Why does cannabis interact with other drugs ?

If you ask anyone how the cannabis plant affects them, you will almost always get a different answer. That’s because there are over 550 active compounds in marijuana, more than 100 of which are cannabinoids. Cannabinoids and terpens are represented differently in each plant and each person reacts differently to these combinations

General view on mixing cannabis with other substances

First of all, it is important to understand that cannabis will always have different effects on each person, mainly due to the endocannabinoid system. Codi Peterson, MD and principal researcher at The Cannigma claims this: “The ECS is a huge cellular system that is connected to many other systems in our bodies. This means that the effects of cannabinoids can show up where various medications may not. Cannabis is relatively safe, but in combination with other substances it can carry some risks.”

Dr. Jordan Tishler, CEO and head of InhaleMD, has an interesting take on the issue.

“There are many active chemicals in cannabis that make it unique. Psylocibin and LSD, for example, are just one active ingredient, whereas in marijuana you have THC, CBD and many other compounds that we know very little about how they interact with other substances at this point.”

How does cannabis react with stimulants?

Stimulants are substances that speed up the release of certain neurotransmitters such as dopamine serotonin, norepinephrine and others in our nervous system.

They are used to sharpen attention, they make people feel energised, confident and alert.

Common stimulants include caffeine, methamphetamine, nicotine, cocaine, ritalin, adderall and concerta.

According to Peterson, stimulants can exceed their normal effects when combined with THC due to cannabis’ effect on the endocannabinoid system. This can lead to increased heart rate and perception, which combined with anxiety, for example, can only worsen the resulting mental state. Peterson also says it’s largely down to dosage. People with ADHD, for example, can combine cannabis with a drug like Aderal, but only with an optimized dose. Cannabis therefore increases the effect of stimulants.

According to a 2015 study, the wrong combination of cannabis and an ADHD drug (such as methylphenidate, which is the active ingredient in Ritalin) can result in a huge overload of stress, which is not good for the heart.

People with heart disease or a genetic predisposition to it should avoid the combination of cannabis and stimulants.

Using cannabis together with depressants

Depressants act on the GABA system, which is like a brake pedal for the brain. As GABA activity increases, the nervous system slows down. THC in large doses also acts as a depressant, but when combined with other depressants (benzodiazepines) there is a risk of sedation.

Known depressants are Valium, Xanax, Klonopin and Halcion.

CBD and depressants form another interaction. The level of depressants in the blood increases, precisely because of the active connection with CBD, which also prevents the body from breaking them down. Depressants then last longer and there is a risk of side effects (dizziness, confusion and lightheadedness), as described in a 2019 study.

The two substances are therefore not recommended to be consumed together, at least not in large quantities.

Can we use cannabis as a substitute for opiates?

Opiates act on those receptors in the body that are responsible for pain perception and can even push our pain threshold a little further with their effects.

Some of the best known opiates are heroin, Vicodin, Codeine, Morphine, Fentanyl, Oxycontin and Tramadol.

Recent research has shown that the use of opiates and cannabis is safe and we do not have to worry about the interaction of these two ingredients.  According to Peterson, the endocannabinoid system and the opiate perception system overlap each other, thus cannabis has the function of enhancing the effects of opiates. In practice, it seems that a smaller dose of pain medicine has a stronger effect. Thus, the use of cannabis can avert a possible opiate overdose or the development of opiate dependence.

Mixing opiates and marijuana can lead to increased sedation and drowsiness.

Mixing cannabis and hallucinogens

We know the least about mixing hallucinogens and marijuana. Hallucinogens affect and can alter our perceptions, affecting mood and thought processes in general.

Known hallucinogens include Psilocybin, LSD, Mescaline, ketamine, MDMA, Salvia and DMT.

In large doses, even THC is considered a hallucinogen, at least according to some people. According to Peterson, the endocannabinoid system and the Serotonin system (which is activated by psychedelics) are directly linked, so the specific dose of each substance will also play a role.

Many people have described a stronger psychoactive effect when combining these substances.

Recent research reports that taking both substances supports the overall trip and gives it a new touch of mystique.

The combination of cannabis and hallucinogens should not cause any life-threatening or problematic situations.

Using marijuana and prescription drugs – how does cannabis work with these substances?

In addition to these four groups, there are other substances and drugs that cannabis works with.

CBD, like grapefruit, inhibits the metabolic pathway used by some drugs. When this pathway is inhibited, the drugs take longer to metabolize or break down in the body, so drug levels can build up and circulate in the blood longer. This in turn increases the probability of side effects, so if you are considering taking CBD together with prescription medication, it is essential to consult your doctor first.

Recreational use of cannabis together with other substances is safe except for stimulants (in the case of heart disease). However, the use of stimulants by people with heart disease is dangerous even without cannabis. Want to know more about the effects of cannabis on your health ? Check out other Nukaseeds articles on cannabis treatments, recipes for making cannabis ointments, cannabis oils, etc.