How Does Medical Cannabis Affect Surgery?
It should come as no surprise, if you have upcoming surgery of any kind, you’ll be asked by your sedation dentist, anesthesiologist, or nurse anesthetist whether you use medical cannabis. When it comes to surgical intervention, it is key to divulge all foods, beverages, and medications you’ve ingested, and whether you’ve made use of pain patches. Typically, prior to surgery, you were asked about your alcohol consumption and smoking habits and any medications taken the day of surgery.
Gone are the days of skirting the “smoking” question. Your healthcare providers, charged with keeping you breathing during surgery and recovery, aren’t just asking about cigarette smoking, which we know substantially slows the healing process, but they're also asking about MMJ, in particular the more potent formulations: these weaken the sedative Propofol, the anesthetizing agent used for various procedures, including endoscopy, surgery, and mechanical ventilation. Marijuana apparently reduces the efficacy of painkillers needed during and after surgery.
According to Wall Street Journal writer Sumathi Reddy, “People who use cannabis may need more anesthesia during procedures, but many remain wary of mentioning their habit.” (Reddy, S. (2023, February 6). How Marijuana Use Can Affect Surgery. The Wall Street Journal. Retrieved August 29, 2023, from https://www.wsj.com). She continues, “It (cannabis) has a longer-lasting impact when it is ingested, in say an edible, and has to be processed by the liver….”
A warning: “Marijuana has a central nervous system (CNS) depressant effect. As a result, marijuana use in combination with anesthesia or other drugs used during or after surgery might cause an additive effect. Don't use marijuana two weeks before planned surgery.” (June 2023, Mayo Clinic Staff, Marijuana. Mayo Clinic. Retrieved August 29, 2023, from mayoclinic.org/drugs-supplements-marijuana/art-20364974).
Research has shown that, for a medical cannabis patient, surgeons have needed to add other sedatives and additional painkillers—even Fentanyl---to create the same levels of sedation during general surgery and pain management thereafter. This gives us all cause for pause. Cannabis users have historically self-reported higher post-op pain levels.
Your required surgical outcomes from beginning to end are meant to better the quality of your life, even if this means the temporary cessation of your regular MMJ routine. Your surgical team wants to ensure your oxygen levels and overall post-operative outcomes lead you safely out of the healthcare facility and on the path to recovering at home.
You are Your Best Healthcare Advocate
Medical cannabis patients do have options. Having your medical marijuana doctor consult with your surgeon about three weeks ahead of surgery is crucial. You might be told not to ingest any cannabis products, or you might be encouraged to abstain entirely. It’s best to err on the side of caution and give authorizations for your physicians to communicate with one another about this serious topic. Your marijuana doctor knows your unique MMJ needs, your surgeon will be best able to estimate the amount of time you will need sedation; Both are part of your healthcare team with you having the ultimate decision-making power.
While you await your surgery, utilizing your interim regimen, remind yourself often that the end goal is to have successful surgery and recovery. Lastly, be sure to convey to your doctors your intention to continue your pre-op MMJ routine and stay open-minded to hearing what they recommend for the most optimal post-op recovery.
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