effects.
[06:44] CBD and THC differences.
[08:40] Drug interactions with cannabis/CBD.
[19:09] Journaling for patient-centered care.
[22:33] Cannabis vs. Opioids.
[26:14] THC and CBD dosages. A personal story.

Resources:

Pain Free with CBD: (https://www.simonandschuster.com/books/Pain-Free-with-CBD/Alice-OLeary-Randall/9781641525541)
Drug Interaction Checker Tools (enter your drug names and see)
- https://www.drugs.com/drug_interactions.html
- https://go.drugbank.com/drug-interaction-checker
Healer Hemp (medicinal hemp, CBD products): https://healercbd.com/coupon/cwg20/?ref=173

Cannabis Education Resources and how to contact Steve if you have a cannabis story to share: https://grandmaandhergummies.com/resources/