Study Finds Regular Cannabis Users need Twice as much Anesthesia

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Every day, doctors are learning more and more about cannabis and its potential health impacts. Sometimes, their work leaves us with more questions than answers

A study published in the Journal of the American Osteopathic Association Monday has found that people who smoke pot on the regular may require more sedation during even minor medical procedures—like a colonoscopy. In fact, some patients may require more than two times what non-cannabis users require.

The team of Colorado-based researchers decided to analyze this potential risk after hearing from anesthesiologists that more and more patients were requiring a little extra sedation after the state legalized the drug in 2012. However, science can’t rely on hearsay, so these doctors took to the facts.

They examined the medical records of some 250 patients who received endoscopic procedures after 2012. These typically involve the insertion of a tube fitted with a camera to assess a person’s gastrointestinal system, according to American Society for Gastrointestinal Endoscopy. Think colonoscopy or enteroscopy. Both suck, but at least patients are put under to avoid the discomfort of having a tube stuck down their throat—or, worse, their ass.

Anyway, the study found that the individuals undergoing these procedures who smoked daily or weekly needed 14 percent more fentanyl, 20 percent more midazolam and 220 percent more propofol to properly knock out.

The doctors don’t quite know why this is the case, but they know that it’s something worth looking at closely, especially as more and more states begin legalizing the recreational use of cannabis. These sedation drugs are nothing to mess with, and they can lead to some more dangerous consequences if not administered carefully.

“Some of the sedative medications have dose-dependent side effects, meaning the higher the dose, the greater likelihood for problems,” said lead researcher Mark Twardowski, an internal medicine physician who specializes in osteopathic medicine, in a statement. “That becomes particularly dangerous when suppressed respiratory function is a known side effect.”

That’s the real danger here if further research supports this finding. Increasing people’s doses could lead to these other side effects, so it should be avoided if possible. However, evidence based on a larger sample size that looks at patients’ reactions over several procedures (not a single event) would help better understand these findings.

The study authors would like to see patient intake forms include more questions around cannabis use in states where it’s legal, according to their press release. That could help inform the care they offer—which may help ensure those worst-case scenarios don’t come to fruition.

“This study really marks a small first step,” said Twardowski, in a statement. “We still don’t understand the mechanism behind the need for higher dosages, which is important to finding better care management solutions.”

Twardowski’s team is already working on a second study to learn more about this connection. The scientists are hoping to discover whether anesthesia should be administered differently between regular weed smokers and non-users. They’ll also be exploring whether post-procedure prescriptions for pain should change, too. If future research supports the need for a shift in protocols, they don’t want to waste any more time. Weed legalization is here, and medical practices need to catch up.

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