Marijuana Drug Interactions: Is Combining Other Substances with Weed OK?

SpringBoard Recovery provides effective treatment for substance use & mental health disorders.

Evan Leonard MS, MMS, PA-C

Dr. Leonard is a Doctor of Medical Science and a clinical anatomist. He has practiced in both internal and emergency medicine and has published several, peer-reviewed articles and a medical book chapter.

Marijuana can be quite strong on its own, considering the higher THC levels it contains today. But it can also lead to drug interactions when it is mixed with other substances. Second only to alcohol, weed has become one of the most popular drugs used and abused in the United States.

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Marijuana has a perception of safety among most people. They believe it is non-addictive, and considering the fact that so many states have legalized it for recreational use, it is easy to back that belief up. But the reality is that it can be psychologically addictive, and when mixed with other drugs, it can also be dangerous.

We want to help people learn more about the drug interactions that can occur when combining marijuana with other substances. People need to know the risks so they can make better choices. Also, if they are addicted, they need to know where to get help.

What is Marijuana?

When people use marijuana, they are using the dried leaves, stems, flowers and seeds from either the cannabis Sativa or the cannabis Indica plants. Both contain THC, which is a psychoactive chemical, as well as many other compounds. Using it produces a euphoric, relaxing high.

There are several ways people use marijuana. They include:

  • Smoking it in a pipe.
  • Rolling it into a joint and smoking it.
  • Vaporizing it either in plant form or in the form of a manufactured oil.
  • Eating foods that have had weed added to them.
  • Smoking the oils from the plant.

Marijuana is not physically addictive, and stopping its use typically does not result in hard-to-manage withdrawal symptoms. But as we mentioned previously, it can be psychologically addictive. Once a person has been using it for a long time, they may feel like they cannot go without it.

The Side Effects of Marijuana

The side effects of marijuana are often experienced within a few minutes, depending on the type of drug being used. It can take edibles longer to feel the effects because they must go through the digestive process first.

Some of the side effects of weed include:

  • Heightened sensory perceptions.
  • An altered perception of time.
  • An increased appetite.
  • Feelings of anxiety.
  • Feelings of fear or distrust.
  • A sense of panic.
  • Acute psychosis (with large doses), including hallucinations and delusions.

The Legality of Weed in the United States

In 2012, both Colorado and Washington State made recreational marijuana use legal. Since that time, more states have followed suit. Those that did not – for the most part – moved forward with either making medical marijuana legal, or decriminalizing weed. Today, there are only a few states in which this drug is still illegal. Those states are:

  • South Carolina
  • Alabama
  • Tennessee
  • Idaho
  • Wyoming

Laws regarding the legality of marijuana are always changing with every passing year. Most experts believe that it will not be long before this drug is legal for recreational use in all 50 states. One thing is for certain – weed’s legality has made it more likely for more people to abuse it.

Marijuana and Drug Tolerance

When a person forms a drug tolerance, it means that they need to use more of a substance in order to get the same effects. This is seen all the time in people who smoke weed or consume edible marijuana.

Having a drug tolerance to marijuana will typically result in a few different actions on the part of the user. They may:

  • Increase how much of the drug they use at one time.
  • Use the drug more frequently.
  • Begin mixing the drug with other substances to enhance the high.

People may be much more likely to combine marijuana with other drugs than they would a substance like cocaine or heroin. This is because it is perceived to be a safer option. But what they do not realize is that it can produce negative – or even dangerous – drug interactions.

Mixing Weed with Other Drugs

Marijuana is commonly combined with other drugs for a few different reasons. People who use it recreationally may be attempting to increase its euphoric effects. Those who are taking it for medical reasons may be trying to get more pain-relieving effects. Regardless, it can be dangerous to mix it with other substances.

The following are all drugs that are commonly combined with marijuana.


Alcohol has become the only other drug that is more popular than marijuana. It is not surprising that they are often used together to enhance the effects of each other. But dangerous drug interactions can occur as a result.

Alcohol is classified as a depressant drug, just like marijuana. This means that it tends to cause relaxation and slow the system down when it is used. Combining two depressant drugs can be dangerous.

Some of the effects of alcohol include:

  • Changes in mood and behavior.
  • Difficulty thinking clearly.
  • Coordination and balance issues.
  • Heart issues, such as an irregular heartbeat or high blood pressure.
  • A weak immune system.
  • Blackouts.
  • Slurred speech.
  • Nausea and/or vomiting.
  • An upset stomach with or without diarrhea.

Drinking too much alcohol can result in breathing problems, which can also be true of marijuana. Mixing them together can result in:

  • Excessive drowsiness.
  • Slower reflexes than normal.
  • Changes in judgment.
  • Dehydration.
  • Reduced cognitive function levels.

Some people believe that the order in which these drugs are abused makes a difference. Using marijuana before drinking alcohol may slow down or delay the feeling of being drunk. This is because of how much more slowly blood alcohol levels rise with weed in the person’s system.

But smoking marijuana after drinking alcohol is a different story. The effects of weed can be magnified as a result and cause people to get sick. Using these drugs in this order often results in a stronger high, but it is not pleasant at all. It can also lead to a “green out,” which causes nausea and vomiting, excessive sweating and dizziness.


Cocaine is different from marijuana in that it is a stimulant drug. That means that instead of slowing body processes down, it speeds them up. This drug can be dangerous all on its own, but even more so when it is mixed with other drugs; even one that is non-physically addictive, like weed.

Some of the side effects of cocaine include:

  • Feelings of euphoria.
  • Increased energy levels.
  • Feeling more mentally alert.
  • Becoming hypersensitive to touch, light and sound.
  • A decreased need for sleep and/or food.
  • Increased blood pressure.
  • Increased body temperature.
  • Increased heart rate.
  • Bizarre, erratic and even violent behaviors.
  • Feelings of restlessness and irritability.
  • Feelings of anxiety and panic.
  • Paranoia.

Sometimes people will mix marijuana and cocaine to enhance their high. But there are also those who will combine these drugs in order to lessen the negative effects of each one. But this can be dangerous as well.

The effects of mixing cocaine with weed include:

  • An increased risk of overdosing on cocaine because its effects are not felt as strongly. This can lead the user to take more of it than they should.
  • Lower inhibitions, which can result in dangerous risk-taking behaviors.
  • Increased stress on the cardiovascular system, which can lead to a heart attack and/or stroke.
  • A higher risk of dependence on one or both drugs.


The term opioids refers to both prescription painkillers, which are legal, and drugs like heroin, which are illegal. Our country has been battling an opioid epidemic for many years, and the number of people abusing these drugs has increased drastically. Even though legal medications, such as Oxycodone and Vicodin, certainly have their places in the medical community, they are often abused. When people cannot obtain their prescription painkillers, many of them turn to heroin instead.

The side effects of opioid drugs include:

  • Constipation
  • Extreme drowsiness
  • Nausea
  • Mental fog
  • Slower breathing rates than normal.

Both opioids and marijuana are depressant drugs. A lot of people who use this combination are doing so for the pain relief that both substances can bring. But what they do not realize is that they could be the victims of dangerous drug interactions.

In one study that was conducted by the Recovery Research Institute, the results were interesting. They found that:

  • The combination of opioids and marijuana resulted in more anxiety and depression than opioids on their own.
  • People who combined the two drugs were more likely to be using opioids nonmedically.
  • These individuals were much more likely to be addicted or dependent upon opioids.
  • They were also much more likely to use other drugs with opioids, aside from marijuana.
  • These individuals’ pain levels were very similar to those of people who were using opioids alone.

What are Cross Addictions?

The term cross addiction refers to a situation in which a person has more than one addictive behavior. This is also called having Addiction Interaction Disorder. A lot of people participate in polydrug abuse, which means that they abuse more than one drug at a time.

Cross addictions can be very dangerous due to the risk of overdosing as well as other negative drug interactions. It is important for people in these situations to get treatment for both addictions at the same time. If they do not, there is a good chance that they will simply return to using both drugs again.

Drug Treatment for Marijuana Addiction and Cross Addictions

People who are addicted to marijuana as well as one other drug will need professional treatment to stop using. It is possible for people who are only addicted to weed to stop using on their own; although we always at least recommend outpatient therapy. But once another drug has been added to the mix, specialized treatment may be needed to help people stop using safely.

Drug Detox

Drug detox is generally not needed for people who are addicted to marijuana only. But if that person is also addicted to a drug like alcohol, cocaine or opioids, they will need to go through the detoxification process.

There are a few types of treatment that may be offered, depending on the drugs a person is using. They include:

  • Medical tapering Medical tapering is for people who are addicted to a prescription medication, such as a painkiller. Tapering the dose down slowly can help to avoid some withdrawal symptoms.
  • Medical detox Medical detox involves receiving medical supervision as well as taking medications to help with withdrawal.
  • Medication assisted treatment MAT involves behavioral counseling and medications that have been approved by the FDA to treat alcohol and opioid withdrawal.
  • Holistic detox – This method of treatment involves natural methods, such as nutrition therapy and exercise. It may be combined with any of the above.

Drug Rehab

After detoxing, the individual is ready to move on to drug rehab. Rehabilitation is a necessity in most cases. People need to learn why they got addicted to drugs in the first place so they can make the needed changes in their lives.

A lot of people come to rehab with co-occurring disorders, which means they also have mental health issues. These are often undiagnosed and the person will use drugs as a means of self-medication.

Dual diagnosis treatment is recommended for people with co-occurring disorders. This ensures that both the addiction and the mental health problem will be treated at the same time. As a result, it increases the likelihood of a positive long-term outcome.

Get More Information About Mixing Marijuana with Other Drugs and the Available Addiction Treatment Programs

At SpringBoard Recovery, we see cross addictions all the time. Marijuana is a drug that is commonly used with other drugs to enhance the effects of both substances. Polydrug use is very dangerous, and professional treatment is often needed.

We offer a high-quality outpatient addiction treatment program as well as sober living services. Our clients get the absolute best care possible.

Do you have questions about using marijuana with other drugs and the interactions that can occur? Would you like to know more about our treatment program? Please contact us today.

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