People Who Smoke Cannabis May Need More Anesthesia

cannabis and anesthesia

No one likes the thought of surgery. It’s something to hope to avoid for as long as possible yet becomes more inevitable as we age. Big or small, most surgeries require anesthesia. With the number of cannabis users on the rise, medical professionals and researchers are now realizing that regular consumers may need more anesthesia than those who don’t participate (source 1). Keep reading to learn more about the relationship between cannabis and anesthesia.

Based On A Study In Colorado

While it’s unclear who performed the very first study, the results of a Colorado study, which was led by Dr. Mark Twardowski, suggests cannabis users require larger doses of anesthesia. According to an article by Reuters Health on this body of research: “cannabis users needed more than twice as much of the anesthetic propofol,” as well as “14 percent more of the analgesic fentanyl and 20 percent more of the sedative midazolam” (source 2).

The Four Types Of Anesthesia

According to UCLA Health are four types of anesthesia.

  • General anesthesia is what people most often think of when they think of surgery. During general anesthesia, you are unconscious and have no awareness or sensations. Many different medications may be used to achieve this.
  • Regional anesthesia makes an area of the body numb to prevent the patient from feeling pain. It can completely block all sensation to the area of the body that requires surgery. This type is often used at the dentist.
  • Monitored anesthesia care refers to being kept under mild sedation. Medications are given, usually through an IV, to make the patient feel drowsy and relaxed.
  • Local anesthesia uses a needle to inject medications (most often lidocaine) into a smaller area, such as the thumb. Numbing cream may also be applied (source 3).

How To Calculate Anesthesia Dosage

Thankfully, as the patient, it’s never your job to determine how much anesthesia you need. “Hello, doctor, I would like 10mg of anesthesia, please!” Could you imagine a nightmare like that? Surgeons and doctors are professionally trained to calculate how much anesthesia patients need based on a variety of factors. Age comes into play, as well as weight and the duration of the surgery itself.

“One unit of time is recorded for each 15-minute increment of anesthesia time,” according to Medical Business Management. “For example, for a 63-minute procedure, one would receive 4.2-time units (four-time units x 15 minutes plus 1/5th of a time unit, or 0.2)” (source 4).

What To Tell Your Doctor

Based on Dr. Twardowski’s findings, which we referred to above, it now becomes crucial (and potentially life-saving) to tell your doctor that you regularly consume cannabis. If you smoked one blunt five years ago, you probably don’t need to mention it. However, it never hurts to be as honest as possible with your doctor, especially before surgery. It’s every person’s nightmare to wake up during surgery and flop around on the table. 

Yes, even surgeons acknowledge this fear. They can tell when a patient needs more anesthesia based on their body twitches or if they become agitated. The correct dosage of anesthesia will knock you right out without you realizing it.

The Problem With Cannabis And Anesthesia

Unfortunately, increasing a patient’s anesthesia could invite some medical setbacks and complications. Again, according to Dr. Twardowski in a separate interview with NBC News, there is “the danger of shutting off a patient’s respiration while still not achieving pain control” (source 5).

We Should Have Expected This…

After news outlets published Twardowski’s Colorado study, other medical professionals chimed in on the matter. And nobody is surprised by the results. In the same NBC News interview, Dr. Ajay Wasan, a professor of anesthesia and psychiatry at the University of Pittsburgh School of Medicine, said: “Any kind of brain-altering substance can have an effect on another brain-altering drug.” Might this suggest that frequent beer drinks require less/more anesthesia? What about coffee and caffeine? Or energy drinks? Technically, these could all be considered brain-altering substances.

We hope we didn’t startle you with this study. Surgery is already shrouded with feelings of uncertainties and fears as it is, and now we have yet another thing to overthink about. The good news is that doctors are aware of the connection between cannabis and anesthesia, and they know how to respond once you’re on the surgery table. The key takeaway here is to always be honest with your doctor about cannabis use.

External References

  1. Harvard Health Publishing. (2020). “Coming clean: Your anesthesiologist needs to know about marijuana use before surgery.” Retrieved from the Harvard Health Publishing website.
  2. Reuters. (2019). “Cannabis users may need more anesthesia for surgery.” Retrieved from the Reuters website.
  3. UCLA Health. (2024). Types of Anesthesia. Retrieved from the UCLA Health website.
  4. Medical Business Management. (2022). “Calculating Time Units for Anesthesia Billing and Coding.” Retrieved from the Medical Business Management website.
  5. NBC News. (2019). “Regular marijuana users may need more anesthesia for medical procedures.” Retrieved from the NBC News website.

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