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Mixing Marijuana with Other Drugs

Disclaimer: AspenRidge Recovery does NOT endorse the use of any mind-altering substances, including cannabis. We know that marijuana is an addictive substance that can cause significant problems in the lives of many individuals and families. If you or someone you know is struggling with marijuana addiction, contact us directly at (855) 281-5588. Please understand the risks associated with mixing marijuana with other drugs. Read more below.

Mixing Marijuana with Other Drugs: What You Need to Know

Our advice to those who struggle with addiction is always to abstain from the use of habit-forming substances. However, because weed is readily available to residents of Colorado and other states, we believe it is our duty to provide relevant health considerations and educate you about marijuana drug interactions.

Considering there’s a lot of buzz surrounding the potential benefits of medical marijuana, it can be easy to assume that this drug is safer than others. However, there are many risks that come with marijuana use, particularly when used in combination with other prescription medications or with illicit substances. Mixing marijuana with other drugs, in fact, can be risky and even

Weed – Colorado Legalization & Nationwide Use

Without question, the United States has seen a profound shift in drug policy in the past decade. Colorado was the first to legalize marijuana in the U.S. with Amendment 64 passed in 2012. Since then, a number of other states have followed suit, making it legal and accessible for recreational and medicinal use. Nevertheless, pot is still illegal in most states. Users caught in possession of the drug can be ordered to pay hefty fines or spend time in jail. Still, millions of Americans are daily users and rely on this substance to get through the day.

As more studies are conducted with respect to pot use nationwide, the more is understood about risks involved in mixing marijuana with other drugs. There’s some indication that cannabis interacts negatively with other substances, such as alcohol, for example. We’re taking a closer look.

How does cannabis interact with other drugs?

Although most people would probably rank weed pretty low on the totem pole in terms of danger, combining it with other substances can have negative consequences. In this article, we will talk about what happens when mixing marijuana with other drugs, such as:

  • alcohol
  • prescription drugs
  • illegal substances.

But, first – let’s answer some of the most commonly asked questions about cannabis. We will be talking about naturally grown cannabis – NOT dabbing or synthetic marijuana.

We offer marijuana addiction programs for Colorado residents. Our compassionate staff offers supportive services for a variety of substance addiction and we provide a dual-diagnosis approach to the treatment of ongoing substance misuse, abuse, and addiction.

1. Can Marijuana Kill You?

The potency of the weed available for sale on both the black market and in legal dispensaries around the country is significantly higher than it was decades ago.

Unfortunately, the potency of marijuana can create issues for users. In fact, many described the sensation of feeling like they’re dying. A weed induced panic attack can sometimes cause a feeling of impending death.

When cannabis contains high levels of THC (the active ingredient in pot that gives you a buzz), it can cause a feeling of overwhelming anxiety, which can generate a feeling of extreme panic. In this frenzied state, many people will think, “Uh-oh. Can marijuana kill you?” The answer is no. While ingesting high levels of THC can cause a user to FEEL like they are going to die, the feeling quickly passes.

Still, there are both short and long term adverse side effects of marijuana use. It has been known to cause impaired judgment and motor skills, and there are increased risks of use when mixing marijuana with other drugs.

2. Is Marijuana a Depressant?

Many people who come to us for addiction treatment ask us, “Is weed a depressant?” The drug actually falls into three categories. Weed can be classified as a:

  • depressant
  • stimulant
  • hallucinogen.

This is because cannabis affects everybody in unique ways and various types of pot generates different kinds of effects. When some people get stoned, they feel relaxed and sleepy.

Some immediate side effects include and experienced:

  • loss of motor skills
  • poor coordination
  • lowered blood pressure
  • short-term memory loss.

In this way, cannabis is a depressant for many users. However, you might be surprised to learn that for many, weed is a stimulant. When most people think of stimulants, they think of cocaine or methamphetamines. These drugs make the user feel super “speedy.” Pot doesn’t deliver this type of extreme mental or physical stimulation. Nevertheless, it can cause someone to experience an increase in:

  • heart rate
  • raised blood pressure
  • anxiety
  • paranoia
  • amped energy
  • a jolt of motivation.

Finally, weed can be hallucinogenic. While a user won’t experience extreme hallucinations like they would if they took LSD or DMT, they can have auditory, visual, or sensory hallucinations. (For example, someone who is high on weed might think their cat is telepathically communicating with them). So, there you have it. Clear as mud, right? Whether weed is a depressant, stimulant, or hallucinogen depends on your own body chemistry and the type of cannabis you are using.

3. How Does Marijuana Affect The Brain?

In order to understand why mixing marijuana with other drugs is not a good idea, it helps to first understand how cannabis affects your brain. Essentially, when you use cannabis in any form, the drug activates tiny little spots on the cells in your brain. These are called “cannabinoid receptors.” Those little receptors are there to receive endocannabinoids, which are neurotransmitters that our system produces naturally to help our body and brain communicate with each other.

When someone uses weed, however, the drug generates “phytocannabinoids” (THC, CBD, and others) in their body that jump in and take the place of the naturally-produced cannabinoids. Some effects of the drug, like euphoria or decreased pain, can be attributed to the fact that these new cannabinoids alter the way the body and brain are communicating with each other.

Combining weed with other drugs, however, can alter this process, making things a bit more complicated. Marijuana drug interactions can cause phytocannabinoid production to increase at an unsafe rate, making it difficult for the user to function properly.

4. Can You Become Addicted to Weed?

Without a doubt, absolutely, no question about it – you CAN become addicted to marijuana. Most regular pot users will laugh at this assertion. They will say they can quit anytime, but they don’t want to. They will say they enjoy the way green makes them feel and that they have no intention of stopping. They will say weed is a natural substance that grows from the earth and that it completely harmless. Most people who use bud regularly refuse to even consider the possibility that they might be addicted. Here’s the thing. Heroin is also a natural substance that grows from the earth. Those who chase the dragon offer up the same explanations for their habit – they can quit anytime they want, they don’t want to quit, they like the way the drug makes them feel, etc. No one questions if heroin is addictive, yet users will insist they aren’t hooked! The same is true for regular cannabis users.

The Straight Scoop On Marijuana Drug Interactions

Now that we have answered some of the most commonly asked questions about weed, let’s talk about mixing marijuana with other drugs.

Most pot users completely downplay the powerful effect this drug has on the brain and body. In recent years especially, we have been taught that weed is relatively safe – especially when compared to alcohol, cocaine, heroin, crystal meth, and other addictive drugs. Like any psychoactive drug, pot can interact with other psychoactive chemicals in a way that produces less than desirable results.

As weed becomes increasingly more accessible, it is helpful to know about marijuana drug interactions. That way, if you or someone you care about chooses to partake of this substance, you’ll be able to do so in the safest and most responsible manner possible.

Mixing Marijuana and Depressants

Many people mix marijuana with depressant drugs like alcohol, barbiturates, and benzodiazepines (like Xanax) because they like the way it makes them feel. This can be dangerous.

Here is a quick study in pharmacology. Depressants are drugs that inhibit the central nervous system (CNS) functioning and cause breathing and blood pressure to slow down. Many depressants also increase the production of the neurotransmitter known as gamma-aminobutyric acid (GABA). GABA carries messages between cells. Increased GABA activity reduces brain function. This leads to drowsiness, increased relaxation, and deep sleep.

Mixing marijuana with other drugs like depressants can cause the heart rate to decrease to a very low rate. It can also inhibit the user’s basic motor skills, making it difficult for them to think clearly, speak, or react appropriately to things around them. More importantly, mixing weed with depressants can be fatal or cause serious health complications. This may sound extreme, but many people who have gone to the emergency room because they have stopped breathing tested positive for marijuana and depressants. This is not a coincidence.

Mixing Marijuana and Alcohol

Let’s talk about mixing marijuana and alcohol for a minute. These are the two most commonly used drugs in America.

Getting “crossfaded” is very common among pot users. People say they like the buzz caused by the effects of booze and pot. The risks can be significant. For starters, the combination of weed and alcohol is known to increase the effects of each drug. Users who mix the two become drunk and stoned much quicker and with greater intensity. Exaggerated effects of THC can cause those terrifying weed-induced panic attacks, as well. It can also cause:

  • extreme paranoia
  • frightening hallucinations
  • disorienting short-term memory loss
  • complete disconnection from reality.

Exaggerated effects of alcohol can lead to blurred vision, complete loss of motor skills, slurred speech, nausea, vomiting, and other unpleasant consequences. Put these two together – and it’s a recipe for disaster. If your goal is to get high and drunk at the same time by mixing alcohol and marijuana, just know going in that you might be in over your head.

Excessive drinking becomes problematic when done in combination with cannabis because weed prevents you from vomiting. While you might become nauseous, you may not be able to throw up. Usually, when someone drinks too much, they throw up, which helps flush all the alcohol out of the system. However; pot can prevent this from happening. As a result, drinking alcohol and using cannabis at the same time leads to an increased risk of alcohol poisoning – which almost guarantees a hospital visit. According to US News at least 2,200 people die every year from alcohol poisoning. Many of them were drunk AND stoned. Also, It should go without saying that no one should ever drive or operate heavy machinery while they are under the influence of green and alcohol. It is particularly important for those who use a combination of marijuana and alcohol to stay far away from the driver’s seat of a car.

Mixing Marijuana and Prescription Medicine

Millions of Americans are prescribed benzodiazepines like Xanax, Valium, and Klonopin for anxiety, insomnia, and other health conditions. By themselves, these anti-anxiety medications are dangerous. They are not only highly addictive, but they also deliver a powerful sedative effect many. If you combine benzos and weed, you are looking for trouble. Remember, we told you that Xanax and other benzos are depressants. You should never mix depressants and cannabis. They can significantly reduce heart rate and blood pressure and lead to coma or death. Another thing you should know about mixing marijuana and benzos is that you are likely to wake up in the morning (if you are lucky enough to make it home safe) with absolutely no recollection of how you got there.

Benzodiazepines are notorious for affecting memory and causing blackouts. Bud is also associated with short-term memory loss. When you mix these two substances, you are likely to walk around in a mental fog that will prevent your brain from creating new memories. This increases the likelihood that you will put yourself in dangerous situations that could result in you getting robbed, assaulted, or something much worse.

Mixing Marijuana And Suboxone

What about mixing marijuana with other drugs like suboxone? This synthetic compound, which can be found in many opioid replacement therapy drugs like Suboxone and Subutex, has a sedating effect much like marijuana. Buprenorphine is often prescribed to those who are dependent on opioid drugs like heroin, Oxycodone, or Fentanyl. It helps fight off cravings and withdrawal symptoms. Therefore, it is likely that someone who is prescribed the drug would not want to mix it with an addictive substance like cannabis in the first place. However, those who are considering using bud while on Suboxone, Subutex, or another drug containing buprenorphine should seriously consider the safety risks. The problems with mixing marijuana and buprenorphine stem from the fact that the opioid replacement drug has strong depressant effects. Upon taking a prescribed dose of drugs like Suboxone, the user’s central nervous system will begin to slow down. Because marijuana can also act as a depressant, using the two drugs in combination can lead to respiratory depression and death. Also, it is important to note that combining marijuana and Suboxone or other opioid replacement therapies can render buprenorphine ineffective. This means that cravings for opioids and withdrawal symptoms will eventually kick in, which can lead to a relapse.

Can You Mix Marijuana And Antidepressants?

Mixing marijuana with other drugs like antidepressants are, also, a no.

Most drugs don’t mix with antidepressants. Pot is no exception. Antidepressants are prescribed to treat psychiatric conditions like

  • anxiety
  • depression
  • PTSD
  • other mental disorders.

Many people use green while taking their antidepressants to self-medicate in an attempt to find relief from their mental health issues. This is not the solution. In fact, mixing marijuana and antidepressants can actually make things much worse. For example, cannabis causes many people to experience anxiety. Those who have Generalized Anxiety Disorder or other similar conditions can actually feel more anxiety when they use pot. Medications like Prozac, Lexapro, and Zoloft are commonly prescribed to treat anxiety. Combining these antidepressants with marijuana can counteract the meds and enhance anxious thoughts and feelings. Some studies have shown that chronic cannabis use can lead to depression. This is ironic because many people think getting high makes their condition better. The problem is, the drug wears off and feelings of despair return. Then, the user uses more pot to feel better. It can become a vicious cycle. Wellbutrin, Celexa, and Paxil are often prescribed for the treatment of depression.

Mixing weed and these antidepressants prevent the medications from working properly. Some Doctors Won’t Prescribe Antidepressants to Marijuana Users It is important to mention that taking antidepressants and weed together makes it almost impossible for your doctor to help you get better. When you are under the care of a psychiatrist, they monitor your progress and determine if the medication you have been prescribed is working. If you are using marijuana and antidepressants at the same time, there is no way to figure out which substance is causing what specific effect. Medication adjustments and changes are basically out of the question because they are completely counterproductive. Many doctors won’t even treat you if you are mixing these two substances.

Different Types of Antidepressants and Marijuana Drug Interactions

There are three different types of antidepressants that may interact with cannabis in negative ways – SSRIs, SNRIs, and MAOIs. Mixing different antidepressants with weed can produce varied side effects and problems. Let’s talk about these. Selective Serotonin Reuptake Inhibitors, also known as SSRIs, are the most commonly prescribed type of antidepressant. Drugs like Lexapro, Zoloft, Prozac, Wellbutrin and Paxil are examples. These help to treat depression other mental health conditions by increasing the amount of serotonin released in the body. Serotonin is a natural feel-good neurotransmitter. It promotes feelings of wellness and contentment.

Studies have shown that weed also helps release serotonin in the brain. For this reason, mixing marijuana and Prozac, combining weed and Wellbutrin, or doing pot with other antidepressants can have dire consequences. Specifically, too much serotonin can lead to Serotonin Syndrome. This occurs when the brain can’t handle the quantity of the chemical it’s been tasked to process. People who have Serotonin Syndrome will experience a variety of symptoms that range from mild to severe. These include agitation, restlessness, mental confusion, rapid heartrate, high blood pressure, sweats, vomiting, and diarrhea. Also, be warned: using marijuana and SSRIs can lead to life-threatening conditions like high fever, seizures, shock, irregular heartbeat, and unconsciousness. On another note, many people take the antidepressant Wellbutrin to help fight cravings for harmful substances. It is sometimes prescribed to people who are quitting smoking or in recovery from heroin addiction.

Mixing marijuana and Wellbutrin, like other SSRIs, is not a good idea for the reasons we have explained. Effexor is a Serotonin and Norepinephrine Reuptake Inhibitor (SNRI). Other SNRIs include Cymbalta and Pristiq. These antidepressants work in very much the same way that SSRIs do. People who are prescribed SNRIs should not mix them with cannabis. THC and CBD (two of the major compounds in pot) and SNRIs can have an effect on the way serotonin is regulated in the brain. The combination of them can produce unpredictable results. Those who are prescribed to an SNRI and throw cannabis into the mix might find themselves feeling extremely disoriented. They are also subject to developing Serotonin Syndrome. MAOIs: Although Monoamine Oxidase Inhibitors (MAOIs) like Nardil are not prescribed very much these days (most patients who would have been prescribed them receive SSRIs or SNRIs instead), those who do take these drugs shouldn’t smoke pot. MAOIs interact with marijuana in a way that heightens the sedative qualities of cannabis to an unsafe level.

Be Aware of Cannabis Drug Interactions and Stay Safe

Truth be told, we think it’s a good idea to stay away from weed altogether. The stuff is addictive and it can cause some significant health problems. If you want to be healthy and avoid many of the problems that can come from getting high, your best bet is to find other pleasurable activities to engage in. But, as we have said – you are going to use the stuff until you are ready to quit. We respect that. Nevertheless, as cannabis becomes more commonly used in Colorado and elsewhere, we can all benefit from increased awareness of marijuana drug interactions. The effects of weed do not pose the kind of immediate health threats that other drugs do. However, when combined with incompatible substances, pot can be quite dangerous. Those who do choose to use weed should carefully take inventory of what else they put into their bodies. If you’re going to get high, please be safe. Think twice about mixing marijuana with alcohol and other drugs.

Mixing marijuana with other drugs carries serious health effects. Learn more about how cannabis interacts with other drugs here.

Why Are Methadone Patients Still Being Punished for Marijuana Use?

M arijuana, which is now legal for medical use in 33 states and counting, can help treat pain — something which opioids also treat. But people with opioid use disorders (OUDs), including those getting treatment with methadone or buprenorphine, may have a hard time getting the pain relief they need (and these days, even people without OUDs have a hard time getting pain relief).

So why do so many treatment programs — including opioid treatment programs (OTPs, also known as methadone clinics) and office-based opioid treatment (OBOT) providers — test for tetrahydrocannabinol (THC), the psychoactive ingredient of cannabis?

Contradictions in Colorado

Even in Colorado, one of the first two states to legalize cannabis for recreational use, OTPs are required by state law to test for THC.

Treatment providers there are frustrated by this. Tina Beckley, regional director in Colorado for Behavioral Health Group , said recently that ever since Colorado started requiring OTPs to test for THC in 2006, many patients have lost their take-home doses —often, understandably, having thought that their medical marijuana card would spare them this sanction. Some decided to leave treatment as a result. It was a recipe for chaos and increased risk.

In Colorado, take-homes for people who receive medical marijuana are limited to those with no history of illicit marijuana use, who had a medical condition that was identified as being treatable with marijuana, and whose primary care providers agreed to the use of medical marijuana.

These problems began when only medical marijuana was permitted. With the advent of recreational marijuana in 2012, life for OTP patients — and providers — got even more complicated.

Methadone patients use nicotine and alcohol without sanctions, yet the same still doesn’t apply to state-legal marijuana. And this after many methadone patients, according to Beckley, moved to Colorado specifically for the marijuana.

What Federal Rules Say—And Don’t

Here’s the catch-22. If an OTP does test for THC, and the sample comes up positive, the OTP can’t necessarily just disregard it. Under some state and clinic rules, the OTP may take steps such as reducing the patient’s take-home doses.

But there’s no reason to do so, according to the federal guidelines .

Even though THC testing is frequently applied in some states, this testing is never federally mandated except at admission.

If methadone doesn’t show up in the toxicology reports, there is reason for concern—the patient may be diverting take-homes and foregoing the benefits of methadone. If barbiturates or benzodiazepines show up, there is also reason for concern because of risks to the patient. (But taking barbiturates, benzodiazepines, or other opioids in addition to methadone might mean that the patient is not getting high enough dose of methadone; it does not mean that the patient should be punished.)

There is, however, no evidence that cannabis combined with methadone is harmful. This is why, in the era of medical marijuana, there is little point in even testing for THC in OTPs, and in fact the federal government doesn’t recommend it after the patient’s first visit. Outmoded and outdated state regulations need to be fixed.

Even though THC testing is frequently applied in some states, this testing is never federally mandated except at admission. Both the federal Substance Abuse and Mental Health Services Administration (SAMHSA), and the Joint Commission, which together accredit and certify OTPs, say OTPs should only test patients for THC once — upon admission. A “Dear Colleague” letter from SAMHSA, which is equivalent to regulation, does not suggest that OTPs test for THC.

But there is pushback — don’t assume that the federal government supports cannabis for people with OUDs. The SAMHSA letter expresses plenty of concern about potential harms related to marijuana use. And while some states have decreed that cannabis can be used instead of opioid agonists to treat opioid use disorders, this has prompted SAMHSA head Elinore McCance-Katz, MD, PhD, as well as OTPs, to disagree.

According to the American Society of Addiction Medicine , however, in states where medical cannabis is legal, the same approaches should apply as are used for other medications. Indeed, other medications may cause some problems for patients taking methadone which cannabis does not cause.

A Psychiatrist Who Prescribes Buprenorphine and Cannabis

Leaving the situation of OTPs and methadone for a moment, let’s consider buprenorphine. It’s not only OTPs, which mainly dispense methadone, that are interested in helping patients by allowing cannabis.

Frederick E. Kahn, MD, a psychiatrist practicing with Forest Recovery in New Jersey, prescribes cannabis for pain in his buprenorphine patients (though patients can’t obtain a medical marijuana card from Forest; they need to have one already).

“If the piece of the withdrawal you’re experiencing is anxiety, maybe [cannabis] can help you.”

“One hundred percent of my patients became addicted to opioids because of having pain problems, mostly chronic,” he told Filter . Complaints included lower-back pain, lupus, neck injuries and autoimmune diseases, he said. In addition, he said some of his patients became addicted following acute pain — they were prescribed hundreds of pills of opioids after, for example, shoulder surgery.

Kahn said the cannabis doesn’t help opioid withdrawal specifically — there are other drugs for that — but it can treat anxiety in some patients. “If the piece of the withdrawal you’re experiencing is anxiety, maybe it can help you,” he said.

When beginning treatment for opioid use disorder with buprenorphine, his patients have adequate doses within the first 24 hours to treat their withdrawal, he said. Under-medication — a dose that’s not high enough—is responsible for patients feeling withdrawal symptoms, and should not occur with good treatment. This is not always the case with OTPs, which are required by law to start methadone on low doses regardless of the dose the patient will end up on.

Kahn does test his patients, including for THC. But he doesn’t use the results punitively. (And he’s not an OTP, so doesn’t have those federal regulations to deal with.)

“If someone is positive and we didn’t know about it, we talk about it with them, see what it’s doing or not doing for them,” said Kahn. “We work with them about it. Toxicology is not there to punish people. It’s there to help guide treatment.”

How does Kahn know that his patients are not, for example, using the cannabis addictively, but really need it for pain? “That comes from the doctor-patient relationship,” he said. “You can’t tell from the blood level.”

But you can discuss it. “Ask them how much they’re smoking. We can talk about changing from smoking to either vaping or making some kind of foodstuff because of [lung] problems with smoking anything,” he said. “You can talk about how many times they’re using it a day, how many puffs, how many grams.” The point is to make an active commitment to work together as doctor and patient, he said—and to bear in mind that most of these cannabis-using patients are on fewer opioids for pain.

At Forest, patients come in voluntarily. “Everybody’s in therapy, so we’re not just handing out buprenorphine — we’re following them closely,” he said.

People who work in New Jersey’s cannabis dispensaries usually consult with the patients about strains and potency. But Kahn described this set-up as “the Wild West.” They’re not pharmacists or doctors, he said, “they just work there.”

Contrasting Approaches in New York and Massachusetts

New York State does not require its OTPs to test for THC. Allegra Schorr, president of the Coalition of Medication-Assisted Treatment Providers and Advocates, the state’s membership association of OTPs, told Filter that there is a very mixed message going out to OTPs about cannabis. Schorr, who is married to Kahn, also heads West Midtown Medical Group, a proprietary OTP based in New York City.

“There’s enough evidence on chronic pain so that we should try this,” said Schorr of medical cannabis for OTP patients. “There are some conditions that we can easily find consensus on.”

And she commended the state’s regulatory agency, the Office of Alcoholism and Substance Abuse Services (OASAS), for not taking a hardline approach. Many other states have much to learn from this.

Massachusetts, by way of contrast, is another state that, like Colorado, requires THC testing in its OTPs.

“Conquering an opioid addiction is no easy feat for someone chemically handcuffed to narcotic medicines,” said Benjamin Caplan, MD, founder of the CED Foundation and a physician who treats patients at the CED clinic. “In states with medicinal cannabis as an option, we see strong evidence of better results for recovery from opiates: fewer prescriptions, better pain management, less suffering, and better quality of life.”

Peter Grinspoon, MD, has treated OUD patients with cannabis as well. He has a primary care practice affiliated with Massachusetts General Hospital. “In the almost-universal anecdotal experience of the patients I’ve treated, cannabis is the most effective medication for withdrawal symptoms from opioid addiction,” he told Filter . “Certainly better than clonidine and lofexidine. This is true whether they are or aren’t in OTP programs.”

“In my personal experience transitioning off of opiates,” he added, “I found cannabis to be profoundly helpful, particular in offsetting the physical symptoms of opiate withdrawal, as well as cravings and anxiety.”

Seeing Cannabis Use for What It Is

Among many studies on this issue, there have been these findings showing the benefits or lack of harms of cannabis for OTP patients:

Cannabis use does not negatively influence opioid outcomes among patients receiving buprenorphine maintenance treatment, with no difference in productivity and quality of life between individuals maintained on buprenorphine with and without current cannabis use.

For people who use drugs and start opioid agonist treatment, daily cannabis use was associated with a 21 percent greater odds of treatment retention compared with less-than-daily cannabis use.

Cannabis use dropped significantly following methadone dose stabilization , and data suggested that objective ratings of withdrawal symptoms decrease in methadone patients using cannabis during this stabilization period

It’s not that most OTPs necessarily want their patients to take cannabis; many do not. But it should be up to the program’s discretion, they say, not mandated by state or federal governments in terms of testing and sanctions such as loss of take-homes.

And emerging evidence that cannabis helps with opioid craving make it even more important to use judgment, and not hard-and-fast rules, about cannabis — especially during an opioid-involved overdose crisis.

Retention in treatment is much more important than keeping people off of cannabis, which — unlike, say, illicit fentanyl — isn’t responsible for any deaths.

Many methadone clinics test patients for THC and impose sanctions for positives. Federal rules don't require most of this, and it's unjustifiable.