"Most probably, the number of patients which require increased dosages of anesthetics because of recreational and/or medical use of cannabis will increase due to the legalization of medical or recreational marijuana", said Hauser who was not a part of the study.
People who use cannabis on a regular basis could require up to two times the usual level of sedation when undergoing medical procedures, a small-scale study suggests. Researchers looked at the medical records of 250 patients in the state who underwent endoscopies between January 1, 2016, and December 31, 2017 - years after the state legalized recreational marijuana in 2012. Scientists Believe It's Important To Keep Studying Cannabis Twardowski expresses concern over the unforeseen issues of cannabis use, especially in the wake of its widespread legalization and the lack of research on the drug. Compared to other patients, cannabis users needed more than twice as much of the anesthetic propofol, the study found. Cannabis users also needed 14 percent more of the analgesic fentanyl and 20 percent more of the sedative midazolam. The researchers say this finding is significant because higher doses often means a higher likelihood of negative - and potentially risky - side effects.
The study, by researchers at Community Hospital in Grand Junction, Colorado, compared three sedatives used routinely in endoscopic procedures, fentanyl, midazolam, and propofol.
The study authors note that some sedatives have side effects and the higher the dose, the greater likelihood for problems. "That becomes particularly unsafe when suppressed respiratory function is a known side effect", said lead researcher Mark Twardowski, an osteopathic internal medicine physician in Grand Junction, Colo., in a statement.
But researchers are now racing to understand exactly what those risks are as the drug becomes ubiquitous, with legal medical marijuana in more than half the US. This study, while a small "first step", is just one more reason that the federal law needs to be changed to allow for more thorough studies into the medical uses of cannabis and the effects of health care procedures and pharmaceuticals on cannabis users. The researchers think it might have something to do with how the main psychoactive chemical compound in marijuana, called tetrahydrocannabiol (THC), interacts with the body's endocannabinoid and opioid systems.
The records were collected from patients with the same endoscopist, at the same clinic in Colorado to minimize variables.
While research lags, consumption of the drug is booming.
"We were surprised by the extent and consistency of the effect that cannabis use had on the increasing doses needed to achieve adequate sedation for the procedures. We're seeing some problematic trends anecdotally, and there is virtually no formal data to provide a sense of scale or suggest any evidence-based protocols", says Dr. Twardowski. Also, it relied on patients being honest about their cannabis use: as a stigma is attached to the drug, individuals may have undereported. Meanwhile, cannabis use around the world was estimated to include 183 million people, or almost 4% of the adult population, in 2015.