Absolutely. Inhaled CBD gets into the blood the fastest, reaching high concentration within 30 minutes and increasing the risk of acute side effects. Edibles require longer time to absorb and are less likely to produce a high concentration peak, although they may eventually reach high enough levels to cause an issue or interact with other medications. Topical formulations, such as creams and lotions, may not absorb and get into the blood in sufficient amount to interact with other medications, although there is very little information on how much of CBD gets into the blood eventually. All of this is further complicated by the fact that none of these products are regulated or checked for purity, concentration, or safety.
The researchers further warned that while the list may be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products may deliver highly variable cannabinoid concentrations (unlike the FDA-regulated prescription cannabinoid medications previously mentioned), and may contain many other compounds that can increase the risk of unintended drug interactions.
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.
Does the form of CBD matter?
Many drugs are broken down by enzymes in the liver, and CBD may compete for or interfere with these enzymes, leading to too much or not enough of the drug in the body, called altered concentration. The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.
While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC or prescription medications and substances that cause sleepiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol may lead to increased sleepiness, fatigue, and possibly accidental falls and accidents when driving. Increased sedation and tiredness may also happen when using certain herbal supplements, such as kava, melatonin, and St. John’s wort. Taking CBD with stimulants (such as Adderall) may lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn drugs (such as Prilosec) may increase the risk of diarrhea.
People considering or taking CBD products should always mention their use to their doctor, particularly if they are taking other medications or have underlying medical conditions, such as liver disease, kidney disease, epilepsy, heart issues, a weakened immune system, or are on medications that can weaken the immune system (such as cancer medications). A pharmacist is a great resource to help you learn about a potential interaction with a supplement, an herbal product (many of which have their own drug interactions), or an over-the-counter or prescription medication. Don’t assume that just because something is natural, it is safe and trying it won’t hurt. It very well might.
Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included
These types of studies enroll human participants and randomly divide them into two groups: The control group receives a placebo while the experimental group receives the medication being tested, but participants do not know which group they are in. This helps researchers establish the effectiveness of tested medications as they track each group.
A 2020 study published in the Journal of Substance Abuse Treatment found that 62% of people detoxing from opioids such as OxyContin experienced relief from withdrawal symptoms like insomnia, anxiety, and tremors when using cannabis.
“Although further research is needed, in select populations that include addictions to alcohol, opioids or other substances, medical cannabis may dampen the behaviors that contribute to relapse,” physician and Cannalogue CEO Mohan Cooray, MD, FRCPC, tells WebMD Connect to Care.
CBD Oil and OxyContin Detox
Researchers have discovered many benefits of cannabis and CBD oil. CBD and medical cannabis products have been used to help with pain, anxiety, and sleep problems, among other ailments. But can cannabis products help you successfully detox from OxyContin? While there are some promising studies, more research is needed in order to quantify the efficacy of cannabis as an opioid withdrawal aid. We asked medical experts to weigh in.
“Both cannabis and CBD are commonly used to treat these symptoms and can be very beneficial to patients while detoxing to make it easier for them to complete the detox,” anesthesiologist and pain medicine physician Anand Dugar, MD, tells WebMD Connect to Care. “In addition, New Mexico, New Jersey, New York and Pennsylvania specifically allow patients with an opiate disorder to become medical cannabis patients because of the benefit of medical cannabis in helping these patients wean off opiates.”
It’s also important to know that cannabis use can come with its own risks. Mayo Clinic notes that some potential problems that can occur with cannabis use include:
Drug cravings are a major hurdle for people detoxing from OxyContin and other opioids, according to the U.S. Department of Health and Human Services. According to a 2019 study published in the American Journal of Psychiatry, CBD oil significantly reduced cravings and anxiety in patients detoxing from opioid drugs. Reduced cravings can not only make the detox experience more tolerable but can also decrease the chance of relapse.