People who regularly use cannabis may need two times the level of sedation required by nonusers when undergoing medical procedures, a small-scale study finds. Fentanyl, midazolam and propofol, three sedation drugs commonly used during endoscopic procedures, were compared in the research.
With “continued increase in legalization and use of cannabis, the field of anesthesia and sedation needs further studies with greater depth,” wrote the authors of the study, published Monday in The Journal of the American Osteopathic Association.
Marijuana has gained popularity around the globe in recent years due, in part, to changing laws. Between 2007 and 2015, use of marijuana increased 43% in the United States, where an estimated 13.5% of adults use cannabis, according to a United Nations report. Meanwhile, cannabis use around the world was estimated to include 183 million people, or nearly 4% of the adult population, in 2015.
How does increasing cannabis use affect medical care? Researchers at Community Hospital in Grand Junction, Colorado, explored one small area of medical care: sedation. They examined the medical records of 250 patients who received endoscopic procedures between January 1, 2016, and December 31, 2017 — years after the state legalized recreational marijuana in 2012.
Comparing cannabis users to nonusers, they found that patients who reported smoking or using edibles on a daily or weekly basis required 14% more fentanyl, 20% more midazolam and 220% more propofol to achieve optimum sedation for routine procedures, including colonoscopies. For example, it took 13.83 milligrams of propofol, on average, for 225 nonusers to float into unconsciousness, compared with 44.81 milligrams needed, on average, by 25 cannabis users.