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Cannabis is a complex plant that, due to decades of prohibition, we still don’t completely understand. What we do know, however, is that cannabis’ unique chemical compounds can interact with other substances (both recreational and medical), and interrupt the way our bodies process different compounds.

If you’re thinking about mixing cannabis with other recreational substances or prescription medication, keep reading for a detailed overview of how cannabis interacts with other drugs.

Understanding Drug Interactions

A drug interaction is an interaction between a drug (prescription medicine or a recreational substance—legal or illicit) and any other drug, food, or drink. These interactions can alter the way one or more of the drugs taken together work, affecting their efficacy in turn.

When you take two or more substances together, a few different outcomes can occur:

  • Additive effect: This means each substance produces the effect it is intended to produce independently. Thus, when combined, the effects of both substances are “added” to each other, rather than synergising.
  • Synergistic effect: This is when substances combine to produce a greater effect than they would when taken separately.
  • Antagonistic effect: This means one or more of the substances taken together become less effective than if they were taken on their own.

Drug interactions occur via numerous mechanisms, including:

  • Increasing or decreasing drug absorption in the digestive tract
  • Altering drug metabolism in the liver
  • Increasing or decreasing the rate at which the body excretes drugs via the kidneys
  • By triggering competing actions in the body

A few factors can affect how at-risk you are of experiencing a drug interaction:

  • Being dehydrated
  • Being very young or very old
  • Being over- or underweight
  • Having an underlying medical condition
  • Taking multiple medications at a time
  • Having poor nutrition

How Cannabis Is Broken Down by the Body

Cannabis contains over 100 different cannabinoid compounds, but the ones we know the most about are THC and CBD. Research shows that both compounds are metabolised by cytochrome p450, a group of enzymes responsible for metabolising a large number of compounds, particularly those found in prescription medications.

When THC and CBD are present in our bodies, they compete for oxidation by cytochrome p450, which often slows down the metabolism of other compounds found in recreational drugs (like LSD, amphetamines, and alcohol, among others) and prescription medications. Make sure to keep that in mind whenever you’re thinking of combining cannabis with other substances.

What Makes Cannabis Unique to Other Drugs?

Cannabis is unique to many other drugs (both recreational substances and prescription medications) in numerous ways:

  • Chemical composition: Cannabis doesn’t contain just one single active ingredient. While THC is by far the most recognised component in cannabis, the plant contains over 400 different compounds of note, including other cannabinoids, terpenes, and more.
  • Variety: Cannabis strains vary dramatically. Even strains of the same name can have very different chemical profiles and potencies, and therefore produce very different effects.
  • Personal experience: Cannabis affects different people in different ways, and some people may be more tolerant of its effects than others.
  • Effects: Cannabis doesn’t fit neatly into the categories we use to classify other substances. While it can definitely be a “downer” (or depressant), it can also produce uplifting effects similar to those produced by stimulants or “uppers”. At the same time, cannabis can produce some of the effects typically associated with hallucinogens (such as a warped perception of time).

Understanding the unique nature of cannabis and, more importantly, the way it affects us personally, can be very useful in helping us decide when, where, and how to use the herb. If you find cannabis often has a relaxing, sedative-like effect on you, make sure to keep that in mind when mixing it with other substances that have the same or opposite effect.

How Does Cannabis Interact With Other Recreational Drugs?

Cannabis is one of the most commonly used recreational drugs on the planet, even in areas where it remains criminalised. Here’s how it reacts with other recreational drugs.

  • Alcohol

Alcohol is arguably the most popular recreational drug on the planet. And, while you can legally buy almost unlimited amounts of alcohol almost anywhere in the world, it’s far from safe, especially when you compare it to other substances.

There’s limited scientific research on the effects of mixing alcohol and cannabis. One study suggests that drinking alcohol prior to consuming cannabis can increase absorption of THC in the body. Elevated levels of THC in the body will not lead to fatality, but it can cause sweating, dizziness, nausea, and vomiting.

  • Amphetamines

Cannabis is often used in conjunction with amphetamines and derivatives like MDMA. Anecdotal evidence suggests cannabis may attenuate some of the negative symptoms of the amphetamine comedown.

Few scientific studies have actually looked at the interaction between cannabis and amphetamines. However, animal studies suggest that the endocannabinoid system may play a role in addiction, and therefore affect the addictive properties of amphetamines. However, it’s also important to remember that amphetamines are stimulant drugs, and cannabis can produce depressant, stimulant, and even hallucinogenic effects, complicating the interaction between the two drugs.

How Does Cannabis Interact With Other Recreational Drugs?

  • Cocaine

Cocaine is a potent stimulant, and the way it interacts with cannabis can be difficult to pin down. When it acts as a depressant, cannabis might offset the cocaine high, and possibly offset some of the cravings and negative side effects of a cocaine comedown. However, mixing the stimulative effects of cocaine with the depressant effects of cannabis may exacerbate some of the negative side effects of either drug.

Cannabis can also block cocaine-induced blood vessel constriction, which increases absorption of cocaine in the body, resulting in a faster onset, longer-lasting cocaine rush, and an increased risk of side effects and overdose. When it acts as a stimulant, cannabis might exacerbate some of the effects of cocaine. Because both drugs are capable of inducing anxiety and paranoia on their own, combining the two can increase the possibility of those effects taking hold.

  • Codeine

Codeine is an opioid drug that depresses the central nervous system. When combined with cannabis, the two substances can produce a very sedative and euphoric buzz. And while cannabis isn’t technically classified as a depressant, it can act like one, and therefore have a synergistic effect on codeine and other depressants. Studies have also shown that using codeine with cannabis can cause anxiety and depression.