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In this Your Healthy Family, any time you interact with a doctor, it’s vital for your own good that you are honest with them when talking about your lifestyle and habits - whether you're there for an annual physical or because of an illness. But it’s especially important when it comes to having surgery under anesthesia.
Dr. Jennifer Kollman is the senior medical director of anesthesia for UCHealth’s southern Colorado region. Talking with patients prior to surgery about whether they use drugs has long been common practice, particularly when it comes to marijuana, because regular or heavy users may need much more anesthesia than normal during their procedure.
Users might also have a tougher time with pain management after surgery.
The American Society of Regional Anesthesia and Pain Medicine recently published guidelines recommending that patients undergoing anesthesia be asked about cannabis use – how much they use, whether they ingest or smoke it, and how often.
Kollman said she’s noticed that the legalization of marijuana in Colorado has made patients a bit more truthful when she asks them about use in preoperative discussions.
Dr. Kollman tells me: “I don't think the way that we approach the topic (of marijuana use) has changed, but what has changed is that people are a little more willing to let us know and to be honest about it. I've always told people that I don't really care what it is that they use. What I care about is taking good care of them. If they let me know what they've been using and how much, I can adjust my medications to make sure that they have the best anesthetic possible.”
While for many there is stigma around discussing drug use even with medical professionals, others may have fears of legal ramifications.
“We're not going to turn people in… Our job is to be the best doctor that we can be for that one person at that one time. So be brutally honest with us, because all we're going to do is take that information and make it better for you.”
Dr. Kollman also says in the future there may be guidelines on what to do in terms of marijuana use before you have surgery, but for now, don’t make any changes without discussing it with your doctor.
“I think it's something that we'll do be doing more of in our pre-anesthesia testing clinics before people get to the surgery and they'll have that conversation two or three days beforehand. There is not quite enough evidence yet to tell people to stop cold turkey or to taper, and there are some conflicting reports about whether it works, or it needs to be. Seven days, whether it needs to be 14 days, so we need more research on that. It'll really depend on the person and on their coexisting conditions.”
And when it comes to any drug use, even alcohol or tobacco, your doctor may always recommend you quit or cut way back. It’s still important that you’re honest with them about your habits so they can give you the best care possible. A good doctor will always encourage you and never shame you.
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