Wondering if CBD is safe to use before & after surgery? Board certified plastic surgeon Dr. Emily Kirby explains why you may need to rethink this popular product. Individuals scheduled for surgery should always disclose their CBD or cannabis use to the surgeon & anesthesiologist who would handle the procedure. Learn more. Thinking of using CBD to manage anxiety prior to surgery? Get the facts on what the research suggests.
CBD Oil Before / After Surgery Safe?
While some states are slowly adopting more lenient laws regarding the recreational use of marijuana, it is a byproduct of this plant that seems to be taking the country by storm. Whether it is tinctures to manage physical pain and anxiety, or topical creams and smokeable “joints,” CBD appears to be the latest “cure-all” craze—and users are flocking to pharmacies and pop-up dispensaries in droves.
CBD is considered to be generally safe by many, but the popularity of the product has far surpassed current regulation. Unregulated, synthetic products should be avoided entirely and even regulated CBD should not be taken immediately before or after surgery.
As a physician, I must weigh the popularity vs. the published research for medical and health-related products. While CBD oil does appear to have potential as an effective treatment for some people, it’s important to know the possible risks before using or consuming CBD.
I have recently had some patients ask about using CBD oil before and after elective surgery, and I want to clear a few things up to ensure that patients have a safe surgery and recovery.
What is CBD?
Cannabidiol (CBD) is one of the main extracts of the marijuana plant, second only to tetrahydrocannabinol (THC, the psychoactive component of marijuana). While it has experienced a boom in popularity over the last few years, this derivative from the hemp plant has a long history, with documentation of therapeutic use dating back to 2737 BC.
There are a number of studies that suggest that CBD can be a powerful alternative for managing epilepsy, insomnia, and mental health disorders, however, the popularity of the product has far surpassed current research on its effectiveness.
Is CBD legal in Texas?
Earlier this summer, Governor Greg Abbott signed a bill making the production of hemp and hemp-derived CBD legal in Texas. While producing and purchasing CBD products is now technically legal, many available products are still unregulated and could contain more or less CBD than advertised, have undisclosed ingredients, or could be concocted with synthetic cannabinoids. Commonly found in gas stations and convenience stores, synthetic cannabinoids are completely unregulated and pose significant risks.
CBD may now be legal, but that doesn’t mean it’s safe: the FDA has issued a warning about synthetic, contaminated CBD products.
Just because a product is legal does not mean it is guaranteed to be safe. The FDA released a warning last year about the health risks of synthetic cannabinoid products, which were found to be contaminated with the rat poison brodifacoum. After ingesting these products, many people experienced vomiting, increased heart rate and blood pressure, and even violent behavior and suicidal thoughts. Synthetic cannabinoids have now been linked to severe, uncontrolled bleeding and death. Hundreds of people across several states have been affected negatively by CBD products.
Should I stop taking CBD before cosmetic surgery?
CBD is used widely in the self-management of pain and anxiety, so many patients wonder if they can ingest CBD oil drops or tinctures before their cosmetic procedure and during their recovery. CBD products should not be taken in the days before or after surgery.
We have an incomplete understanding of how CBD interacts with other medications and how it may impact our body systems, but research has found that it has an anticoagulant effect, which puts patients at risk for increased bleeding during and after surgery. Abundant or easy bleeding after surgery can result in the need to return for another, unanticipated surgery to correct the bleeding problems, asymmetry, and tissue death after surgery.
Just as I ask patients to stop taking herbal supplements, vitamins, and nicotine (and even seemingly harmless beverages like green tea) to ensure there are no problems with anesthesia or increased bleeding, CBD products should be stopped two weeks prior to surgery.
CBD products also have a potent reaction with an enzyme system in the liver that can prevent other medications—such as anesthesia medications or prescription pain killers—from using the same system, leading to a build-up in your system and preventing the medications from doing their job.
The unregulated nature of CBD means that dosing has not been defined and that different brands offer a wide variety of strengths available for purchase. The current state of the CBD industry is like the wild west of supplements, and without truly scientific data, we must err on the side of caution.
Can I smoke weed before surgery?
I encourage patients not to smoke anything before a procedure. Many patients falsely believe that smoking marijuana is a safer choice than cigarettes, which is not true—particularly when it comes to surgery. Smoke of any kind in the lungs can lead to respiratory distress, and marijuana itself can interfere with anesthesia, leading to a higher risk of pneumonia after surgery and a higher risk of airway emergencies. Much like nicotine, smoking marijuana before or after surgery delays the healing process and causes poor scarring of your surgical sites. If you live somewhere where marijuana is legal, edibles are a better choice for eliminating the respiratory problems, however, be sure not to eat past the allowed time before surgery.
It’s crucial to be transparent with your physician; we’re not here to judge, but rather to keep you safe
Before any procedure, it’s important that you share any medications, herbal supplements, or vitamins you take regularly with your surgeon, in addition to information about lifestyle habits like drinking, smoking, and drug use.
As a board certified plastic surgeon, my job is not to pass judgment on your personal decisions or lecture you. However, once you are in my operating room, my ability to perform your procedure safely is very much affected by what you put in your body and whether or not you share that information with me. Something as seemingly innocent as CBD oil drops can lead to surgical complications that can, in turn, impact your wellbeing and your results.
If you are ever unsure about what you can or cannot take prior to surgery, please contact your surgeon for their specific pre-op and post-op instructions.
CBD Oil Before Surgery – August 2022
Is CBD Oil Safe and Beneficial to Take Before Surgery?
Individuals scheduled for surgery should always disclose their CBD or cannabis use to the surgeon and anesthesiologist who would handle the procedure.
Also, patients should ask the presiding surgical doctor if they should be ingesting any cannabinoid at all, and take that advice seriously.
CBD for Anxiety
Some people may be interested in using CBD to manage anxiety before surgery. This interest is understandable since the compound has been shown to possess anti-anxiety characteristics that might benefit those who are anxious about an upcoming operation.
A study published in the Journal of Psychopharmacology found that CBD decreases anxiety levels in individuals with a social anxiety disorder (SAD) with results indicating that, relative to placebo, CBD was associated with significantly decreased subjective anxiety (1 ) .
In the said study, the brain scans showed that CBD regulates chemical uptake and blood flow in the brain.
CBD can help people with anxiety disorders by impacting the CB1 cannabinoid receptors in the brain and modifying the signaling process of serotonin (the “feel-good” chemical) receptors.
However, note that taking CBD too close to a surgery schedule could pose risks, especially since many doctors still do not quite understand the full effects of CBD oil.
CBD vs Anticoagulants
Individuals on any anticoagulant (blood thinner) medication should altogether avoid taking CBD or any cannabis-related product long before going to surgery.
Blood coagulation studies show that CBD showed mild anticoagulating effects (2 ) . Research indicates that CBD can potentially exacerbate bleeding after surgery and slow down wound healing, especially for those who suffer from any clotting disorder.
Whenever one takes CBD or any medicine, it passes through the digestive system to the liver, where an enzymatic pathway, called the cytochrome P450 (CYP450) family of enzymes, metabolizes or breaks down the substance ingested.
Liver enzymes CYP450 process about 60% of all medications, including blood thinners, like warfarin. When used with blood thinners, CBD may decrease how quickly the liver breaks down some medications.
In theory, taking CBD, along with some pharmaceuticals that are broken down by the liver, may increase the concentration and side effects of the drug (3 ) .
A 2017 study showed that CBD is broken down further via the same liver pathways as most prescription anticoagulants (4 ) .
This metabolism is dose-dependent but can affect the potency of the drug. Therefore, those who are taking prescription blood thinners should always consult with their doctor before starting a CBD regimen.
Patients should insist on regular blood checks, as CBD and cannabis can decrease the degradation of the drugs (such as warfarin) in their body, and doses should be adjusted accordingly.
Taking CBD in conjunction with anticoagulants can cause serious complications that may put an individual’s health or life at risk.
CBD vs Anesthetic Risk
Anesthetic risk has many variables and is often related to one’s unique medical issues and specific surgery.
Individuals who use cannabis products do so in many ways, forms and amounts. Thus, CBD’s effect on the body is difficult to predict when combined with a wide variety of anesthetic agents and techniques.
Currently, there is not enough evidence to say that cannabis alone increases one’s anesthetic risk when stopped at an appropriate time.
Still, it is recommended that one abstains from cannabis use as long as possible before surgery.
Below is the minimum time a patient would be expected to stop before receiving an anesthetic, as suggested by the Royal Victoria Regional Health Centre of Canada (5 ) .
|Cannabidiol (CBD)||Cannabis (Marijuana)|
|Oral Dosing/Ingested: Stop 4 hours before surgery||Ingested: Stop 12 hours before surgery|
|Smoked/Vaporized: Stop 12 hours before surgery|
The attending anesthesiologist has a legal obligation to provide patients with the safest care possible during surgery.
However, there may be rare occasions when surgery is delayed, postponed, or canceled at the doctor’s discretion.
Still, under no circumstances shall anyone intoxicated (affected by any drug or alcohol) can receive an anesthetic for non-emergency surgery.
With CBD’s numerous purported therapeutic characteristics, there are several ways that it may benefit individuals in the days before surgery.
However, most experts would suggest avoiding CBD in the hours before a surgical procedure, the same time a doctor recommends avoiding other medications, beverages, and foods.
Thus, those who use CBD regularly or took any CBD in the days before surgery must inform their doctor and their anesthesiologist first.
On the other hand, those who are looking to try CBD for the first time must only do so after consulting with a doctor experienced in cannabis use.
CBD Oil Before Surgery: Is it safe? 5 minute breakdown (2022)
Is taking CBD oil before surgery a good idea? In this article, we outline what many surgery patients who use CBD want to know.
Even though the World Health Organization seems to support the widely accepted, positive safety status of cannabidiol, users of CBD products should still practice caution when using new wellness supplements, especially alongside other medications or treatments.
Because of the way that CBD interacts with some medications, it’s crucial that users take the time to look into how CBD products can affect other aspects of your wellness routine or required medical treatments. One of the most important considerations is the use of CBD oil before surgery.
If you’re wondering “Should I stop taking CBD oil before surgery?” you’re in the right place. Let’s take a look at what the research says, as well as some expert opinions, on how CBD may affect your pre-surgical routine.
CAN I TAKE CBD OIL BEFORE SURGERY?
Various studies have verified that CBD is safe, and CBD’s safety profile is generally well-rounded. Still, researchers are aware that cannabidiol interacts with multiple medications, which may complicate things when surgical anesthesia or other necessary medications become part of the picture.
So, can you take CBD before surgery?
Here’s what we know:
Many sources suggest that you shouldn’t take much of anything, including water, before surgery to prevent serious complications, like aspiration, increased risk of infection, increased heart rate, or sudden nausea and vomiting.
When you go in for a surgical procedure, you’ll often fill out a form or be verbally assessed regarding your use of opioids or other medications. That’s because certain medications can affect the anesthesia, in some cases making it totally ineffective.
Alternatively, frequent use of some medications may not render the anesthesia completely useless, but your anesthesiologist should know so that he or she can adjust your dose based on your tolerance.
Many sources suggest that CBD falls into line with these ideas. Dr. Perry Solomon, MD, suggests that CBD oil is safe to take in the days prior to scheduled surgery under certain conditions.
For instance, research shows that CBD may also have anti-coagulant effects, meaning it may do the same job as traditional blood thinners. According to Dr. Solomon, CBD may be okay to take before surgery as long as you aren’t taking other medications that may interact with CBD, like blood thinners.
However, Dr. Solomon also says that you should “observe the instructions by whoever calls you from the hospital regarding what time to stop eating and drinking fluids,” making sure you don’t take CBD after that time either.
In short, CBD may be safe to use up until you should discontinue other medications, food, and beverages. This is true for edible CBD items, like CBD Gummies, and other types of CBD products, like oils, capsules, or vaporizers.
Just like with opioid medications, you should inform your doctor and your anesthesiologist about your CBD use.
According to Dr. David Hepner, MD, MPH, this communication is crucial. He states in a Harvard Health publication that traditional cannabis use can alter the amount of anesthesia mediations needed during surgery by more than 300%.
Even though CBD alone may not cause the same resistance to anesthesia as THC, you still want your anesthesiologist to be prepared to increase your dose if needed. That means you should keep track of exactly how much CBD oil you take and when you take it so that you can give accurate information to the doctor.
Many people are interested in using CBD to manage anxiety prior to the surgery, but most research suggests that taking CBD too close to your surgery could pose risks, especially since many doctors don’t quite understand the full effects of CBD oil yet.
Of course, using CBD after surgery may be a different story, and may actually pose an even greater range of benefits than as a pre-operative supplement.
BENEFITS OF CBD OIL FOR POST-OPERATIVE RECOVERY
So what about taking CBD oil after surgery? After most surgical procedures, your doctor will send you home with some sort of prescription to help aid the recovery process and manage pain in the days after your surgery.
According to Dr. Solomon, CBD may help the recovery process as well. He suggests that a 1:1 CBD:THC tincture may even be an appropriate replacement for opioids to manage post-recovery pain.
CBD also has benefits when used on its own, and according to Dr. Solomon, “as an anti-inflammatory, it may even help with your wound healing.”
Research about the cannabinoid is limited. However, there is some evidence that suggests cannabidiol has many effects that may make it useful for managing post-operative discomfort and aiding recovery.
Like our expert suggested, cannabidiol has been linked to powerful anti-inflammatory effects, which is why many people use it for managing conditions like arthritis. CBD may help inhibit the inflammatory response by binding with certain neuroreceptors to prevent signals of inflammation from reaching the brain.
Research shows that it works in nearly the same way to help prevent pain signals from reaching the brain, too, which means CBD could be useful for managing pain after your surgery.
Different types of cannabidiol applications may help with these symptoms, and CBD topicals may be an effective option for managing postoperative recovery due to the way CBD interacts with the Endocannabinoid System in the skin.
The side effects of surgery vary depending on unique biological characteristics, medications you take, or the type of surgery you had. However, nausea, vomiting, and loss of appetite are common after many surgical procedures, especially in those who suffer from one of many chronic health conditions. Studies show that CBD is an effective treatment for regulating nausea and vomiting.
Fatigue, another common surgery side effect, may be managed with CBD oil, too. Studies show that cannabidiol has wake-promoting effects, and many people take CBD alongside their coffee to help boost their focus during the day.
Experts also suggest that in larger doses, cannabidiol may even work as a sort of sleep aid. Studies show that CBD may be useful for managing insomnia, especially if sleeplessness is caused by anxiety, inflammation, or pain. Alternatively, other cannabinoids (like CBN) have been linked to sleep benefits that may be useful.
Consult your Doctor about using CBD before surgery and/or after surgery. While your doctor may prescribe medication for any of your post-operative symptoms, many people turn to cannabidiol instead because of its low potential risks.
When compared to most prescription medications, especially narcotics like opioid medications, the side effects of CBD are considerably mild and rare.
For most people, CBD provides the right amount of post-operative relief from anxiety, inflammation, pain, and more, without the same adverse side effects of many prescription options.
TALK TO YOUR DOCTOR ABOUT USING CBD OIL BEFORE OR AFTER SURGERY
As you can see, there are several ways that cannabidiol may benefit you in the days before or after your surgery, but most experts would suggest avoiding CBD in the hours before a surgical procedure, the same time your doctor recommends avoiding other medications, beverages, and foods.
If you use CBD regularly, or took any CBD in the days prior to your surgery, be sure to inform your doctor and your anesthesiologist.
If you want to reap the many benefits of CBD after your surgery, there are multiple different ways to consume CBD that may work for you. Just be sure that you always talk about plans to change your wellness routine with your doctor, especially if you are going to use CBD products in place of any prescription medications.
If you’re interested in taking CBD before or after surgery, make sure you check out our article Common CBD Oil Side Effects and How to Avoid Them.
For premium CBD that fits seamlessly into your wellness routine, be sure to check out our in-house brand, Vida Optima.
Have you used CBD before or after surgery? Let us know how you used it and how it worked for you in the comments!