Now that medical marijuana is legal in the state of Oklahoma, some may be interested in how medical marijuana treatments, or its long-legal derivative CBD, can benefit them. However, there may be concerns about how either of these legal substances could potentially interact with current prescriptions. To help answer some of these questions, local pharmacist Paul Reed, D. Ph., provided some information.
“To start with, this is all theoretical, especially the information we have about marijuana,” Reed said. He went on to list some of the barriers into research on results and side effects.
“Because it’s a schedule one illegal substance by federal statutes people can’t do the testing because they can’t get the government funding or the product,” Reed said before listing what is definitively known.
“Parts of marijuana, in particular, and CBD both activate enzymes in the liver that work to metabolize other drugs,” Reed said. “So those other drug values can either be increased or decreased in a similar way to other things on the market.”
He said that one of the easiest caution flags for potential interaction would be any heart medication that says not to take with grapefruit. He went on to compare THC usage with these sorts of medications to eating grapefruit because both act on the same particular enzyme.
“Does it mean that a patient who is on those heart medications can’t ever have grapefruit in their lives? No, but what it does mean is don’t go out tomorrow and start eating three grapefruit a day every day because that will cause problems. But occasional is not an issue.”
He went on to say that for patients using CBD this should not be much of an issue, or if there were to be any issue a minor adjustment could easily be made. Occasional marijuana usage also should not be an issue, but daily usage used for anxiety, PTSD or seizures should definitely be monitored.
He said one of the biggest issues with medical marijuana is the size and frequency of the dosage. It can particularly be an issue when it comes to edibles.
“The action is delayed, often up to three or four hours,” Reed said. “So it’s very possible for someone to take a dose and think it isn’t working so they need more. Pretty soon you’re overdosed. Literally.”
Reed said there are two things that can happen when a patient overdoses on marijuana. The first is the patient falls asleep. The second can be serious paranoia.
“Their anxiety levels go through the roof instead of being calmed and suppressed,” Reed said, but pointed out that this only happens at higher doses. To avoid either overdose scenario, Reed offered the following advice.
“If you’re going to do edibles, know your dosage and stick to it,” Reed said. “Then give it 12 to 24 hours to see what happens. Ease into this and find out the dose that works.”
Topical treatments, however, do not run the risk of overdose and drug interactions are also minimized.
“Topically, most people are only going to treat a certain muscle area, joint or something of that sort,” Reed said. “It’s hard enough to get things through the skin to get the active effect, and for that to then have enough in the body to circulate, pass through the liver, and then still be there — it’s probably not an issue.” This applies with both THC and CBD products.
In the end Reed said the most important thing to remember is to be cautious.
“There’s not a lot of hard data — so be more observant. That’s the biggest thing, just to watch more,” Reed said.