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Combining Cannabis with Codeine can cause increased drowsiness, dizziness, confusion and impaired coordination. As Codeine is an opioid, it can cause you to breathe more slowly. Combining substances may make the side effects of Codeine unpredictable.
Cannabis can be used for pain, relaxation and other health related reasons. Codeine is a prescription opioid which may be recommended by healthcare professionals for certain types of pain or even some coughs. As they can both impact on the central nervous system it is important to consider the effects of taking them together.
Cannabis and Codeine has become a more relevant topic to discuss due to research being carried out into how people are using cannabis alongside prescription painkillers. Whilst some people may think combining cannabis and codeine will give them more relief, this can be dangerous. The effects of combining them are not well understood and can vary between individuals.
Understanding the potential risks of Cannabis and Codeine will allow patients to make an informed decision, know what signs to look out for and have a discussion with their healthcare professionals about safer treatment options.
What Is Codeine And How Does It Work?
Codeine is an opioid medication used to manage certain types of pain. It can also be found in some prescription cough medications. It acts on opioid receptors in the brain and nervous system.
Some of the codeine is metabolised into morphine by an enzyme called CYP2D6. However, how much is metabolised can vary between individuals due to genetic variations and other factors.
Common side effects include:
- Drowsiness, dizziness, feeling faint
- Nausea, vomiting and constipation
- Sweating, feeling sleepy
- Slowed or shallow breathing particularly if there is an overdose
Codeine can cause tolerances, physical dependance and addiction. Taking more than the prescribed dose or taking it without medical supervision may cause serious harm.
Understanding Cannabis and its effects
There are a variety of natural compounds found in cannabis. These compounds are known as cannabinoids. The two most commonly discussed cannabinoids are THC (Tetrahydrocannabinol) and CBD (Cannabidiol).
THC can cause many of the intoxicating effects associated with cannabis. It can cause changes in your perception, mood, coordination, memory and reaction times. Whilst CBD will not cause any intoxicating effects like THC, it can interact with some medications.
Cannabis can be used for a variety of things including pain relief, increased appetite and to help with symptoms like nausea. The effects of cannabis will depend on the strength of product, the type of cannabinoids present, how you consume it and your personal tolerance.
When looking at Cannabis and Codeine it is important to note that not all cannabis products are created equal. A high THC product, a high CBD product and a mixed product can have different effects on your body.
What Happens If You Take Cannabis With Codeine?
Taking Cannabis and Codeine together can cause additive effects on the brain and nervous system. Both are known to affect alertness and coordination, so taking them together can cause some side effects to be more pronounced.
Whilst there isn’t enough clinical evidence to know exactly what effect it would have, health care guidelines state that taking cannabis and codeine together can increase the risk of serious side effects.
Increased Drowsiness and Sedation
Both can cause some people to feel sleepy. Taking Cannabis and Codeine together may cause increased drowsiness. This can cause problems with concentration, quick reactions and carrying out everyday activities.
This can be problematic if you’re driving, working with machinery or doing any activity that needs your attention.
Respiratory Risks
One of the most dangerous issues related to taking codeine is its depressant effects on breathing. Some opioids can depress breathing in the body especially if taken in high doses or with other sedatives.
Although more research is needed to discover how Cannabis and Codeine will effect breathing together, due to the known dangers to breathing associated with codeine it is unsafe to mix them without supervision. Serious breathing issues caused by opioids can become life threatening.
Confusion & Poor Co-ordination
Cannabis can cause issues with memory, decision making and co-ordination. Codeine can cause dizziness and confusion. This can impair your judgement, balance and reaction to your environment.
This may be more of a risk for older people and those with pre-existing health issues.
What does the research say about taking Cannabis and Codeine?
A 2022 study published in the Journal of Cannabis Research looked at the association between cannabis and codeine use in Canada. 15,459 participants completed the survey (Canadian Tobacco, Alcohol and Drugs Survey) in 2017.
Findings showed that 14% of people who used cannabis also used codeine compared to just 8% of those who did not. Adjusted analysis showed that cannabis users had increased odds of also using codeine.
Those who used cannabis medicinally had almost 3 times the odds of using codeine compared to those using cannabis for non-medical reasons.
It is important to note that this was a cross-sectional study, so only looked at self-reported drug use at one point in time. This means we cannot prove causation between the two drugs and does not indicate any medical implications of taking both drugs together.
The researchers also stated that more research is needed looking at the long-term safety of taking cannabis and opioids together. This is why talking to healthcare professionals about taking Cannabis and Codeine can be useful as they will know your full medical and drug history.
Who Should Take Extra Care?
A 2022 study published in the Journal of Cannabis Research looked at the association between cannabis and codeine use in Canada. 15,459 participants completed the survey (Canadian Tobacco, Alcohol and Drugs Survey) in 2017.
Findings showed that 14% of people who used cannabis also used codeine compared to just 8% of those who did not. Adjusted analysis showed that cannabis users had increased odds of also using codeine.
Those who used cannabis medicinally had almost 3 times the odds of using codeine compared to those using cannabis for non-medical reasons.
It is important to note that this was a cross-sectional study, so only looked at self-reported drug use at one point in time. This means we cannot prove causation between the two drugs and does not indicate any medical implications of taking both drugs together.
The researchers also stated that more research is needed looking at the long-term safety of taking cannabis and opioids together. This is why talking to healthcare professionals about taking Cannabis and Codeine can be useful as they will know your full medical and drug history.
Who Should Take Extra Care?
There may be increased risk using codeine and cannabis depending on other medical conditions and medications.
Increased caution should be taken if you have:
- Breathing conditions or sleep apnoea
- Older adults who may be more sensitive to sedative medications.
- Those taking sleeping tablets, benzodiazepines, alcohol or other opioids.
- Those with a history of substance misuse or opioid use.
Using cannabis and codeine together can increase the concern if combined with alcohol or other sedatives. It is important to always let your doctor know what cannabis products, prescribed medication, OTC medication and supplements you are taking.
How to Reduce the Risks
The safest option would be to avoid mixing Cannabis and Codeine unless your healthcare professional has assessed the combination and discussed the risks with you. You shouldn’t assume that taking them separately will be safe.
Things to consider:
- Be honest with your healthcare professional about how often you’re using cannabis products, what kind and whether it contains THC or CBD.
- Only take your codeine as directed. Don’t take more than you should and don’t take medication prescribed to someone else.
- Don’t take anything else that could cause drowsiness. Unless your doctor has discussed the risks of taking alcohol, sleeping tablets or other opioids.
- Don’t drive whilst under the influence. Taking codeine may cause you to feel sleepy and less coordinated.
- Don’t stop or alter your treatment. Speak to the person who has prescribed your medicine.
If you have taken Cannabis with Codeine in the past avoid taking any further amounts and speak to a medical professional. If you are worried about a possible interaction don’t wait until your symptoms get worse.
Know the signs of an opioid emergency
An opioid overdose is a medical emergency. Signs of overdose may include very slow or absent breathing; being unable to wake them; floppy limbs; or blue, grey or very pale lips/skin.
If you think someone has had an overdose:
- Call an ambulance immediately.
- If you have access to any naloxone then give it to them. Naloxone can reverse an overdose of opioids including codeine.
- Follow the advice of the emergency operator and stay with them until they get there.
Don’t assume they are just asleep. Acting quickly can save their life.
Frequently Asked Questions
Is it safe to mix Cannabis and Codeine?
It is safest not to mix these without consulting a health care professional. This is because they can have an effect on alertness and codeine can cause slowed breathing. The full effects of mixing them are not known.
Can Cannabis and Codeine cause excessive sleepiness?
Yes, increased sleepiness and reduced coordination can occur. Which can make driving, operating machinery and other activities unsafe.
Does CBD interact with codeine?
CBD can affect some enzymes that process certain medications. However, the full effects of taking CBD and codeine together is not known. Check with your doctor or pharmacist before mixing them together.
Can cannabis be used instead of codeine?
Cannabis shouldn’t be used as a direct replacement for codeine that has been prescribed. Pain management will depend on the cause and severity of your condition, your medical history and how you react to the medication. Speak to your health care provider about any alternatives.
What should I tell my doctor?
What type of cannabis product you’re using, if you know what amount of THC and CBD it contains, how often you’re using it, what dose of codeine you’re using, any other medications or supplements you are taking and if you’ve had any side effects.
Conclusion
The interaction between Cannabis and Codeine should be considered carefully as they can impact on the central nervous system. Research has determined that there is an association between the two drugs however more clinical data is needed. It is important to avoid use of these substances together due to increased sedation, impaired coordination and risk of respiratory issues caused by codeine. Please always consult a qualified healthcare professional before mixing cannabis with prescribed medication.
Make Informed Decisions About Medical Cannabis and Medication Safety
Understanding the possible interaction between Cannabis and Codeine is an important step toward making safer decisions about your health. If you are considering medical cannabis for pain management or other health-related reasons, professional guidance can help you understand potential benefits, medication interactions, and safety concerns.
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