Marijuana could interfere with your heart or anxiety drugs. Check now, and be honest

When you list your medications at a check-up with your primary care provider, do you include the gummies or chocolate bar you picked up at the cannabis dispensary last weekend?

Most patients likely don’t think to include those types of items, but marijuana is a drug that can potentially interfere with other prescription medications — or have unexpected side effects for people with certain health conditions.

Doctors have found that both are particularly true for conditions related to anxiety or cardiovascular health, experts say, conditions that can more often affect seniors.

As cannabis has become legal in nearly two dozen states — as of 2016 in Massachusetts — its use has increased in all age groups. In 2022, the number of people aged 65 or older who reported using cannabis in the previous year climbed to 8.4 percent, according to the National Survey on Drug Use and Health from the U.S. Department of Health and Human Services. That number was reported as just 0.4 percent of seniors in 2007, according to an American Medical Association journal.

A growing number of people have investigated the therapeutic effects of cannabis for medical issues, but the possible impacts of recreational use — whether smoking it, or through gummies, oils, vapes or other products available in varying degrees of potency — doesn’t always come to mind. So, communication with all medical caregivers about marijuana use is important for any age, said Angela Medeiros, director of outpatient pharmacy services and practice manager for Cape Cod Hospital Pain Center.

Be Up Front About It

Patients shouldn’t wait to be asked.

“Anytime anyone’s going to start a new drug, whether it’s a medication that's prescribed by your doctor or marijuana, it's important to check with your primary care physician and your pharmacist and tell them everything that you're taking,” she said. “And be honest.”

People can be impacted by or be more susceptible to cannabis effects in different ways, based on a variety of issues, Medeiros noted. That includes their age, and whether they have underlying chronic diseases, preexisting mental health issues, or cognitive impairment. 

In addition, the therapeutic as well as unwanted effects seem to be inconsistent across individuals, she said. 

Doctors or pharmacists “can look into your profile and check to see whether it interacts with any of your medications,” she said, “or can look at any of the chronic diseases that somebody may have that marijuana may exacerbate or increase the impairment involved.”

Possible Drug Interactions

Among the classes of drugs that are thought to interact with marijuana, according to Medeiros, are central nervous system depressants.

“So, marijuana can enhance the effects of other depressants, like alcohol and benzodiazepines and opioids,” she said. “And that can increase the risk of some of the side effects that are associated with those drugs — side effects like sedation, and drowsiness, and possibly an impairment of coordination.”

Potential interaction with various mental health medications, antidepressants and antipsychotics, should also be noted, she said. Some drugs may be prescribed for more than one thing — seizures as well as anxiety, for example — so experts would better know if there’s potential for a negative interaction between a particular drug and marijuana. 

Anyone with a history of cardiovascular disease should be careful with marijuana use, Medeiros cautioned. A combination of that with high blood pressure medication or anti-coagulants could potentially affect a heart condition, so check on these, too.

Two preliminary studies presented in November at a science meeting of the American Heart Association indicated that regular marijuana use may raise the risk for heart failure, stroke or heart attack — even after accounting for other cardiovascular risk factors such as Type 2 diabetes, high blood pressure and obesity. Experts noted that smoking and inhaling cannabis have effects similar to those of inhaling a tobacco cigarette, so could be linked to serious heart conditions and should be closely monitored.

CBD is not psychoactive, but still has the potential to interact with medications, Medeiros said. Again, communication with your doctor and pharmacist on all the products is necessary.

How marijuana affects the heart and brain health is still not completely known, the American Heart Association noted in releasing the non-peer-reviewed November study results.

“There’s not enough high quality information out there,” Medeiros warned. “I think it's an area that's going to continue to be studied, and we'll get more information as time goes on.”