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Drugs That Don’t Mix With Cannabis, Part I: Recreational Drugs

Cannabis is one of the safest drugs in the world, but that doesn’t mean it’s completely without risk. A cannabis high can be accompanied by some side effects such as anxiety and nausea, but they are usually fairly moderate and short-lived. However, cannabis can be dangerous when it is used in combination with various other drugs. 

I don’t recommend mixing cannabis with anything, but many users would disagree. Some enjoy cannabis and a few beers during the same weekend evening; others say that cannabis can enhance an LSD trip; still others use cannabis with MDMA to take the edge off of the comedown. Unfortunately, none of these things are without risk. What do you need to know about cannabis’ interactions with other drugs, and what do you need to avoid?

Alcohol

Alcohol and cannabis are the two most widely used recreational drugs, so it makes sense that they would be the most common pairing. Many cannabis users are able to get away with this with no real issue, as long as they don’t overdo their dose on either substance. However, cannabis use can increase the user’s chances of alcohol poisoning, or even a fatal alcohol overdose.

When taken alongside cannabis, alcohol increases the amount of time it takes for THC to be metabolized. This is because the liver prioritizes metabolizing the alcohol, and THC stays in the blood longer. Cannabis intoxication raises the user’s chance of getting alcohol poisoning by inhibiting the user’s ability to vomit, which is how the body would normally void itself of toxic levels of alcohol. 

Psychedelics

Unsurprisingly, since most strong psychedelics are illegal, interactions between them and other drugs haven’t been studied much. So, unfortunately, information on cannabis’ interactions with psychedelics will mostly have to come from anecdotal evidence.

When cannabis is combined with the classic psychedelics – LSD and psilocybin mushrooms – the THC will increase the intensity of the trip and its visuals. Some users enjoy this, and smoke cannabis as they’re coming down to extend the length of the trip’s peak. However, these intensified trips come at a price: a much higher chance of having a bad trip, which can include feelings of paranoia, impending doom, terrifying thoughts, and possibly even temporary psychosis or panic attacks. 

The dangers associated with psychedelics are mostly within the mind, they are sometimes more difficult to quantify and measure than the physiological dangers posed by other drugs. However, dangers posed to the mind are real dangers, and should not be taken lightly.

With every drug, user reports vary – some people have a great time combining salvia, DMT, cannabis, and LSD, according to one story, while many others find that cannabis almost instantly induces a bad trip. Some users say that for a period of time after taking LSD, smoking cannabis brings back certain elements of the trip. That’s something to watch out for, especially if your trip wasn’t a pleasant experience. 

There is less information available on cannabis’ relationship to other psychedelics. Mescaline and DMT work on the same receptors that are targeted by LSD and psilocybin, so it’s likely that cannabis interacts with them in a similar way. Overall, I strongly recommend against mixing cannabis and any psychedelic.

MDMA (Ecstasy)

Cannabis and ecstasy are frequently used together for two reasons: to enhance the effects of the ecstasy and extend the experience, and to help users get through the MDMA “hangover” that follows use. This hangover is often severe, with symptoms that may include anxiety, irritability, depression, mood swings, and paranoia. These result from a depletion of serotonin in the brain.

Cannabis does enhance the ecstasy high; but again, it doesn’t do this without a cost. Ecstasy inhibits long-term memory formation at the same time that cannabis reduces short term memory, which can lead to serious impairment while intoxicated. This combination may also cause long-term harm to the brain. Typically, if the user abstains for a period following their ecstasy use, the brain returns to normal. If the user continues to take these drugs consistently, though, recovery will take longer and the user may never return to complete normalcy. 

Both marijuana and ecstasy may be able to trigger mood disorders, and are more likely to do so when taking together. If you have a family history or personal history of such disorders, you should be extra careful to avoid this combination.

On a positive note, one study found that moderate use of cannabis while on ecstasy may reduce the user’s aggression and other symptoms. Cannabinoids can also prevent the acute hyperthermia that is caused by MDMA, which may make the drug somewhat safer when it is taken in hot, crowded clubs, raves, or festivals. This is potentially important, because high temperatures can worsen MDMA’s neurotoxic effects. High cannabis use alongside ecstasy did not show the same beneficial effects, and can increase the chances of the user becoming paranoid.

On the whole, there are indications that moderate cannabis use could help protect the user from ecstasy’s negative side effects. However, it will also cause significantly more short-term impairment, and could cause long-term problems. Until more real research has been conducted, we won’t have a complete picture of how these two drugs interact.

Dissociative Drugs

Cannabis’ relationship to dissociative drugs does not appear to have been the subject of many actual studies, so once again, we’ll have to rely on anecdotal evidence. Users say that cannabis can enhance the cognitive, visual, and hallucinatory effects of various dissociatives. They can also intensify internal hallucinations, as well as any holes/spaces/voids (if you’re unfamiliar with the term, a “hole” is an experience where the user dissociates to the point where he or she no longer receives real visual input; instead, they find themselves floating in a vast, perhaps infinite black space filled with shifting, morphing geometric structures).

Some users enjoy these experiences, while others find them uncomfortable or even terrifying. In addition to these effects and enhancements, cannabis use while using dissociatives creates an increased risk of confusion, delusions, and even psychosis.

As far as information regarding specific drugs go, there isn’t much. Some Reddit users claim that cannabis can take the edge off of a ketamine experience, while others say that it just contributes to confusion and paranoia. One erowid trip report states that after using cannabis and DXM together, the sensations of the DXM trip returned when he smoked cannabis the next day. For more anecdotal evidence regarding cannabis and any other drug, look for trip reports on the psychonaut wiki or erowid. For the time being, that’s some of the best information available.

Stimulants

Like other combinations of cannabis and illegal drugs, this hasn’t been well-researched. Information on cannabis combined with non-prescription amphetamines such as meth – which, for obvious reasons, I would not recommend taking at all, let alone mixing with cannabis or any other drug – is rare. While the trip reports I read ended well (compared to how it could have gone, anyway), they were full of extremely risky behavior and were quite alarming. Let’s leave it at this: just don’t do meth.

Perhaps simply because cocaine is a more popular and safer (but still not safe, by many standards) drug, there is more information available about mixing cocaine and cannabis. Unlike many other combos, some research was actually done on this one! Subjects in the study found that the cocaine high came on more quickly, and lasted around five times longer than it would have if taken on its own. That sounds like a good thing, if you’re into cocaine, but it also comes with an increased risk of heart problems. Severe cocaine overdoses can result in seizures, strokes, or heart attacks. Both cocaine and cannabis can cause tachycardia, and this effect is additive when both are taken at once, which increases the risk of a heart attack. Add in the fact that once again, adding cannabis to the mix increases the risk of paranoia, confusion, and drug-induced pyschosis, and this is a combo that’s best avoided.

The stimulant that is most commonly used in conjunction with cannabis is Adderall. Since Adderall is a legally prescribed drug, this combination has been more thoroughly studied. For information on this combo, continue on to part two of this article, which deals with cannabis and prescription drugs.

Heroin

I was unable to find any information on the combination of heroin and cannabis, save for two trip reports on erowid. One of these also included alcohol use, and the other involved taking such a large dose of heroin that he had to be revived from an overdose by EMTs. Neither accurately represents the effects of mixed cannabis and heroin. Since opiates are a depressant and cannabis sometimes also acts as a depressant, it’s likely that there is some risk of general CNS depression, which can lead to a host of severe, possibly fatal symptoms. Just don’t do heroin.

Parting Thoughts

Drugs, almost by definition, come with side effects. In combination with other drugs – even a drug as safe as cannabis – these side effects are often worsened. Some combos are much safer than others, and a few (like alcohol and cannabis) are so common that many users don’t even think about it. Unfortunately, there is a lot about drug interactions that we just don’t know, and while many of them remain illegal, it’s unlikely that much research will be conducted into the subject anytime soon. There could be other dangers that we are not currently aware of.

Personally, I recommend against mixing cannabis with any of the above drugs, with the exception of small amounts of alcohol. An additional danger that I have not discussed yet is cannabis’ potential to lower the user’s inhibitions. Several alarming trip reports that I read began with the writer taking alcohol, cannabis, or both, and then accepting an offer of harder drugs when they usually would have said no. That is a recipe for disaster. Whenever I drink or smoke, I make sure I never do anything that I wouldn’t do sober. If I’m on the fence, I go for the safer bet and assume that it’s a bad idea. Stick to that rule, and don’t ever combine two drugs if you haven’t taken each one independently first. If you’re going to do it at all, do some additional research, take reasonable doses, and be safe.

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