{"id":25778,"date":"2023-02-06T08:00:27","date_gmt":"2023-02-06T13:00:27","guid":{"rendered":"https:\/\/www.veriheal.com\/blog\/?p=25778"},"modified":"2026-03-27T08:30:22","modified_gmt":"2026-03-27T12:30:22","slug":"like-mixing-cannabis-with-other-substances-here-are-the-pitfalls-of-polysubstance-use","status":"publish","type":"post","link":"https:\/\/www.veriheal.com\/blog\/like-mixing-cannabis-with-other-substances-here-are-the-pitfalls-of-polysubstance-use\/","title":{"rendered":"Like Mixing Cannabis With Other Substances? Here Are the Pitfalls of Polysubstance Use"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Mixing cannabis with recreational drugs, medications, or alcohol can be a rollercoaster ride for your mind and body. While it may seem like an exciting idea to indulge in some extra fun, the pursuit of pleasure could come with undesired risks down the line.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">With a unique mix of <\/span><a href=\"https:\/\/www.nccih.nih.gov\/health\/cannabis-marijuana-and-cannabinoids-what-you-need-to-know\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">over 550 chemical compounds and 100 cannabinoids<\/span><\/a><span style=\"font-weight: 400;\">, cannabis is truly a medicinal powerhouse. Depending on what you&#8217;re mixing, the results could go from being relatively mild to downright dangerous.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In this article, we&#8217;ll explore the fascinating world of cannabis and its interactions with the four major drug classes:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK539896\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stimulants<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/nida.nih.gov\/sites\/default\/files\/drugfacts-cnsdepressants.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Depressants<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459161\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Opioids<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/nida.nih.gov\/publications\/drugfacts\/hallucinogens#:~:text=What%20are%20hallucinogens%3F,their%20own%20thoughts%20and%20feelings.&amp;text=and%20dissociative%20drugs%20(such%20as,real%20though%20they%20are%20not.\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Hallucinogens<\/span><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\nAnd, of course, no discussion would be complete without addressing something more unconventional\u2014exploring what happens when marijuana meets psychedelics like <\/span><a href=\"https:\/\/www.veriheal.com\/blog\/psilocybin-interaction-with-antidepressants-research\/\">psilocybin<\/a> <span style=\"font-weight: 400;\">or <\/span><a href=\"https:\/\/www.veriheal.com\/blog\/study-demonstrates-power-of-using-ketamine-for-parkinsons-disease\/\">ketamine<\/a><span style=\"font-weight: 400;\">. Here&#8217;s what science has to say about how cannabis interacts with other drugs.<\/span><\/p>\n<h2>A Brief Review of Combining Cannabis With Other Substances<\/h2>\n<p><span style=\"font-weight: 400;\">When it comes to cannabis, our <\/span><a href=\"https:\/\/www.veriheal.com\/blog\/cannabinoids-and-the-endocannabinoid-system-a-match-made-in-heaven\/\">endocannabinoid system (ECS)<\/a><span style=\"font-weight: 400;\"> ensures that we are uniquely responsive and open to the effects of this incredible plant\u2014so much so that its interactions with a vast range of substances can be far-reaching.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3736954\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">research published<\/span><\/a><span style=\"font-weight: 400;\"> in <\/span><span style=\"font-weight: 400;\">Therapeutic Advances In Psychopharmacolog<\/span><span style=\"font-weight: 400;\">y, cannabis presents a unique dilemma due to its rich chemical diversity. Unlike LSD, MDMA, or psilocybin, which are single compounds, cannabis contains a variety of lesser-known cannabinoids that are not fully understood.\u00a0<\/span><\/p>\n<h2>Do Stimulants Interact With Cannabis?<\/h2>\n<p><a href=\"https:\/\/nida.nih.gov\/publications\/drugfacts\/prescription-stimulants\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stimulants<\/span><\/a><span style=\"font-weight: 400;\"> offer a brief escape from reality, often providing users with an intense rush of energy and positive feelings. Stimulants work on neurotransmitters in the brain to increase focus and wakefulness. However, while they may have short-term positive effects, stimulants can ultimately harm our central nervous system by increasing <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK10795\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">neurotransmitter<\/span><\/a><span style=\"font-weight: 400;\"> activity, leading to elevated heart rate and blood pressure levels, which can cause paranoia and anxiety.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The most common stimulants are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cocaine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Methamphetamine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Caffeine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nicotine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Ritalin\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Adderall\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Concerta<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\nSince everyone reacts differently to different drugs, it is hard to predict the general effects of combining stimulants and cannabis. While these drugs tend to help boost alertness and concentration, these same qualities can potentially intensify when mixed with cannabis.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ultimately, the outcome of mixing cannabis and stimulants depends heavily on the amount of each substance taken and how an individual responds to them. The ECS interacts with both substances, so it shouldn&#8217;t be surprising that they have similar effects, with too much of either leading to increased heart rate and racing thoughts.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Interestingly, many people with ADHD report successfully self-treating their condition exclusively with cannabis, while others find more success by combining multiple medications, lifestyle changes, and cannabis.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Despite potential therapeutic benefits, combining THC with stimulants can lead to dangerous side effects. A <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4250392\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">2015 study<\/span><\/a><span style=\"font-weight: 400;\"> presented by the <\/span><span style=\"font-weight: 400;\">Journal Of Substance Abuse Treatment<\/span><span style=\"font-weight: 400;\"> revealed that THC and methylphenidate place undue strain on the cardiovascular system. Whatever the case, you should always consult your doctor or pharmacist before combining cannabis and stimulants.\u00a0<\/span><\/p>\n<h2>Combining Cannabis With Depressants<\/h2>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6602821\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Depressants<\/span><\/a><span style=\"font-weight: 400;\"> deliver a tranquil respite from everyday stress, though high doses can quickly turn this relaxation into disorientation and drowsiness. But embarking too far down this path can lead you astray, negatively affecting coordination or concentration.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are several common depressants, which include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Valium (diazepam)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.veriheal.com\/blog\/can-should-you-combine-xanax-alprazolam-and-cannabis\/\">Xanax (alprazolam<\/a>)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Halcion (triazolam)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Klonopin (clonazepam)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Alcohol<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Kava<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\nOur brain is like a finely-tuned vehicle, with neurotransmitters acting as the fuel that powers us. <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK513311\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">The gamma-aminobutyric acid (GABA) system<\/span><\/a><span style=\"font-weight: 400;\"> is an essential piece of the neurological puzzle. It&#8217;s like having a brake pedal in the brain that brings it all to a slow, steady and relaxed state when deployed\u2014which depressants frequently do at higher doses. THC acts in much the same way at larger doses causing users an extreme case of sedation if consumed with another depressant.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In contrast, combining CBD with depressants appears to have another interaction. An <\/span><a href=\"https:\/\/www.mdpi.com\/2077-0383\/8\/7\/989?utm_sq=g4xlu2tj61\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">alarming 2019 article<\/span><\/a><span style=\"font-weight: 400;\"> documented that, when taken together with the class of depressants called benzodiazepines, CBD can lead to a heightened risk of adverse effects such as drowsiness and confusion. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Due to its pharmacokinetic ability to prevent the effective breakdown of the drug in the liver, depressants remain elevated in the blood, posing potential health risks.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Additionally, <\/span><a href=\"https:\/\/nida.nih.gov\/news-events\/nida-notes\/2021\/06\/using-alcohol-marijuana-together-exacerbates-negative-consequences-young-adults\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">combining THC with alcohol<\/span><\/a><span style=\"font-weight: 400;\"> can create an unpredictable experience. With just a single cocktail or beer accompanying your cannabis experience, the effects are more powerful than either substance on their own\u2014significantly heightening psychoactivity.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While this combination may be enticingly enjoyable in moderation, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7363401\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">research shows<\/span><\/a><span style=\"font-weight: 400;\"> mixing these two substances often lead to traffic accidents at higher rates than if consumed separately.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In addition, it is also pertinent to be aware that high blood concentrations of depressants will also cause respiratory depression, or ineffectively slow breathing, therefore, use caution if adding CBD to the mix. In contrast, consuming CBD with alcohol does not appear to be associated with decreased respiration.<\/span><\/p>\n<h2>Could Cannabis Be a Viable Alternative to Opioids?<\/h2>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK551720\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Opioids<\/span><\/a><span style=\"font-weight: 400;\"> are potent substances capable of altering the body&#8217;s <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK573080\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">perception and experience of acute pain<\/span><\/a><span style=\"font-weight: 400;\">. They work by manipulating the body&#8217;s natural opioid receptors to increase its threshold of discomfort and desensitize nerve endings. In essence, these highly effective painkillers work by tricking the brain into feeling less distress.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are several common opioids, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Vicodin (hydrocodone)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Oxycontin (oxycodone)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Morphine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Ultram (<a href=\"https:\/\/www.veriheal.com\/blog\/tramadol-and-cannabis-why-you-shouldnt-combine-the-two\/\">tramadol<\/a>)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Methadone<\/span><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.veriheal.com\/blog\/the-dangers-of-mixing-cannabis-and-codeine\/\"><span style=\"font-weight: 400;\">Codeine<\/span><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\nWith the opioid epidemic continuing to ravage our nation, scientists are inspired by cannabis research that shows it as a <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7000155\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">potential alternative pain management solution<\/span><\/a><span style=\"font-weight: 400;\">. The ECS and opioid pathways work in harmony as if part of one extended relief network within everyone.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">With cannabis and opioids, users should exercise caution as with any other medication. Nevertheless, don&#8217;t be too alarmed, as <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7122694\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">a 2019 rhesus monkey study<\/span><\/a><span style=\"font-weight: 400;\"> published in <\/span><span style=\"font-weight: 400;\">Behavioural Pharmacology<\/span><span style=\"font-weight: 400;\"> concluded that THC and opioids don&#8217;t impair memory or decision-making.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As a result, there is hope that cannabis will play an increasingly important role in today&#8217;s healthcare landscape, with evidence that this natural remedy can reduce overdose and addiction dangers associated with prescription medications.<\/span><\/p>\n<h2>Cannabis May Enhance Psychedelic Experiences<\/h2>\n<p><a href=\"https:\/\/www.camh.ca\/en\/health-info\/mental-illness-and-addiction-index\/hallucinogens\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Hallucinogens<\/span><\/a><span style=\"font-weight: 400;\"> are an intriguing class of psychedelic substances that induce surreal transformations in how we perceive, feel, and think. These compounds produce an array of mind-altering effects through a single pathway, activating <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK1853\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">serotonin (5-HT2A) receptors<\/span><\/a><span style=\"font-weight: 400;\">. Although the effects of cannabis on most major drug classes are widely understood, adding hallucinogens into the equation remains a mystery\u2014a fascinating unknown yet to be fully explored.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Psychedelics include the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Psilocybin (the active ingredient in magic mushrooms)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">MDMA<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">DMT<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">LSD<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Mescaline\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Ketamine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Salvia<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Dextromethorphan (present in cough medications like Dimetapp and Mucinex)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\nPsychedelics activate the serotonin system, which connects directly to the ECS. In some cases, the combination enhances psychoactivity, but it can also mellow out the tripping experience in others. Nevertheless, it is possible to become overwhelmed by the use of either substance if you use too much.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">High doses of <a href=\"https:\/\/www.veriheal.com\/blog\/is-cannabis-classified-as-a-hallucinogen-stimulant-or-depressant\/\">THC can mimic the effects of hallucinogens<\/a>, as experts point out that cannabis and psychedelics have many parallels. But it&#8217;s ultimately as varied an experience as those who consume them, with dose and individual tolerance determining how these two altered states intertwine.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Although data on mixing hallucinogens and cannabis is scarce, years of anecdotal experience have shown no apparent adverse effects. In fact, recent research indicates that<\/span><a href=\"https:\/\/www.veriheal.com\/blog\/psilocybin-combining-cannabis-psilocybin\/\"><span style=\"font-weight: 400;\"> pairing psychedelics with low doses of cannabis<\/span><\/a><span style=\"font-weight: 400;\"> can dramatically heighten mystical experiences associated with the psychedelic journey. On the other hand, higher doses might increase undesirable sensations like fear or what was referred to as &#8220;insanity&#8221; in the study.\u00a0<\/span><\/p>\n<h2>Do Prescription Medications Interact With Cannabis?<\/h2>\n<p><span style=\"font-weight: 400;\">Simply put, yes! Cannabis can also interact with other medications and compounds besides the substances listed above.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">THC does not significantly affect prescription medications. In contrast, CBD has a unique interaction with certain medications, blocking the metabolic pathway used by drugs such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Blood thinners like warfarin and clopidogrel<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Heart medicines like amiodarone<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Transplant immunosuppressants like Tacrolimus<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Antihistamines like Claritin and Benadryl<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\nSimilar to how components of grapefruit or St. John&#8217;s Wort tend to react with pharmaceuticals, CBD could inhibit the breakdown of these medications, resulting in them circulating longer than usual. To ensure your safety and well-being, always consult your doctor before using cannabis or CBD with other medicines.<\/span><\/p>\n<h2>A Few Tips For Avoiding Cannabis Drug Interactions<\/h2>\n<p><span style=\"font-weight: 400;\">When combining psychoactive substances, it&#8217;s essential to exercise caution and proceed with a controlled approach. A great way of doing this is by taking small steps by <a href=\"https:\/\/www.veriheal.com\/blog\/microdosing-cannabis-explained-how-to-do-it-and-why-you-should-try-it\/\">microdosing<\/a>. For example, take no more than two puffs every 15 minutes when combining cannabis with other substances. This way, you can enjoy the experience while remaining in control of your responses afterward.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Additionally, potent cannabis edibles can make for an intense experience. Therefore, it&#8217;s a great idea to be mindful of dosage. Delays in digestion mean the effects may take a while before they truly hit\u2014and when the euphoria does knock on your door, you won&#8217;t be able to reverse the high until it wears off. Keep a watchful eye if you want to avoid being overwhelmed by marijuana&#8217;s potent power, and above all, consult your doctor or pharmacist before mixing things up.<\/span><\/p>\n<hr \/>\n<p><i><span style=\"font-weight: 400;\">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.<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Mixing cannabis with recreational drugs, medications, or alcohol can be a rollercoaster ride for your mind and body. While it may seem like an exciting idea to indulge in some extra fun, the pursuit of pleasure could come with undesired risks down the line.\u00a0 With a unique mix of over 550 chemical compounds and 100&#8230;<\/p>\n","protected":false},"author":75,"featured_media":25949,"parent":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[254,259],"tags":[13689,13690],"class_list":["post-25778","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lifestyle","category-research","tag-mixing-cannabis-with-other-substances","tag-polysubstance-use"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.1 (Yoast SEO v26.1.1) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Risks of Mixing Cannabis With Other Substances<\/title>\n<meta name=\"description\" content=\"If you enjoy mixing cannabis with other substances, check out this post to learn more about the dangers and risks associated with mixing drugs.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.veriheal.com\/blog\/like-mixing-cannabis-with-other-substances-here-are-the-pitfalls-of-polysubstance-use\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Like Mixing Cannabis With Other Substances? 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