Cannabis

Cannabis Overview

Cannabis consumption is growing in the United States because of state legalization for recreational and medical use. However, many anesthesia practitioners are unaware of the potential adverse effects that may occur if cannabis is taken before the administration of an anesthetic.

Not only might cannabis users require more anesthesia during surgery than non-users, they may have increased pain afterwards and use higher doses of opioids while in the hospital.

A growing body of research shows that patients who use cannabis have higher anesthesia needs and more surgery-related pain.

With recreational and medical cannabis use increasing in the United States, it is necessary for anesthesia providers to consider cannabis’ effects when delivering care. This begins with screening for substance use while performing the preoperative evaluation.

Once cannabis or synthetic cannabinoid use is con- firmed, the anesthesia provider should assess for cardiovascular complications of the drug.

AANA Guidance and Resources

Analgesia and Anesthesia for the Substance Use Disorder Patient

Patient Safety CRNAs and Health-Related Impaired Practice

Fitness for Duty Workplace Resources

Substance Use Disorder (SUD)

Integrating the ASRA Pain Medicine Cannabis Consensus Guidelines into Certified Registered Nurse Anesthetist Clinical Practice, AANA Journal, August 2023

Additional Resources

Safety-Sensitive Occupations and Marijuana Use

North Carolina, Implications for use of Marijuana and Marijuana Containing Products Among Nurses
State Nursing Regulations and Guidelines
- Refer to individual state boards of nursing and the substance use disorder monitoring programs for applicable regulations and guidelines. Examples of state nursing regulations include allowable limits for the amount of THC in the urine drug test (random or for cause). Other states may follow the airline industry or the US Department of Transportation and require 100% abstinence; for example, even if on medicinal THC, a nurse regulated by the nursing board is not allowed to practice until treatment has ceased.
National Safety Council (NSC):
- Marijuana at Work: What Employers Need to Know
- Drugs at Work: What Employers Need to Know

Medical Marijuana and Patient Care

ANA Position Statement: Therapeutic Use of Marijuana and Related Cannabinoids, The Online Journal of Issues in Nursing, January 2022
ASRA Pain Medicine Consensus Guidelines on the Management of the Perioperative Patient on Cannabis and Cannabinoids, BMJ Journals, January 2023
FDA and Medical Marijuana
Groundbreaking, Comprehensive, Vital: The National Nursing Guidelines for Medical Marijuana
Nursing Care of the Patient Using Medical Marijuana, Journal of Nursing Regulations, July 2018
FSMB Model Guidelines for the Recommendation of Marijuana in Patient Care

Marijuana Risk Facts

Learn About Marijuana Risks, SAMHSA
Statement from FDA Warning Significant Health Risks of Contaminated Illegal Synthetic Cannabinoid Products
Marijuana and Pregnancy (Infographic), ACOG

Disclaimer

The resources on this page may incorporate or summarize views, guidelines, or recommendations of third parties. Such material is assembled and presented in good faith, but does not necessarily reflect the views of the AANA. Links to third-party websites are inserted for informational purposes and do not constitute endorsement of the material on those sites, or of any associated organization.