Regular users of cannabis need a dosage greater than 220% for sedation during medical procedures

According to a study published in the Journal of the American Osteopathic Associationmore than the usual level of sedation in medical procedures is needed for regular cannabis users.

Colorado researchers reviewed the medical records of 250 patients who underwent endoscopic surgery after 2012, when the state had legalized cannabis for recreational purposes. They found that regular users of cannabis, patients who smoked or ingested cannabis daily or weekly, needed 14% more fentanyl, 20% more midazolam and 220% more propofol to get it. optimal sedation during medical procedures.

What do you know about sedation in medical procedures?

"Some sedative medications have dose-related side effects, which means that the higher the dose, the greater the risk of problems," says lead researcher Mark Twardowski, DO, a physician in osteopathy in internal medicine.

"It becomes especially dangerous when the suppression of the respiratory function is a known side effect."

The lack of research, due to the cannabis status of Schedule 1 cannabis, combined with its sudden generalized legalization, worries Dr. Twardowski about other unforeseen problems.

Regular cannabis users and uncertainty of consumption

In the United States, cannabis use increased by 43% between 2007 and 2015. According to this study, approximately 13.5% of the adult population reportedly used cannabis during this period, with the largest increase in cannabis use. 26 years old and over.

As more and more states legalize cannabis for medical and recreational purposes, the potential for useful data collection is also greater. Not only are there more regular users of cannabis and more patients who use cannabis, but more of them are now willing to admit that cannabis has been consumed, which increases chances that they will manifest themselves when they are interviewed by a health professional.

"Cannabis has metabolic effects that we do not understand, and patients should be aware that their use of cannabis could affect the effectiveness of other drugs. We observe some problematic trends anecdotally, and there is virtually no formal data to give a sense of scale or to suggest evidence-based protocols, "adds Twardowski.

The need for higher sedation in medical procedures

According to Twardowski, colleagues from nearby emergency departments have noticed that more and more patients are complaining of chronic nausea, a symptom that may result from regular cannabis use. He also stated that colleagues in anesthesiology had noted patients requiring much higher doses for general anesthesia and higher rates of postoperative convulsions.

In addition, according to the researchers, adding specific questions about cannabis use to patient intake forms is the first step in gaining useful information that affects patient care.

"This study really marks a small first step," says Dr. Twardowski. "We still do not understand the mechanism behind the need for higher doses, which is important for finding better care management solutions."