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Do Marijuana Users Need More Drugs During Endoscopies and Colonoscopies?
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CANNABIS ENDOSCOPY COLONOSCOPY
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What's Your MAC Score? - Why Cannabis
Users Need Stronger Sedation Drugs for
Colonoscopies and Endoscopies
New study says marijuana users may need extra sedation during a colonoscopy or endoscopy
Posted by:
DanaSmith, today at 12:00am
Endoscopies are a type of nonsurgical medical procedure (https://cannabis.net/blog/medical/why-you-shouldnt-smoke-
cannabis-before-surgery) that involves inserting an endoscope into the throat and down into the esophagus.
The tool, known as an endoscope, is used to examine the digestive system with a camera that has been designed into it.
Gastroenterologists or other specialists will use this procedure to determine if there are any illnesses that affect the
stomach, esophagus, or the upper digestive system. In some cases, patients need to be sedated with anesthesia to
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perform an endoscopy especially if itâs a high-risk case, or if the patient is pregnant since inserting the scope may irritate
the upper area of the gastrointestinal tract (https://cannabis.net/blog/medical/top-5-cannabis-strains-for-gastrointestinal-
pain-and-discomfort). This can cause a gag reflex and major discomfort in some people.
Now, a new study has found that cannabis users may require more anesthesia than usual if they have to undergo an
endoscopy.
The study, which was presented during the Digestive Disease Week 2022 (https://ddw.org/2022/05/21/cannabis-users-
require-more-sedation-for-endoscopy/), involved researchers analyzing 419 adult patients who were about to undergo an
endoscopy in Canadian medical centers. The endoscopy was to be performed with conscious sedation wherein the patient
and relaxed though partially conscious. All patients were also asked to fill in two surveys, one before the endoscopy
regarding their cannabis consumption while the other was after, asking them questions about how aware and
comfortable they were during the procedure.
The researchers found that marijuana use was associated with the chances of requiring more anesthesia
(https://cannabis.net/blog/news/you-cant-knock-me-out-cannabis-users-need-twice-the-anesthesia-to-go-under-before-
surgery), such as over 5mg of midazolam, more diphenhydramine, or over 100mcg of fentanyl.
(https://cannabis.net/blog/news/fentanyl-maker-may-have-just-caused-marijuana-legalization-to-jump-forward)
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âPatients didnât have increased awareness or discomfort during procedures, but they did require more drugs,â explains
the studyâs lead author, Dr. Yasmin Nasser, during a press release by the American Gastroenterological Association.
Same Results As Older Studies
There have been several other studies proving that cannabis users require more anesthesia during surgical procedures,
which is a note of caution for consumers.
One report from 2019 (https://www.uspharmacist.com/article/certain-patients-need-more-sedation-during-endoscopic-
procedures/preview/uspeditorial?utm_source=TrendMD&utm_medium=cpc&utm_campaign=US_Pharmacist_TrendMD_0),
which was published in the Journal of the American Osteopathic Association (https://jom.osteopathic.org/), found that
cannabis users may need as much as twice more the normal dosage. The researchers from Colorado analyzed the medical
5. 6/16/22, 7:05 AM What's Your MAC Score? - Why Cannabis Users Need Stronger Sedation Drugs for Colonoscopies and Endoscopies
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records belonging to 250 patients who underwent endoscopic procedures after 2012, which is when recreational
marijuana was legalized in the state. They found that daily or weekly marijuana consumers needed 220% more propofol,
20% more midazolam, and 14% more fentanyl to get to the ideal sedative state for procedures including colonoscopies.
âSome of the sedative medications have dose-dependent side effects, meaning the higher the dose, the greater likelihood
for problems,â said head researcher Mark Twardowski, DO. âThat becomes particularly dangerous when suppressed
respiratory function is a known side effect,â he added. Twardowski also acknowledged that marijuana has interactions
with other drugs. âCannabis has some metabolic effects we donât understand and patients need to know that their
cannabis use might make other medications less effective. Weâre seeing some problematic trends anecdotally, and there is
virtually no formal data to provide a sense of scale or suggest any evidence-based protocols,â he says.
The researchers also suggest that patient forms asking about their cannabis use is critical for medical professionals to get
the information they need to identify the right patient care protocols. âDetermining cannabis use before procedural
sedation can be an important tool for planning patient care and assessing both medication needs and possible risks
related to increased dosage requirements during endoscopic procedures,â they wrote.
Another preliminary study from 2020 (https://www.webmd.com/mental-health/addiction/news/20201006/during-and-
after-surgery-pot-users-need-more-anesthesia-painkillers-study) revealed that cannabis users who needed to undergo
surgical repair for a broken leg needed almost 60% more opioid painkillers each day as they recovered in the hospital.
 âItâs similar to flying a plane. You have a takeoff section, and then you have your cruising section and then your landing.
These in anesthesia are induction, maintenance and emergence,â explains Dr. Ian Holmen, resident anesthesiologist at the
Colorado Anschutz Medical Campus and the studyâs lead author. âWe found that itâs not just in the induction phase of
anesthesia that you need more anesthesia, but even during that cruising phase you need more inhaled anesthetic.â
Holmen and his team analyzed the medical records of 118 surgery patients who went in for a broken shin bone. Thirty of
them admitted to cannabis use, though the frequency and quantity were unknown. Those patients reported more pain
after surgery, requiring more opioid painkillers.
They also found that cannabis users who already have existing lung or heart problems can face serious risks while in
operation based on the quantity of anesthesia that they need for surgery. âSevoflurane has a very clear dose-dependent
effect on blood pressure,â says Dr. David Dickerson, who sits as vice chairman of the American Society of Anesthesiologists
6. 6/16/22, 7:05 AM What's Your MAC Score? - Why Cannabis Users Need Stronger Sedation Drugs for Colonoscopies and Endoscopies
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(ASA). âThe more sevoflurane you receive in the OR, the more a patientâs blood pressure drops. If you have heart problems
or lung problems coming into the OR, it could be dangerous.â
Conclusion
It can be understandable that you feel worried or uncomfortable about sharing your marijuana consumption habits with
your health care provider. However, as more states legalize the plant, more doctors are becoming knowledgeable about
its use as well as benefits.
Disclosing your cannabis habit to your doctor is extremely important if you are taking prescription medications or may
have to undergo endoscopy or any other kind of surgery (https://cannabis.net/blog/medical/studies-show-that-cannabis-
use-reduces-mortality-rates-during-major-surgery-hospitalization). Even if your health questionnaire doesnât ask about it,
doing so can make a critical difference in the outcome of your surgery since more sedative use may lead to complications.
Last but not least, itâs in your best interest to share your medical history including cannabis consumption.
MARIJUANA USE AND ANESTHESIA, READ MORE..
(https://cannabis.net/blog/news/you-cant-knock-me-out-cannabis-users-
need-twice-the-anesthesia-to-go-under-before-surgery)
WHY CANNABIS USERS NEED MORE ANESTHESIA THAN OTHERS! (https://cannabis.net/blog/news/you-cant-knock-me-
out-cannabis-users-need-twice-the-anesthesia-to-go-under-before-surgery)
What did you think?
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44 US House Members Tell The DOJ To Shove It
Rep. Dana Rohrabacher leads a bipartisan group of 44 members of the house who are keeping the DOJâs hands off states that have legalized medical marijuana.