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Many patients use cannabis (THC), CBD, or hemp products for relaxation, pain relief, or other health reasons.
However, these substances can affect your body’s response to anesthesia and medication during oral surgery. They may influence your heart rate, blood pressure, sedation needs, and how certain drugs work.
Letting your surgical team know what you use, how often, and when you last used it allows us to plan your care for the safest possible outcome.
Table of Contents
- Why Disclosure Matters
- What Current Guidelines Say About Timing
- Using Cannabis or CBD After Oral Surgery
- Pre-Op Information We Will Ask For
- Our Recommendations
- Book an Appointment with Foley & Le in Boulder, CO
- FAQ
Why Disclosure Matters
Telling us about cannabis or CBD use helps us plan anesthesia safely.
- Anesthetic dose can change: Regular cannabis users often require more IV sedation or general anesthesia than nonusers, including higher propofol doses, across endoscopy, hospital, and oral/maxillofacial surgery settings. (1)
- Airway and heart effects: Cannabis, especially when smoked, can increase heart rate and blood pressure and is linked to airway reactivity such as wheezing and sputum. These factors influence monitoring, breathing support, and drug choices. (2)
- Medication interactions (CBD included): Cannabinoids can inhibit CYP450 enzymes, which may raise or lower levels of sedatives, pain medicines, and other prescriptions. Share your products and doses so we can adjust safely. (3)
What Current Guidelines Say About Timing
Timing your last use matters for anesthesia safety and recovery.
- Day‑of‑surgery smoking: ASRA Pain Medicine recommends delaying elective surgery at least 2 hours after smoking cannabis and postponing if you are intoxicated or have altered mental status.
- Broader pause before anesthesia: The American College of Surgeons advises stopping marijuana products for about 72 hours before surgery. Daily users may benefit from a longer pause; discuss this with your surgeon. Ideally patients stop any THC use for at least 2 weeks prior to surgery.
- Our office policy: Please do not arrive under the influence, we will decline to treat you and you will be charged a cancellation fee. Tell us what you used, how much, and when you last used it (smoked, vaped, edibles, tinctures, topical). We will individualize your plan based on frequency, product type, and procedure.
CBD Interactions
CBD does not cause a “high,” but it can still affect how your body processes common dental and anesthesia medications. It may interact with sedatives (such as midazolam or diazepam), certain pain medicines, and some NSAIDs through CYP enzyme pathways.
Depending on the dose and frequency, CBD can increase sedation or change how long medications stay active in your system. Always share the brand, strength (mg), form (gummies or oil), and timing of your CBD use with your surgical team.
Using Cannabis or CBD After Oral Surgery
Your recovery plan may need to account for cannabis or CBD use.
- Pain control: Some patients turn to THC or CBD for pain, but research on effectiveness is mixed. Chronic users may actually report higher postoperative pain and need more pain medication. We will work with you on a multimodal plan that may include ice, acetaminophen, NSAIDs (if appropriate), Exparel (long lasting local anesthetic) and prescription medication when needed.
- Smoking or vaping: Avoid smoking or vaping during the first 6 weeks of the healing period. The heat and suction can disturb the blood clot and irritate tissues. Edibles or tinctures avoid smoke exposure, but timing should still be discussed with your surgeon to prevent drug interactions. If you choose to use THC products in the first 6 weeks please use edibles or tinctures
- Nausea: Cannabis can help with nausea in some people, but heavy use can make it worse. Share your history so we can choose the best anti-nausea medications for you.
Pre-Op Information We Will Ask For
We gather detailed information so we can plan the safest anesthesia and recovery for you.
- Type and route: Flower, vape, concentrates, edibles, tinctures, topicals; CBD-only or THC/CBD ratio.
- Frequency and last use: Daily, weekly, monthly; exact time of last dose.
- Dose and brand: Amount of THC or CBD per serving and number of servings.
- Effects you notice: Anxiety relief, nausea control, sleep aid, or other effects.
- Other medications or supplements: Especially sedatives, antidepressants, anticoagulants, or pain medicines.
This information allows us to anticipate dose needs and reduce the risk of complications.
Our Recommendations
We follow evidence-based guidelines for patient safety.
- Be open with your team: There is no judgment, our goal is your safety.
- Pause use before surgery: At a minimum, avoid same-day smoking or vaping (ASRA recommends at least 2 hours). Many patients, especially daily users, should pause for 24–72 hours. However, our strong preference is that patients do not use for 14 days prior to surgery.
- Bring your products or labels: This helps us confirm strengths and ingredients.
- Post-op precautions: Avoid smoking or vaping until your surgeon says it is safe. Always ask before restarting cannabis or CBD, especially if you are taking prescription pain medicine or antibiotics.
Following these recommendations can make your anesthesia safer, reduce complications, and help you recover more smoothly.
Book an Appointment with Foley & Le in Boulder, CO
Whether you need wisdom tooth removal, dental implants, or another oral surgery procedure, our team is here to provide safe, personalized care from start to finish.
To book an appointment at our oral surgery office in Boulder, CO, call (303) 444-2255 or visit us at 1420 28th St, Suite 100, Boulder, CO.
FAQ
Some patients choose cannabis products for pain relief, but you should discuss timing and dosage with your surgeon. Smoking or vaping is strongly discouraged early on due to its effect on healing and oral health. Edibles or tinctures may be safer from a wound-healing standpoint, but they can still interact with medications.
Studies show regular cannabis users often require higher anesthetic requirements, especially for IV sedation or general anesthesia. Your anesthesia plan will be adjusted to keep you safe and comfortable.
Recent use can increase surgical risks, including heart rate changes, blood pressure spikes, and airway reactivity. These risks are why disclosure and proper pre-surgery timing are important.
Smoking cannabis can irritate tissues, delay healing, and increase the risk of infection. Even non-smoked cannabis products can influence medication effects, so it’s important to coordinate use with your surgeon.
References
- Ripperger D, Atte A, Ritto F. Cannabis Users Require More Anesthetic Agents for General Anesthesia in Ambulatory Oral and Maxillofacial Surgery Procedures. J Oral Maxillofac Surg. 2023 Dec;81(12):1460-1465. doi: 10.1016/j.joms.2023.09.008. Epub 2023 Sep 14. PMID: 37783364.
- Echeverria-Villalobos M, Guevara Y, Mitchell J, et al. Potential perioperative cardiovascular outcomes in cannabis/cannabinoid users. A call for caution. Front Cardiovasc Med. 2024;11:1343549. Published 2024 Jun 21. doi:10.3389/fcvm.2024.1343549
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos. 2021;49(12):1070-1080. doi:10.1124/dmd.121.000442
