CBD, Surgery, and Medication: Important Things to Keep in Mind [2022 Update]

Loving your cannabidiol (CBD) especially for its anxiolytic and anti-inflammatory properties? Great. Can you safely take it before surgery to help you through the ordeal? Well, as usual, the answer is not straightforward, and those in the know don’t seem to agree 100 percent, either. But that’s not a problem.

With CBD, hospital stays can definitely be more positive, but you need to see the whole picture before making a choice. Surgery involves a lot more than meets the eye, obviously. So, you and your doctor will need to work together closely if you want to include CBD in your arsenal against anxiety, pain, and inflammation. (Click to Tweet)

Table of Contents:

1. CBD and Surgery: The Most Important Factor
2. CBD, Surgery, and Concomitant Medications
3. CBD, Surgery, and Anesthesia Interactions
4. CBD and Surgery: How Soon Do I Stop Taking CBD?
5. In a Nutshell

1. CBD and Surgery: The Most Important Factor

Let's lead with one important piece of advice, though: always disclose your CBD and/or cannabis use (including weed) to the surgeon and anesthesiologist or any medical staff responsible for your hospital intake.

Also, ask the presiding surgical doctor if you should be ingesting any cannabinoid at all, and take that advice seriously. Read on for the basic guidelines, but sticking to what the doctor says will be the best course of action.

RELATED: Why CBD Is Inflammation’s Worst Enemy

2. CBD, Surgery, and Concomitant Medications

Are there any guidelines as to who should really avoid taking CBD before surgery, though? Yup, and they’re pretty simple—if you are on any anticoagulant, you should completely avoid taking CBD or any cannabis-related product long before getting operated on. (Click to tweet)

Check this out:

Here’s why, according to Jason Brett, writing for CBD Oil Review: 

"Broad spectrum CBD, or full spectrum CBD oil in particular, may be a useful tool in preventing thrombosis, or the formation of blood clots. A study on the anticoagulant effects of cannabis found the cannabinoids tetrahydrocannabinol (THC) and cannabinol (CBN) to be effective anti-thrombotics, doubling the amount of time it took for blood clots to form in obese and lean rat test subjects compared to the control group." [1]

RELATED: A Holistic Approach to Pain Management

In simpler terms—research shows that CBD is a mild blood thinner. It could potentially exacerbate bleeding after surgery and slow down wound healing, especially if you suffer from any clotting disorder.

Cannabidiol furthermore gets metabolized via the same liver pathways as most prescription anti-coagulants. This effect is dose dependent, but it can affect the potency of the drug. (Research has shown that CBD increases serum warfarin, which could prove fatal.) [2]

Therefore, if you’re taking prescription blood thinners, always consult with your doctor before starting on any CBD regimen. They should insist on regular blood checks, as CBD and cannabis can decrease the degradation of especially warfarin in your body, and doses should be adjusted accordingly. If not, it could cause serious complications that would put your health—even your life—at risk.

RELATED: CBD Interactions with Prescription Drugs

Here’s something to remember:

If you are taking CBD together with any chronic medicine (especially those with a risk of drug-drug interaction), the rule of thumb should be to consult with your doctor for guidance days before uptake for surgery or any other hospital procedure.

3. CBD, Surgery, and Anesthesia Interactions

Anesthesia is no joke. Your body literally gets paralyzed by powerful drugs (ergo, the need for ventilators, because you cannot breathe by yourself while “under!”) before the surgeon takes to it with their blade. You don't want to mess with this procedure.

This is important:

For this reason, patients are always advised to disclose any chronic supplements and medication they take well before surgery, including cannabis and related products.

From CBDclinicals.com, written by Clarence Swader, as discussed in a pamphlet from the Royal Victoria Regional Health Centre of Canada:

“Anesthetic risk has many variables and is often related to one’s unique medical issues and specific surgery. Individuals who use cannabis do so in many ways, forms and amounts. Therefore, CBD’s effect on the body is difficult to predict when combined with a wide variety of anesthetic agents and techniques. 

Currently, there is not enough evidence to say that cannabis alone will increase one’s anesthetic risk when stopped at an appropriate time.” [3]

RELATED: How Useful Is CBD Oil for Pain Management?

4. CBD and Surgery: How Soon Do I Stop Taking CBD?

If you’re not taking chronic medication, it gets somewhat easier.

At the Royal Victoria, patients are advised to stick to the following times for stopping any cannabis product:

CBD Oil (Tinctures, Capsules, and Edibles): 

• Oral Dosing/Ingested: stop four (4) hours before surgery.

Cannabis/Marijuana: 

• Smoked/Vaporized: stop 12 hours before surgery.
• Ingested (edibles, etc.): stop 12 hours before surgery.

Another doctor responder for the HelloMD forum sends this notice to her patients:

“If you ever do end up with surgery, you must discontinue your CBDs and your vitamin D3 approximately 48 hours before surgery. Both CBD and vitamin D thin the blood so typically surgeons would like to have you off anything that thins your blood for 48 hours before surgery. You may start in both medications again after surgery, typically when you’re released from the hospital.” [4]

Here’s more:

Yet another doctor, the Chief Medical Officer of HelloMD, says this on the same forum:

“There should be no issue with you taking CBD the day before surgery, unless you are on blood thinners. CBD could perhaps prolong your bleeding time. As an anti-inflammatory it may even help with your wound healing. Depending on the time of your surgery, I would make sure that if you are taking a capsule that you observe the instructions by whoever calls you from the hospital regarding what time to stop eating and drinking fluids. You should not take the CBD after that time either. For post operative pain, you might want to consider using a 1:1 CBD:THC ratio tincture instead of an opioid, if one is prescribed by your surgeon. I would also let them know that you are taking it as well.” [4]

5. In a Nutshell

Get the idea? Cannabis, CBD, hospitals, and surgery are not simple and easy companions—and research is lacking, so there are no formal guidelines.

Here’s the takeaway:

The safest route would always be to consult with your physician and disclose what you ingested well before surgery.

Sources:

1. https://www.cbdoilreview.org/diseases-conditions/cbd-oil-blood-thinners-interaction/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789126/
3. https://cbdclinicals.com/cbd-oil-before-surgery/
4. https://www.hellomd.com/questions-and-answers/is-it-safe-to-take-cbd-the-day-before-surgery-where-i-will-be-receiving-anesthesia