Marijuana use is at an all-time high as more and more people use it to cope with the new Covid-19 pandemic. A recent study published in the Journal of Addictive Diseases shows that medical cannabis use for mental health has increased this past year. But, a question that’s often posed is whether people who use weed without prescription should disclose cannabis use to their healthcare provider.
Imagine this scenario. You’re sitting in your doctor’s office, ready for an annual check-up, when you’re given a piece of paper where you should list your medical history. You get to the section about alcohol consumption, cigarette smoking, and illegal drug use. Do you mention cannabis use and does it become part of your medical record? Can your insurance company or the federal government find out about it?
These are probably the most common questions that come to mind as you are filling out the document. Read on to learn why it is, in fact, important for you to disclose your full medical history to your doctor.
Medical Marijuana Use
Given that marijuana legalization is on the rise around the world, especially for medical use, cannabis users think that it’s not worth mentioning it to their physicians.
CBD and hemp oil is used as treatment for both somatic and psychiatric disorders, without patients experiencing the intoxicating adverse effects of medical marijuana. (VanDolah et al, 2019, Larsen et al 2020)
But, even though the cannabinoids found in weed can be beneficial for certain conditions, smoking cannabis, like smoking tobacco, can be a risk factor for many cardiovascular diseases, affect lung function, and regular marijuana use is even known to affect blood pressure levels.
Moreover, you can experience negative side effects when mixing weed with other prescription medication. THC and CBD use, paired with the use of other medication, can even result in further health issues. (Brown et al, 2019, Atakan et al, 2012)
Can I Tell My Doctor I Smoke Weed?
If you’re worried about your medical history remaining private, don’t worry. Doctors are bound by doctor-patient confidentiality and the HIPAA act and they can’t reveal your marijuana use to law enforcement. The only times they can break doctor-patient confidentiality is when healthcare providers find themselves in emergency situations such as:
- Preventing a serious and imminent threat;
- Treating the patient;
- Ensuring public health and safety.
So, if you are above the age of 18, you’re an adult and the doctor is bound by law to keep your health information private. And this may even prove beneficial to you since your doctor would know which medication to prescribe for a certain condition, without you fearing if it will result in side effects as a result of cannabis use.
Your Anesthesiologist Needs to Know if You Smoke Pot
Talking to your doctor about your marijuana use is especially important if you have an upcoming surgery scheduled since the effects of cannabis can lead to serious complications if you’re going to be under the effect of anesthesia.
Weed and Anesthesia
If you’re a regular marijuana user, you’ll probably need a larger dose of anesthesia when going under the knife. A small study of Colorado patients compared the relative amounts of anesthesia needed for marijuana users and people who don’t use marijuana and the results were staggering.
If propofol was used as an anesthetic, marijuana users would need three times the amount of propofol, about 45 mg, compared to the amount of propofol needed for nonusers, which is less than 15 mg, in order to achieve adequate sedation for endoscopies. That’s a big increase of anesthesia that can result in delayed awakening after the surgery.
Weed and Postoperative Care
Smoking weed can also affect the lungs and increase phlegm and coughing, as well as the risk of respiratory infections post-op. These lung issues can result in sensitivity when the breathing tube is put in or taken out of the airway after the operation.
Moreover, patients using marijuana regularly might experience increased postoperative pain and require higher opioid use after surgery. Because marijuana users generally have a tolerance for pain medication, they’ll probably need a higher dose of opioids post-op.
This can result in patients using more opioids after surgery which can lead to opioid use disorder in the future. THC substitutes like Marinol pills are sometimes used instead of opioids in the hospital, since it’s an FDA approved medication, although the ingredient in Marinol, dronabinol, can also cause side effects.
The 411 on Disclosing Marijuana Use to Your Doctor
Medical professionals’ job is to provide patients with the best patient care possible, which is hard to do if you’re not completely honest with your healthcare provider about your medical history.
Your doctor needs to have all the information concerning your dietary habits, exercise routine, sleep schedule, symptoms, as well as alcohol, cigarette, and drug consumption, in order to give you the best treatment option.
Furthermore, if you’re having surgery, make sure you give your anesthesiologist the right amount of the marijuana you use, including how often you use it, so a proper anesthesia dose can be administered.
Larsen, C., & Shahinas, J. (2020). Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials. Journal of clinical medicine research, 12(3), 129–141. https://doi.org/10.14740/jocmr4090
Brown, J. D., & Winterstein, A. G. (2019). Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. Journal of clinical medicine, 8(7), 989. https://doi.org/10.3390/jcm8070989
Atakan Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241–254. https://doi.org/10.1177/2045125312457586