Post Surgical Pain – is Cannabis Effective?

The questions are – will cannabis be enough pain control or would using cannabis at least reduce your narcotic demand. Both would be a victory for you due to the risk of addiction and side effects of narcotics. Will cannabis be enough pain control for major surgery? For major surgery you most likely will not be able to control your pain level with just cannabis – this is the place for a PCA (patient controlled analgesia) pump where you can titrate your pain with a pump and IV narcotics. HOWEVER, Cannabis has been shown to act synergistically with opiates to reduce pain, thus reducing opiate use.

Every thing we give patients has a risk benefit ration, while the risks of Cannabis are low, cannabis can cause tachycardia and lower blood pressure which may be contraindicated after surgeries where hemodynamic stability cannot be compromised. The moral of the story in to wait until your physician says you are stable and then cannabinoids may be appropriate. Consult your physician, but be an advocate for your right to use cannabinoids as medicine!

I recommend using tinctures or losenges, the time of onset is rapid within 15-25 minutes and you can easily titrate yourself to the right level of medication to comfort you by taking a few drops or a small piece of a lozenge and seeing how you are doing every 20 minutes before taking another small piece or few drops until you are comfortable.

The other concern in the post operative period is that Cannabis can inhibit the liver enzyme responsible for warfarin degradation this could lead to requiring less of a dosage of the warfarin, which will most likely not be a problem as you and your physician will be monitoring your INR and titrating your warfarin dose accordingly.

Enjoy your right as a person to reduce your narcotics usage with medical Cannabis!

Dr. D