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Research Library

A-Z Conditions  Participate in ORR

Inhaled D9 -tetrahydrocannabinol does not enhance oxycodone-induced respiratory depression

  • Journal : British Journal of Anaesthesia
  • Publication Year : 2023
  • Authors : Cornelis Jan van Dam, Rutger van der Schrier, Monique van Velzen, Maarten van Lemmen, Pieter Simons, Kiki W. K. Kuijpers, Simone Jansen, Mikael A. Kowal, Erik Olofsen, Cornelis Kramers, Albert Dahan, and Marieke Niesters

Abstract

 

Background: In humans, the effect of cannabis on ventilatory control is poorly studied, and consequently, the effect of D9 -tetrahydrocannabinol (THC) remains unknown, particularly when THC is combined with an opioid. We studied the effect of THC on breathing without and with oxycodone pretreatment. We hypothesised that THC causes respiratory depression, which is amplified when THC and oxycodone are combined.

 

Methods: In this randomised controlled crossover trial, healthy volunteers were administered inhaled Bedrocan® 100 mg (Bedrocan International B.V., Veendam, The Netherlands), a pharmaceutical-grade high-THC cannabis variant (21.8% THC; 0.1% cannabidiol), after placebo or oral oxycodone 20 mg pretreatment; THC was inhaled 1.5 and 4.5 h after placebo or oxycodone intake. The primary endpoint was isohypercapnic ventilation at an end-tidal PCO2 of 55 mm Hg or 7.3 kPa (VE55), measured at 1-h intervals for 7 h after placebo/oxycodone intake.

 

Results: In 18 volunteers (age 22 yr [3]; 9 [50%] female), oxycodone produced a 30% decrease in VE55, whereas placebo was without effect on VE55. The first cannabis inhalation resulted in VE55 changing from 20.3 (3.1) to 23.8 (2.4) L min1 (P¼0.06) after placebo, and from 11.8 (2.8) to 13.0 (3.9) L min1 (P¼0.83) after oxycodone. The second cannabis inhalation also had no effect on VE55, but slightly increased sedation.

 

Conclusions: In humans, THC has no effect on ventilatory control after placebo or oxycodone pretreatment.

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