Doctors Get New Clinical Guidelines for Managing Chronic Pain With Cannabis, Courtesy of Canadian Researchers
by Bethan Rose
We all know that cannabis and prednisone can affect our bodies differently when used separately. But if you’re dealing with a pretty nasty bout of an inflammatory reaction, perhaps you are curious about what happens when you combine them.
Is it safe and particularly beneficial to do so? Or will it enhance the frustrating side effects commonly associated with prednisone use? We did some digging to find out the potential risks and benefits of combining cannabis and prednisone. Here’s what we found out.
Prednisone is a medication that belongs to a class of drugs known as corticosteroids, commonly used to treat inflammation. It can treat a wide range of conditions, including allergies, cancers, asthma, arthritis, skin conditions, and other autoimmune diseases like Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. Common side effects include:
Prednisone works best with short-term use. It can cause serious side effects such as osteoporosis (bone loss leading to weakness and increased fracture risk), skin fragility, glaucoma, or cataracts with long-term use. For most people, however, the health benefits of short-term prednisone use outweigh the potential risks.
Prednisone works by suppressing the immune system response, which helps to reduce inflammation. It does this by binding to specialized receptors on cells, which prevents the release of inflammatory substances. This action can help to relieve symptoms such as swelling, pain, and redness. In addition, prednisone decreases the immune system’s response to prevent organ transplant rejections.
Since corticosteroids’ primary mechanism involves suppressing the immune system, infections are more likely to develop in patients who take them. Prednisone users should avoid being around sick people, crowded places, and sharing food and drinks if they have been taking it for a long time. Furthermore, patients taking certain potentially dangerous medicines, like Coumadin (warfarin) or Lasix (furosemide), should discuss with their healthcare providers whether they can take these drugs along with prednisone.
You should also speak to your doctor if you are pregnant, thinking of becoming pregnant, or breastfeeding, as research shows using prednisone while pregnant has been linked to birth defects and low birth weight. Also, be sure to follow your doctor’s instructions exactly when taking prednisone and tapering off high dosages. Sudden discontinuation of corticosteroids can result in adrenal failure or even death.
Although the latest research shows that cannabis and prednisone can be used simultaneously with minimal risk for interaction, there are still some possible risks associated with combining them. This is because cannabis and corticosteroids influence the same physiological region of the brain, which increases the likelihood of enhanced adverse effects. For example, cannabidiol (CBD) has properties that interact with corticosteroids.
As part of the process of drug metabolism, the body uses the cytochrome P450 enzyme CYP3A, which allows our bodies to make use of the medications we take. The enzyme appears along the critical pathways of the body’s gastrointestinal tract, primarily in the liver. There, the active ingredients of drugs change into simpler forms our cells can use. Moreover, since CBD breaks down in the liver, it might affect how other substances break down there as well.
So, while corticosteroids suppress CYP3A, CBD also suppresses CYP3A. In turn, this may exacerbate the systemic side effects of corticosteroids.
It should also be noted that patients should choose safe consumption methods throughout their treatment process since smoking cannabis may contribute to decreased bone density (especially if you’re on steroids), increasing the likelihood of fractures and osteoporosis. The best option for these patients is to consume cannabis edibles or vaporize flower instead of smoking.
Check out this article for more information on alternatives to smoking cannabis: How to Get High Without Smoking: 8 Ways to Consume Cannabis
In recent years, more and more research has been conducted on cannabis’ anti-inflammatory effects. Cannabinoids like cannabigerol (CBG), CBD, and tetrahydrocannabinolic acid (THCA) naturally possess anti-inflammatory properties. However, could you use one or more of these as an alternative to prednisone?
Simply put, no. Prednisone, for example, is a potent and effective corticosteroid widely used with extensive scientific and clinical understanding. Nevertheless, while there is evidence of the anti-inflammatory properties of cannabinoids, research exists mainly in cultured cells (test tubes) or mice due to the decades-long prohibition of marijuana.
For years, prohibition prevented the study of the anti-inflammatory properties of cannabis alone, which raises the question of whether humans would benefit from it exclusively. Using cannabis to treat inflammation is likely to yield the best outcome when used along with conventional treatment, not in place of it.
Although more research may help us understand the full extent of how these two substances work together, it seems that cannabis and prednisone are powerful allies against inflammation. While it is promising that the two work well together with minimal risk for interaction, always consult your doctor or pharmacist before starting or stopping any medications. The last thing you want is to experience any unpleasant side effects and dangers associated with abruptly stopping corticosteroid therapy.
Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.
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Bill C says:
February 1, 2023 at 3:25 pm
Big pharmaceutical companies may steer people towards Prednisone, but I’m fine with CBD twice a day and sometimes RSO in order to reduce inflammation. Plenty of over the counter products as well….you don’t need to risk taking Prednisone. Keep in mind, a lot of doctors are ignorant when it comes to THC and CBD so they prescribe what the AMA has backed all along and that’s not always the wisest decision. Case in point: a lot of us baby boomers remember when dentists were told by the ADA that mercury was great for fillings and that sure turned out to be hogwash.