NutriStack
Cannabis (THC-Dominant) and Hydrocodone, a caution.
Direct hydrocodone-THC clinical studies are limited, but hydrocodone shares the opioid respiratory-depression and sedation liabilities studied with oxycodone. THC-dominant cannabis can add sedation, impaired attention, and coordination problems, and cannabinoid-opioid studies show clinically meaningful analgesic and behavioral interactions with oxycodone. The combination is most concerning with higher opioid doses, frequent THC use, sleep apnea, lung disease, older age, or other sedatives.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Cannabis (THC-Dominant) and Hydrocodone
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 3 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Direct hydrocodone-THC clinical studies are limited, but hydrocodone shares the opioid respiratory-depression and sedation liabilities studied with oxycodone. THC-dominant cannabis can add sedation, impaired attention, and coordination problems, and cannabinoid-opioid studies show clinically meaningful analgesic and behavioral interactions with oxycodone. The combination is most concerning with higher opioid doses, frequent THC use, sleep apnea, lung disease, older age, or other sedatives.
Mechanism. Hydrocodone is a mu-opioid receptor agonist that can suppress ventilatory drive and arousal. THC activates CB1 receptors and can impair attention and coordination; by opioid class extrapolation, this can add CNS-depressant burden and may make opioid dosing behavior less predictable.
Recommendation. Do not combine THC-dominant cannabis with hydrocodone unless your opioid prescriber knows. Avoid alcohol, benzodiazepines, sleep aids, and driving after using both. Seek emergency help for severe sleepiness, slow breathing, blue lips, confusion, or inability to wake.
Sources (3)
- Kocis PT, Vrana KE. Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions. Med Cannabis Cannabinoids. 2020;3(1):61-73. PMID 34676340
- Cooper ZD, Bedi G, Ramesh D, Balter R, Comer SD, Haney M. Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability. Neuropsychopharmacology. 2018;43(10):2046-2055. PMID 29463913
- Boom M, Niesters M, Sarton E, Aarts L, Smith TW, Dahan A. Non-analgesic effects of opioids: opioid-induced respiratory depression. Curr Pharm Des. 2012;18(37):5994-6004. PMID 22747535
Stack Score
How this pair moves the number.
Effect on the composite score
If both Cannabis (THC-Dominant) and Hydrocodone are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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