Disclosing marijuana use before surgery: What you need to know

There are few life events as anxiety-inducing as going into surgery. From the fear of anesthesia to time spent in recuperation, the thought of being put under can cause even the most mellow to seek a way to lessen the stress that surgery can bring.

Tell your anesthesiologist you smoke weed – it might have an effect on your surgery
Physicians refuse to perform surgery because patient had medical cannabis oil in handbag
Managing stress and readying for surgery can seem arduous. Luckily, research isn’t suggesting patients need to quit cannabis all-together, but it does recommend leaving some time between consumption and surgery for better health effects.

Here are three things to know before surgery when you’ve smoked or ingested cannabis:

(1) Pot users could need more sedatives than non-users. Kaiser Health News reported that a small study in Colorado found that marijuana users required more than three times the amount of sedation medicine, Propofol.

(2) Smoking cannabis seems to increase sputum, which may lead to an increase of mucus or fluid inside the mouth. More mucus than saliva, sputum can increase risks and complications during the procedure and after.

(3) While tempting, indulging in marijuana immediately before surgery can cause vasodilation, where blood pressure can fall, due to blood vessels relaxing.

You should tell your doctor about cannabis use — particularly before surgery. Getty Images
With all the variables of anesthesiology, having a candid conversation with your care team can ensure the best outcome. The American Society of Anesthesiologists (ASA) states that since marijuana has a sedative effect on the body, it’s always a wise idea to share with your care team if you’ve used edibles, smoked or ingested cannabis before surgery. Many providers ask patients to stop smoking marijuana 12-hours before and to refrain from ingesting edibles at least 4 hours before. New research is showing that cannabis use after surgery can help alleviate pain and bring better healing not only of the body but of the spirit as well.

“Using cannabis right before surgery may add strain to the heart, which can elevate the risk for heart attack or stroke. While we don’t know all the risk factors present with cannabis, we do know that great conversations can lead to better patient experiences.” – Michael Philbin, MD

Dr. Michael Philbin at Edina Plastic Surgery in Minnesota believes “Cannabis use is so common that many providers are no longer phased by its mention.” He supports dialog between doctor and patient that eliminates the stigma around discussing cannabis; to focus on the patient as a whole. Philbin also advocates strongly for open communication between patient and doctor explaining, “Having a conversation about the right waiting time for using marijuana before surgery (and after) can be determined during a pre-surgery check with your doctor.”

One bright spot is that many recent studies are finding cannabis is a great alternative to opioids for long-term pain or those in rehabilitation after surgery. A recent study published in the U.S. National Library of Medicine and National Institutes of Health found that cannabis offered patients a better experience over opioids.

Published in 2017, the analysis found that, “Respondents overwhelmingly reported that cannabis provided relief on par with their other medications, but without the unwanted side effects. Ninety-seven percent of the sample “strongly agreed/agreed” that they can decrease the amount of opiates they consume when they also use cannabis, and 81% “strongly agreed/agreed” that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids. ”

Another study found that harm-reduction was evident when marijuana was combined with opioids, lessening both doses of heavy narcotics, side effects, and the possibility for addition. Presented at the American Society for Pharmacology and Experimental Therapeutics annual meeting in 2019, Vanessa Minervini, Ph.D., found that not only did cannabis help enhance pain-relief aspects and that when combined, the participants had better healing.

When discussing cannabis with your doctor, keep in mind that many medical professionals are in-tune with the growing need for alternatives to pharmaceuticals. Having early and often discussions around how best to manage your care before surgery, and after can help you feel empowered and knowledgeable about your care.

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