After having a nice long chat with a nice lady from a CBD group on Facebook, she told me her quick story about how she used to be on pain killers (opioid – Percocet, morphine, etc) from injuries received from a car crash.

Even though Rick Simpson Oil (RSO) is illegal in Idaho, she graciously gave me a link to a recipe she used to create her own RSO at home.

RSO is potentially one of the absolute best-known cannabis oil I’ve heard of that helps all sorts of people live an active healthy lifestyle.

What makes RSO illegal in Idaho is the HIGH concentration of THC, plus a whole lot of other cannabinoids.

RSO is meant to be used in extreme situations that require the absolutely most powerful cannabis oil on the market.

Even though Idaho residents can’t legally access RSO in 2020, the second-best option is a broad-spectrum CBD oil such as Joy Organics.

I’m always on the hunt to find a “better” CBD oil to recommend to Idaho residents.

After spending years scouring the internet and having INTENSE emotional debates with others as to what is the absolute best CBD oil for Idaho residents.

I keep coming back to Joy Organics for very specific reasons.

Why I continue using Joy Organics is primarily because their CBD oil is legal in Idaho in 2020, their consistent quality, and also their consistency in maintaining absolutely zero THC – while still retaining a broad spectrum CBD oil.

So, after finding the best legal CBD oil in Idaho, the most important question is a question of safety.

Is CBD safe to take with other pain killers or does it cause any adverse reactions due to interacting with other medications?

Let’s find out below.

The Journal Of Addiction Medicine (J Addict Med) performed a double-blind study of the safety of taking oral CBD (cannabidiol) with high-potency opioids – such as intravenous fentanyl, morphine, and other opioids. In this placebo-controlled cross-over study, they tested volunteers between 21-65 years of age, throughout several sessions. What they found was that CBD did not exacerbate any adverse effects with co-administering the CBD with intravenous fentanyl. Their final conclusion was mixing both CBD and opioids was quite safe and very well tolerated among the patients in the study. 

Does CBD interfere with medications?

CBD can interact with some medications for very specific technical reasons.

After reading through the medical journal called Medicines, to take a deep dive into medical cannabis and the various potential drug interactions to be aware of and careful with.

In this journal, they describe what the human endocannabinoid system (ECS) is, how implementing cannabinoids can return various physiological processes back to normal function, as well as modulating negative effects from certain pills.

They go on and report that cannabinoids are generally very well tolerated — up to pretty high doses — however, certain undesirable effects can occur with various membrane transporters and enzymes using in metabolism. Membrane transporters affected can include glycoprotein p, multidrug-resistant proteins, breast cancer resistant proteins, and more.

The certain metabolizing enzymes potentially affected by CBD are cytochrome P450 and UDP-glucuronosyltransferases.

Medicines medical journal recommends extreme caution when taking certain medications.

Special extra caution is also recommended for elderly individuals and those the chronic diseases, as well as those who have liver and/or kidney issues.

How does CBD interact with some drugs?

When taking certain medications that are co-administered with CBD and other cannabinoids can cause chemical reactions or modifications of various biochemical pathways in the metabolization of drugs. 

There are three potential drug interactions that are additive, synergistic, or antagonistic.

This means various potential drug interactions CBD can have can either enhance the responsiveness of the drug, modify the other drug, or produce an unexpected adverse reaction. 

The more specifics of how the specific mechanisms of the various drug interactions go into extensive detail.

Other certain drug interactions of taking CBD with certain drugs cause alterations in the absorption of the other drug, distribution alterations, metabolism alterations, excretion alterations, and potentially more. 

Does CBD enhance opioids?

According to Postgraduate Medicine (Postgrad Med), CBD had the potential to reduce the use of opioids and help return normal body feelings, improved lifestyle, as well as helping normal sleep patterns.

Since CBD appears to have a higher safety profile than opioids, more people are starting to try CBD as an alternative to opioids. Opioids ten to have well documented adverse effects.

Is CBD better than opioids?

What drugs should not be taken with CBD?

On the government website, the U.S. National Library Of Medicine provides a large list of medications in categories of major and moderate.

Major interactions are specific drugs you should absolutely not combine with CBD.

Whereas the moderate CBD drug interaction list recommends caution when combining specific drugs with CBD.

Major drug interactions with CBD include:

  • Clobazam
  • Valproate

Moderate drug interactions with CBD include:

  • Brivaracetam (Briviact)
  • Eslicarbazepine (Aptiom)
  • Everolimus (Zostress)
  • Medications changed by the liver (Cytochrome P450 1A1 (CYP1A1) substrates)
  • Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)
  • Medications changed by the liver (Cytochrome P450 1B1 (CYP1B1) substrates)
  • Medications changed by the liver (Cytochrome P450 2A6 (CYP2A6) substrates)
  • Medications changed by the liver (Cytochrome P450 2B6 (CYP2B6) substrates)
  • Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
  • Medications changed by the liver (Cytochrome P450 2C8 (CYP2C8) substrates)
  • Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
  • Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
  • Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
  • Medications changed by the liver (Cytochrome P450 3A5 (CYP3A5) substrates)
  • Medications changed by the liver (Glucuronidated drugs)
  • Medications that decrease the breakdown of other medications by the liver (Cytochrome P450 2C19 (CYP2C19) inhibitors)
  • Medications that decrease the breakdown of other medications in the liver (Cytochrome P450 3A4 (CYP3A4) inhibitors)
  • Medications that increase the breakdown of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers)
  • Medications that increase the breakdown of other medications by the liver (Cytochrome P450 2C19 (CYP2C19) inducers)
  • Rufinamide (Banzel)
  • Sedative medications (CNS depressants)
  • Tacrolimus (Prograf)
  • Topiramate (Topamax)
  • Zonisamide
  • Herbs and other supplements with sedative properties; calamus, California poppy, catnip, hops, Jamaican dogwood, kava, L-tryptophan, melatonin, sage, SAMe, St. John’s wort, sassafras, skullcap, and others
  • Fats and fat-containing foods

What’s interesting to observe from this list are medications that breakdown in the liver.

Since CBD is also broken down by the liver, it might alter how the liver breaks down other medication, as well as CBD which can produce potentially undesirable effects.

And also may increase the effects of CBD or potentially the other medication.

In conclusion

It appears, from anecdotal information from personal stories, in addition to various medical journals – it appears there’s no real negative effect of taking both opioids and CBD.

As always, it’s best to speak with your primary healthcare provider who is well versed and has extensive experience with CBD and other cannabinoids.