Business
All Surgical Patients in the US are Now Required to Come Clean about Their Cannabis Usage
New rules are in place so doctors and nurses can adjust your anesthesia for surgeries
Like It Or Not, All Patients In The US May Now Have To Undergo Screening For Cannabis Use Before Surgery
New guidelines that have just been published by the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) recommend that all individuals who are set to undergo surgery that requires the use of anesthesia be screened about their marijuana consumption.
ASRA Pain Medicine is one of the biggest medical organizations focusing on anesthesiology, which was founded back in 1975. They currently have over 5,000 members across 6 continents.
These are the first-ever guidelines to be released in the United States making such recommendations. Doctors and physicians state that regular cannabis use can actually result in increased risk for nausea and pain following surgery, causing patients to require the use of opioids.
ASRA Pain Medicine explains that the guidelines were released due to the growing use of cannabis throughout the last 20 years, though there are valid concerns that cannabis can have unwanted interactions with anesthesia. “Before surgery, anesthesiologists should ask patients if they use cannabis – whether medicinally or recreationally – and be prepared to possibly change the anesthesia plan or delay the procedure in certain situations,” explains Samer Narouze, MD, Ph.D., ASRA Pain Medicine’s president and the senior author of the guidelines.
This is not news, as there have been numerous studies in the past pointing towards the possible hazards and risks of cannabis use, when not abstained before surgery. More on this below.
So is it fair for patients to be screened about their cannabis consumption before surgery? This may be a valid point, and one of those situations wherein it may be for the benefit of patients to actually abstain from it, as it may do more harm than good.
“They also need to counsel patients about the possible risks and effects of cannabis. For example, even though some people use cannabis therapeutically to help relieve pain, studies have shown regular users may have more pain and nausea after surgery, not less, and may need more medications, including opioids to manage the discomfort,” reads the guidelines. “We hope the guidelines will serve as a roadmap to help better care for patients who use cannabis and need surgery,” it continues.
What Studies Say
Current studies point towards risks and dangers that marijuana consumers face during surgery. That’s why it’s recommended to abstain before you are due to go under the knife.
In a 2022 study, whose findings were presented during the Anesthesiology 2022 yearly meeting, cannabis users tend to experience more pain following surgery. The researchers analyzed medical records from 34,521 adult patients, 1,681 of whom were marijuana consumers, all of whom had surgeries conducted at the Cleveland Clinic from January 2010 to December 2020. They found that marijuana users who consumed the drug within one month before surgery were found to suffer from 14% more pain within 24 hours after surgery compared to non-cannabis consuming patients.
Furthermore, cannabis consuming patients required 7% more opioids after surgery.
“The association between cannabis use, pain scores and opioid consumption had been reported before in smaller studies, but they’ve had conflicting results,” notes Dr. Elyad Ekrami, MD, the study’s lead author and a clinical research fellow from the Cleveland Clinic’s Anesthesiology Institute. “Our study has a much larger sample size and does not include patients with chronic pain diagnosis or those who received regional anesthesia, which would have seriously conflicted our results. Furthermore, our study groups were balanced by confounding factors including age, sex, tobacco and other illicit drug use, as well as depression and psychological disorders,” he said.
Dr. Ekrami adds that physicians need to take note of patients who consume cannabis it has an impact on their outcomes, especially because they may require more painkillers or opioids post-surgery. “Physicians should consider that patients using cannabis may have more pain and require slightly higher doses of opioids after surgery, emphasizing the need to continue exploring a multimodal approach to post-surgical pain control,” Dr. Ekrami says.
Meanwhile, another study from 2019 demonstrated another impact of cannabis on surgery: requiring more anesthesia. Dr. Mark Twardowski of Colorado’s Western Medical Associates, the lead author of the study, explains that consuming cannabis before surgery will have an impact on patients’ medical care. Dr. Twardowski and his team analyzed 250 patients who had to undergo minimally invasive procedures which required anesthesia in the state, where cannabis has long been legal for recreational use.
Ten percent of the patients reported being regular cannabis users. These individuals needed more than double the amount of propofol, an anesthetic. In addition, cannabis users also needed 14% more fentanyl for the pain, and midazolam for sedation.
“Cannabis users cannot assume that their use will have no effects on their medical care,” Dr. Twardowski explains. “Clearly the fact that use affects the effectiveness of these three medicines certainly raises myriad questions about potential effects on other medications (pain medicines, anxiety medicines etc),” he told Reuters via email.
He also explains that since cannabis stays so long in the human body, it could actually take months for its effects to no longer affect surgical outcomes. “Patients absolutely need to inform their providers about cannabis use prior to any procedure,” he advises.
Conclusion
If you are due for any kind of procedure requiring anesthesia, it’s critical to be upfront with your healthcare provider about your marijuana consumption. Not doing so may result in an extremely unpleasant experience as you may still feel the pain without adequate anesthesia.
Aviation
IndiGo Crisis Exposes Risks of Monopoly: What If Telecom or E-commerce Collapses Next?
Airports across India witnessed scenes of distress and confusion as thousands of passengers were stranded due to IndiGo’s massive flight disruptions. Families with medical emergencies, funerals, and personal crises were left helpless as the airline cancelled hundreds of flights without adequate communication or support.
Passengers described desperate situations — a mother pleading for sanitary pads for her daughter, a woman unable to transport her husband’s coffin, and others stranded while trying to reach family funerals or hospitals. “It was like a lockdown at the airport,” one passenger said, describing the panic that unfolded as IndiGo’s mismanagement crippled operations nationwide.
Root Cause: IndiGo’s Market Monopoly
The turmoil, industry experts argue, stems from IndiGo’s monopolistic control over India’s domestic aviation market. The airline operates nearly 2,100 flights daily and holds around 60% market share — meaning every second plane flying within India belongs to IndiGo.
This dominance has given the company unparalleled influence. When IndiGo falters, the entire aviation system suffers. Passengers are left with few alternatives, as other airlines lack capacity to absorb stranded travellers. The result: skyrocketing ticket prices, chaos at terminals, and total dependence on a single private operator.
Aviation pioneer Captain G.R. Gopinath, founder of Air Deccan, criticised the government’s inaction, noting that on some routes, IndiGo’s economy fares surged to ₹1 lakh. He compared the situation to a hostage crisis, writing that the airline “held the system ransom” and forced regulators to defer new safety rules meant to protect pilots and passengers.
Government Intervention and Regulatory Weakness
The crisis erupted after IndiGo failed to comply with the Flight Duty Time Limitations (FDTL) — rules introduced by the DGCA in January 2024 requiring adequate rest for pilots. Despite having nearly two years to adapt, IndiGo blamed the rule for operational disruptions, citing a shortage of pilots.
Under mounting public pressure, the government stepped in, temporarily relaxing FDTL norms and capping airfare hikes. Officials claimed the move was to protect passengers, but analysts say it exposed the state’s vulnerability to corporate monopolies. “The government had no option but to yield,” said one aviation policy expert, pointing out that ignoring safety regulations for short-term relief could have long-term consequences.
The crisis also rekindled memories of the June 2025 Air India crash near London, which claimed over 240 lives. Experts warn that compromising pilot rest and safety standards to maintain flight schedules could risk another tragedy.
If Telecom Giants Fail: A National Paralysis
The article raises a troubling question — what if a similar crisis struck the telecom sector, where Jio and Airtel together control nearly 80% of subscribers and serve over 780 million users?
If both networks failed simultaneously, the repercussions would be catastrophic. Internet shutdowns would halt UPI transactions, online banking, OTP verifications, video calls, OTT streaming, and emergency communications. Critical services such as airports, hospitals, stock exchanges, and small businesses — many of which rely on WhatsApp and digital payments — would come to a standstill.
In essence, a telecom breakdown could paralyse India’s digital economy, exposing the nation’s dependence on a duopoly.
E-commerce Monopoly: Another Fragile Ecosystem
The same risk looms over the e-commerce sector, where Amazon and Flipkart dominate nearly 80% of the market. A disruption similar to IndiGo’s could cripple daily life — halting delivery of groceries, medicines, and essential goods, freezing refunds and customer support, and leaving small sellers without platforms to trade.
Local retailers, freed from competition, might exploit shortages by inflating prices. Such a scenario underscores the perils of market centralisation in sectors critical to everyday living.
A Wake-Up Call for Regulators
The IndiGo crisis, analysts say, is a warning shot for policymakers and regulators. A single company’s operational failure exposed systemic weaknesses in India’s infrastructure and consumer protection mechanisms.
As the aviation regulator DGCA investigates and IndiGo works to restore normalcy, the broader lesson remains clear: unchecked monopoly power in any essential service — whether air travel, telecom, or e-commerce — poses a direct threat to economic stability and citizen welfare.
Without stronger competition laws, redundancy frameworks, and regulatory oversight, India risks repeating this crisis across multiple sectors — each time with millions of citizens paying the price.
Agriculture & Life Sciences
Canada’s Cannabis Industry Urges Government to Support Growing Export Market
BuzzBuzz Cannabis Business News — 24 November 2025
Canada’s cannabis sector is calling on federal and provincial governments to recognize its fast-growing export potential and extend the same support other regulated industries receive. Industry leaders warn that Canada is losing its early global advantage due to slow regulatory processes, lack of trade promotion, and limited access to government-backed financing.
Canada’s medical-cannabis exporters now generate more than half a billion dollars annually and ship products to major markets including Germany, the UK, Australia, and Poland. Despite this, cannabis remains largely absent from Canada’s official trade and export strategies.
Industry Calls for Streamlined Export System
Paul McCarthy, President of the Cannabis Council of Canada, says the country has everything required to dominate the global medical cannabis trade—except government alignment.
“Our requests are simple,” McCarthy said. “Expedite Health Canada’s export-permit process, integrate cannabis into federal export programs like Global Affairs Canada trade missions and CanExport, and ensure provinces include cannabis in their export strategies.”
He stressed the need for mutual recognition agreements with importing countries to eliminate redundant testing and documentation. Access to Export Development Canada (EDC) and Business Development Bank of Canada (BDC) services also remains off-limits to cannabis exporters, placing them at a steep disadvantage.
“This industry does not just need permission to operate,” McCarthy added. “It needs to be treated like every other legitimate contributor to Canada’s trade objectives.”
Competitors Are Moving Faster
McCarthy warns that while Canada pioneered medical cannabis standards, other countries are rapidly advancing with more flexible and export-friendly systems.
“Faster approvals, lower compliance costs, and active government-backed strategies are helping other nations catch up,” he said. “Canada’s regulatory friction is already costing us global market share.”
Export permits currently must be issued for each shipment—a process that can take weeks—and Canadian testing standards often differ from international requirements, forcing companies to repeat expensive compliance checks.
High Tide CEO: Canada Needs a National Export Strategy
Raj Grover, CEO of High Tide Inc., says Canada risks surrendering its leadership if policymakers remain inactive.
“Canada developed the world’s most advanced cannabis regulatory system and contributed $76.5 billion to GDP since legalization,” Grover said. “But without a National Cannabis Export Strategy, we will lose ground to Australia, Israel, Portugal, and other emerging competitors.”
He noted that Canada’s industry table created by Innovation, Science and Economic Development Canada (ISED) has not met in more than a year—an opportunity wasted.
Grover urged the federal government to introduce domestic GMP certification and potency standards to streamline international market access. “Canadian producers must currently get GMP approval country by country. It’s duplicative and costly. Canada should be setting global benchmarks, not chasing them.”
Germany: A Key Market for Canadian Firms
High Tide recently expanded into Europe with its majority acquisition of Germany’s Remexian Pharma GmbH, giving the company a direct import and distribution channel in Europe’s largest medical-cannabis market.
“Our German strategy is already structured for success,” Grover said. “Through Remexian, we can supply premium medical cannabis at the lowest possible price, helping meet Germany’s quality and cost demands.”
Grover also warned that U.S. companies are already purchasing Canadian firms to stage their own international expansion—another sign that Canada’s leadership position is slipping.
Government Response Remains Limited
In response to industry concerns, a Global Affairs Canada spokesperson said the Trade Commissioner Service “continues to support exporters of cannabis for medical and scientific purposes that have obtained Health Canada permits.”
However, industry leaders argue that this support is minimal and does not include key tools such as trade missions, export credits, or bilateral agreements that other sectors routinely receive.
A Closing Window of Opportunity
With medical-cannabis exports already exceeding $500 million annually, industry executives say Canada must act quickly to preserve its competitive edge.
As McCarthy warns, without coordinated government support, Canada risks losing high-value pharmaceutical manufacturing, research investments, and thousands of skilled jobs.
And as Grover’s expansion into Germany demonstrates, the industry is moving forward—but whether Canada moves with it may determine if the country remains a global leader or becomes a pioneer that let others capitalize on its breakthroughs.
Business
A Tipping Point for Cannabis: President Trump Champions CBD & Cannabis Science on Truth Social
When the President of the United States shares a video about the life changing potential of hemp derived CBD on his personal social media platform, it is more than news, it is a cultural shift.
For decades our government lied to us about cannabis. It demonized the plant, waged war on its users, and filled prisons while allowing pharmaceutical companies to flood the nation with addictive and deadly drugs. For over a century we have been fighting uphill, not just for legalization, but for truth, for science, and for the right to heal ourselves naturally.
Now in 2025, the most powerful political figure on Earth is using his own voice and platform to talk about the endocannabinoid system and the science backed benefits of CBD. That is monumental. It is validation for everyone who has fought, been arrested, been silenced, and been dismissed for telling this truth. The President’s video post is already being described as a pivotal moment in cannabis history, and President Trump CBD Cannabis Science Truth Social is trending across platforms as advocates celebrate the breakthrough.
The Science Behind the Endocannabinoid System
The video begins by introducing something most people, including many doctors, still know little about, the endocannabinoid system. Discovered in the 1990s, the ECS is a network of receptors and signaling molecules that works as the body’s master regulator, coordinating communication between major systems like the nervous, immune, cardiovascular, and digestive systems.
The roots of this discovery go back much further. CBD was first isolated in 1940 by American chemist Roger Adams, but it was Dr. Raphael Mechoulam, an Israeli organic chemist, who fully elucidated the chemical structure of CBD and identified its stereochemistry in the 1960s. His pioneering work not only opened the door to modern cannabinoid science but also earned him the title “Godfather of Cannabis Research.” It was this foundation that led to the identification of the endocannabinoid system itself decades later, revealing how cannabinoids interact with our physiology on a fundamental level.
The ECS is now widely recognized as a vital part of human biology, with extensive research supported by the National Institutes of Health. When functioning properly, the ECS acts like the conductor of an orchestra, ensuring every section plays in harmony. As we age, the system weakens. That imbalance is linked to inflammation, chronic pain, cognitive decline, sleep problems, and many other conditions associated with aging.
Mainstream medicine often addresses these issues with pharmaceutical band aids, dangerous and addictive drugs that treat symptoms rather than root causes. Lifestyle changes such as diet and exercise help, but they only partially support the ECS and do so slowly over time.
Hemp Derived CBD: A Game Changer for Aging
Here is where the science gets exciting. As the video explains, the ECS can be restored much more quickly with hemp derived CBD. Strengthening this system naturally helps the body regain balance, reducing pain, improving sleep, lowering stress, slowing disease progression, and even extending healthy lifespan.
It is not theoretical. One in five seniors is already using CBD to manage pain, arthritis, cancer symptoms, sleep disorders, Alzheimer’s, and more. Despite decades of research and acknowledgment from institutions like the National Institutes of Health, most physicians receive no training on the ECS. There are still no FDA standards for CBD products on the market. If that were the case for any other class of medicine, it would be considered malpractice.
The World Health Organization has confirmed CBD’s excellent safety profile and non addictive nature in its critical review report. The result is that millions of older Americans are suffering unnecessarily when a safe and natural solution exists.
Hemp derived CBD is a powerful first step in restoring balance to the endocannabinoid system, but it is only part of the picture. Research shows that full spectrum cannabis extracts, which include a broader range of cannabinoids and terpenes, can work even more effectively. Complete concentrated cannabis oil, containing the full spectrum of natural endocannabinoids, may deliver the most profound results for certain patients. Expanding access to these therapies will be essential if we want to unlock the full healing potential of this plant.
The Economic and Social Impact
The video cites a powerful figure. A PricewaterhouseCoopers analysis estimates that fully integrating cannabis into the healthcare system could save the United States nearly 64 billion dollars annually. These savings reflect reduced pharmaceutical dependency, fewer hospitalizations, improved chronic disease outcomes, and enhanced quality of life for aging Americans. You can read more about PwC’s research on healthcare innovation here.
It is a financial argument, but it is also a moral one. Why should our elders endure pain, anxiety, and cognitive decline when nature has given us tools to help them live longer, happier, and healthier lives?
A Call to Action: Finish What the Farm Bill Started
The message concludes by crediting the 2018 Farm Bill, championed by President Trump, for legalizing hemp and laying the groundwork for today’s CBD market. The Farm Bill was just the first step.
Now the call is for bold next moves.
- Educate doctors about the endocannabinoid system
- Include CBD under Medicare coverage
- Provide clear federal standards for CBD quality and dosing
These steps would constitute the most significant senior health reform in modern history, one that would transform aging and cement a powerful legacy for any administration that makes it happen.
What This Means for Future Cannabis Medicine
For those of us who have been in the cannabis community for decades, this is not just another news story. It is a signal that our movement is winning. A conversation that was once criminalized and censored is now being amplified by the President of the United States on his own platform.
It means the science is undeniable. It means the truth can no longer be buried. It means the wall of prohibition is cracking, not just legally, but culturally, scientifically, and politically.
It also means that everything we have been fighting for at 420 Magazine since 1993, education, access, healing, and justice, is finally moving full steam ahead. The President Trump CBD Cannabis Science Truth Social moment is proof that science and policy are finally converging.
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