How to Talk to Your Doctor About Cannabis

People use cannabis for many reasons: pain, anxiety, sleep, relaxation, or simply recreation. Whatever the reason, if you use cannabis, your doctor should know.

Cannabis can affect multiple body systems, including heart, brain, and liver functions, and may interact with prescription medications. When your care team is aware, they can account for it in medication decisions and procedure planning.

If bringing up your cannabis use to your doctor makes you feel nervous or uneasy, let’s look at a straightforward way to approach the discussion.

How to Talk to Your Regular Doctor

Start with a clear, straightforward statement.

For example: “I use cannabis for sleep and pain. I want to make sure it is safe with my medications and health history.”

Americans for Safe Access suggests coming prepared with specific details so your doctor can assess potential interaction or other risks.

Be ready to explain:

• What symptoms you’re treating
• When you started using cannabis
• How much you use
• How often you use it
• How you consume it
  

That can be as simple as:

“I take an edible most nights. I use it to help me fall asleep and to take the edge off pain. I usually feel the benefit within a couple of hours. I sometimes feel groggy the next morning. I want to make sure it is not clashing with my prescriptions.”

A plain-language description gives your clinician what they need without you having to speak in cannabis jargon.

If your doctor asks why you use cannabis, that is usually a clinical question, not judgment. When doctors know the symptoms you’re treating, they can help address the underlying issue more effectively.

If Your Doctor is Cautious or Resistant

Unfortunately, some physicians aren’t knowledgeable about cannabis products or have strongly held biases.  However, as a patient, you have options and the right to expect a shared goal with your medical provider of safety and health monitoring. 

In this case, you can direct the conversation with safety-centered questions, such as: “Are there interaction risks I should be aware of?” or “Does my cannabis use change anything about my treatment plan?

Ideally, your relationship with your medical team should be a partnership that promotes open exchange about your conditions and concerns. You rely on your physician’s knowledge, and if there are gaps in their understanding about cannabis and health, you have the prerogative to seek another opinion. 

Cannabis and Medication Interactions

If you use cannabis regularly, it’s something your doctor should know, especially if you take prescription medications.

Many medications are processed by enzymes in the liver that control how long the drug stays active in your body. THC and CBD can influence those enzymes, which may raise or lower medication levels. 

If the body processes a drug more slowly, levels can build up, and side effects may increase. If it processes the drug faster, the medication may wear off sooner.

When your clinician knows your cannabis routine, they can spot changes in how your prescriptions are working and adjust safely if needed. If your cannabis use is steady, using the same doses and product types, your clinician can adjust and monitor more effectively.

One commonly cited example involves Warfarin. THC and CBD may affect how Warfarin is metabolized, which potentially increases bleeding risk.³ That doesn’t mean the combination is off-limits. Still, your clinician will likely want to closely monitor your cannabis dosage, since switching products or changing your dose can alter blood-thinning effects.

Your doctor may recommend extra caution with medications such as certain antidepressants, anti-anxiety medications, anti-seizure drugs, statins, heart rhythm medications, and some chemotherapy treatments. Always check with your doctor or pharmacist before combining cannabis with any new or existing medication.

How To Talk To Specialists and Special Considerations

Talking with your primary care physician is the first step. If your treatment involves other specialists, inform them.

Cannabis can affect several body systems, including the heart, lungs, and brain. If you’re using cannabis alongside medications that cause drowsiness, mention it. Combining sedating substances is a common reason people feel foggy or dizzy.

• For pain management, talk in real-world terms. Instead of focusing only on a pain score, describe what changes day to day, like fewer flare-ups, better sleep, or being able to stay on your feet longer. 
• For cardiology and related care, disclose use and any symptoms you notice around cannabis use, especially changes like heart rate, blood pressure, and how you feel during exertion.
• For mental health care, be open about cannabis use because cannabis can influence mental health symptoms. Sharing the effects of cannabis on your mood, anxiety, or sleep, whether positive or negative, can aid your psychiatrist in coordinating your treatment. 
• For lung or sleep specialists, inhaled use matters because of potential respiratory effects.¹ 

When You Should Discuss Cannabis With Your Doctor

A good rule is to bring it up anytime cannabis could change a medical decision. It can be unsafe for a clinician to prescribe a medication or perform a procedure if they don’t know cannabis is in the mix.

It’s best to tell your doctor if you start or stop using cannabis, if you change how much you use, if you change or add cannabis products like smoking or edibles, and if you notice side effects that feel new or stronger than expected. 

The Anesthesia Conversation: When Talking is a Must

If there is one time you should not downplay cannabis, it is before a procedure involving sedation or anesthesia.

The conversation with your anesthesiologist should be simple and direct: 

“I use cannabis. Here’s how I use it, how often, and when I last used it.”

Your surgical team needs to know because cannabis can affect anesthesia medications. Always disclose your cannabis use during your preoperative evaluation.  

Regular users may require higher doses of anesthesia medications to achieve the same level of sedation. Your anesthesiologist must know what type of cannabis products you use (smoking, edibles, etc) and how often you use them. Without this information, it’s possible to underestimate the amount of anesthesia you’ll need. With it, they can change your anesthetic plan and medication to keep you comfortable during the procedure.

It’s best to skip cannabis completely on the day of surgery. The effects of cannabis can increase the risk of complications. Smoking cannabis, especially within hours of the procedure, can increase the risk by increasing your heart rate or blood pressure. Using edibles on the day of a procedure can violate fasting rules, which increases the risk of choking or stomach contents entering the lungs during sedation.

Doctor-Patient Confidentiality

If you’re concerned about who can access your medical information, conversations with your doctor about cannabis are generally protected under HIPAA, the federal Health Insurance Portability and Accountability Act.

If you are concerned about privacy, you can ask directly:

“Is this conversation protected under medical confidentiality?”

Most clinicians will confirm that it is. If you are concerned about your specific circumstances, check with an attorney.

Your cannabis use is considered part of your medical information. Your doctor cannot disclose your cannabis use to:

• Your employer
• Law enforcement
• Family members
• Anyone else without your permission, except in specific legal situations.

When Confidentiality May Not Apply

There are limited exceptions where doctors are required to disclose information. These include:

• If you express intent to harm yourself or others
• If there is suspected abuse or neglect (child, elder, dependent adult)
  If a court issues a valid legal order
• In certain public safety situations
  

Simply using cannabis, even in a state where it remains illegal, does not automatically trigger reporting. 

What About the VA?

If you receive care through the VA, your cannabis use can be documented in your medical record, but VA providers do not report it to law enforcement. They may not prescribe cannabis, but disclosure is still protected as part of your medical record.

What About Employers?

Your doctor cannot report your cannabis use to your employer.

However:

• Employers may still conduct drug testing under workplace policies.
• A positive test result does not come from your doctor reporting you. It comes from the test itself. These are separate systems.

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.