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Interactions of Marihuana and THC with Other Drugs

What We Don’t, But Should, Know
  • Leo E. Hollister

Abstract

Marihuana use involves more than one substance. Not only is tetrahydrocannabinol (THC), the active psychoactive component, present, but also one or both other major cannabinoids, cannabidiol (CBD) and cannabinol (CBN).At present, evidence indicates that neither of these other two cannabinoids affects the action of THC. For practical purposes, THC alone is a model for the psychoactive action of marihuana. Alcohol is the social drug most used with marihuana, such use often being deliberate. Both have similar intoxicating effects, but these additive effects have not led to serious interactions. Stimulants often reverse some of the effects of THC, but the “high” from cocaine may be additive to that from THC. The interaction is so mild that no pattern of combined use has appeared. The same is true of the hallucinogen phencyclidine. So far as therapeutic drugs are concerned, few data are available. Although medical marihuana is not officially approved, marihuana has been tried empirically for treating a variety of medical disorders, such as nausea and vomiting associated with cancer chemotherapy, wasting syndrome associated with AIDS, and spasticity from neurological diseases. In each instance, other drugs are also present. So far, no adverse interactions from such use have been reported. However, this might not reflect the true prevalence. Unless one looks for something, one is not likely to find it.

Keywords

Multiple Sclerosis Adverse Interaction Cannabis Extract Alcohol Substance Abuse Increase Brain Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Hollister, L. E. (1976) Interactions of delta-9-tetrahydrocannabinol with other drugs. Ann. NY Acad. Sci. 281, 212–218.PubMedCrossRefGoogle Scholar
  2. 2.
    Nahas, G. C. (1984) Marihuana in Science and Medicine Raven, New York, pp.189–197.Google Scholar
  3. 3.
    Herkenham, M., Lynn, A. B., Little, M. D., Johnson, M., Melvin, B., De Costa, B. R. and Rice, K. C. (1960) Cannabinoid receptor localization in brain. Proc. Natl. Acad. Sci. USA 87, 1931–1936.Google Scholar
  4. 4.
    Holleltt, A. C., Bidaut-Russell, M., Devane, W. A., Melvin, L. S., Johnson, M. R., and Herkenham, M. (1960) The cannabinoid receptor, biochemical, anatomical and behavioral characterization. Trends Neurosci. 13, 420–423.Google Scholar
  5. 5.
    Devane, W. A. (1994) New dawn of cannabinoid pharmacology. Trends Pharmacol. Sci. 15, 40–41.PubMedCrossRefGoogle Scholar
  6. 6.
    Bornheim, L. M., Kim, K. Y., Perottti, B. Y. T., and Benet, L. Z. (1994) Effect of cannabidiol (CBD) pretreatment on the kinetics of tetrahydrocannabinol (THC) metabolites in brain. Can. J. Physiol. Pharmacol. 72 (suppl 1) 292.Google Scholar
  7. 7.
    Agurell, S., Carlsson, S., Lindgren, J. E., Ohlssson, A., Gillespie, H., and Hollister, L. E. (1981) Interactions of delta-1-tetrahydrocannabinol cannabinol and cannabinol following oral administration in man. Assay of cannabinol and cannabidiol by mass fragmentography. Experientia 37, 1090–1091.PubMedCrossRefGoogle Scholar
  8. 8.
    Hunt, R. A., Jones, R. T., Herning, R. I., and Bachman, J. (1981) Evidence that cannabidiol does not significanctly alter the pharmacokinetics of tetrahydrocannabinol in man. J. Pharmacokinetics Biopharmaceutics 9, 245–260.CrossRefGoogle Scholar
  9. 9.
    Hollister, L. E. (1973) Cannabidiol and cannabinol in man. Experientia 29, 825–826.PubMedCrossRefGoogle Scholar
  10. 10.
    Hollister, L. E. and Gillespie, H. K. (1975) Interactions in man of delta-9-tetrahydrocannabinol. II. Cannabidiol and cannabinol. Clin Pharmacol. Ther. 18, 80–82.PubMedGoogle Scholar
  11. 11.
    Doty, P., Dykstra, L. A., and Picker, M. J. (1992) Delta-9-tetrahydrocannabinol interactions with phencyclidine and ethanol. Effects on accuracy and rate of responding. Pharmacol. Biochem. Behay. 43, 61–70.CrossRefGoogle Scholar
  12. 12.
    Nishikami, J., Hamajima, K., Watanabe, K., Yamamoto, I., and Yoshimura, H. (1987) The interaction of cannabinoids with various drugs. J. Pharm. Sci. 76, S43.Google Scholar
  13. 13.
    Pertwee, R. G. and Greentree, R. G. (1988) Delta-9-tetrahydrocannabinol-induced caltalepsy in mice enhanced by pretreatment with flurazepam or chlordiazepoxide. Neuropharmacology 27. 486–491.Google Scholar
  14. 14.
    Lukas, S., Sholar, M., Kouri, E., and Mendelson, J. H. (1992) Marihuana smoking increases plasma cocaine levels and subjective reports of euphoria in male volunteers. Pharmacologist, 34, abstract 386.Google Scholar
  15. 15.
    Foltin, R. W., Fischman, M. W., and Kelly, T. H. (1992) Behavior effects of ethanol and marihuana, alone and in combination with cocaine in humans. Proc. Committee on Problems of Drug Dependence. NIDA Res. Monograph 109, 218.Google Scholar
  16. 16.
    Yamamoto, I, Umebayashi, E., Watanebe, E., and Yoshimura, R. (1988) Interactions of cannabis extract, delta-9-tetrahydrocannabinol and 11-hydroxy-delta-8-tetrahydrocannabinol with methamphetamine in mice. Commun. Subst. Abuse 9, 107–116.Google Scholar
  17. 17.
    Godley, P. J., Moore, E. S., Wooworth, J. R., and Fineg, J. (1991) Effects of ethanol and delta-9-tetrahydrocannabinol on phencyclidine disposition in dogs. Biopharm. Drug Dispos. 12, 189–199.PubMedCrossRefGoogle Scholar
  18. 18.
    Lane, M., Vogal, C. L., Ferguson, J., Dransow, S., Saiers, J. L., Hamm, J., Salva, K., Wiernik, P. H., Holroyde, C. P., Hammill, S., Shepherd, K., and Plasse, T. (1990) Dronabinol and prochlorperazine in combination for treatment of cancer. J. Pain Symptom Manage 6, 352–359.CrossRefGoogle Scholar
  19. 19.
    Vinciguerra, V., Moore, T., and Brennan, E. (1988) Inhalation marihuana as an antiemetic for cancer chemotherapy. NY State J. Med. 88, 525–528.Google Scholar
  20. 20.
    Gorter, R. (1991) Management of anorexia-cachexia associated with cancer and HIV infection. Oncology 5 (suppl 9), 13–16.PubMedGoogle Scholar
  21. 21.
    Mattes, R. D., Engelmann, K., Shaw, L. M., and Elsoholy, M. A. (1994) Cannabinoids and appetite stimulation. Pharmacol. Biochem. Behay. 49, 187–195.CrossRefGoogle Scholar
  22. 22.
    Ungerleider, J. T., Andyrsiak, T., Fairbanks, L., Ellison, G. W. and, Myers, L. W. (1987) Delta-9-THC in the treatment of spasticity associated with multiple sclerosis. Adv. Alcohol Substance Abuse 7 (1), 39–50.CrossRefGoogle Scholar
  23. 23.
    Meinck, H., Schonle, P. W., and Conrad, B. (1989) Effect of cannabis of spasticity and ataxia in multiple sclerosis. J. Neurol. 239, 120–122.CrossRefGoogle Scholar
  24. 24.
    Jaeger, W., Benet, L. Z., and Bornheim, L. M. (1996) Inhibition of cyclosporine and tetrahydrocannabinol metabolism by cannabidiol in mouse and human microsomes. Xenobiotica 26, 275–284.PubMedCrossRefGoogle Scholar
  25. 25.
    Lacoursiere, R. B. and Swatek, R. (1983) Adverse interaction between disulfiram and marihuana: a case report. Am. J. Psychiatry 140, 243–244.PubMedGoogle Scholar
  26. 26.
    Stoll, A. L., Cole, J. O., and Lukas, S. L. (1991) Letter. A case of mania as a result of fluoxetine-marihuana interaction. J. Clin Psychiatr. 52, 280–281.Google Scholar

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© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Leo E. Hollister

There are no affiliations available

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