Cannabis and Liver Disease
You might assume liver disease is only a concern for people who drink excessively, but you couldn't be further from the truth. Liver disease in Canada is on the rise, and it's not because Canadian's are drinking more alcohol (In fact, Canadians might be drinking less now that recreational cannabis is legal).
Liver disease is not a singular diagnosis. It actually describes over 1000 different medical conditions, rooted in viral infections, toxins, genetics, unknown triggers, and for some, alcohol abuse. There is growing scientific support behind cannabis for the treatment of liver disease - but it's not as straightforward as adding a dose of cannabis into our daily routine. If we unpack the research, what does it all mean?
What is Liver Disease?
Your liver is responsible for dozens of critical tasks inside your body, without you knowing or thinking about them. Your liver cleans your blood, regulates hormones, produces energy, manages cholesterol, metabolizes vitamins and nutrients, all while removing toxic substances from your body. It's the largest, and arguably one of the busiest organs in your body.
The 1000 or so different types of liver disease all have one characteristic in common: long term and sustained damage leading to tissue scarring. Tissue scarring on the liver is called cirrhosis, which can lead to liver failure, and if untreated, death. Scarring makes it difficult for the liver to do all the jobs required of it.
If there are so many different types of liver disease, how can cannabis target them all? We don't yet know if cannabis would help everyone with liver disease, (despite the evolving research on cannabis) but there are some key indications it might be broadly applicable for some of the most common symptoms including the progression of cirrhosis as well as chronic inflammation.
Can Cannabis Prevent Liver Disease?
Many resources you might come across claim cannabis prevents liver disease. Is this true? In some instances, there is evidence to suggest cannabis protects the liver from the development of cirrhosis. Particularly for liver disease tied to alcohol abuse.
In an often discussed study published in 2018 in Liver International, researchers discovered cannabis use helped reduce the occurrence and severity of liver disease in people who abused alcohol. The authors pulled data from a pool of nearly 320,000 individuals who had a history of abusing alcohol. The study divided people into different categories, including those who struggle with alcohol dependence (addiction), and those who simply drank too much, too often.
Through the analysis, the researchers uncovered a link between cannabis use and a reduced risk of various liver diseases. Both non-dependent and dependent cannabis use were tied to a reduction in alcoholic steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. But cannabis wasn’t a miracle medicine. The study also found when abuse turned to dependence; cannabis had a less protective effect on the liver.
This is a critical discovery and one which will inevitably help craft further research about how cannabis may help prevent liver disease. It's worth keeping in mind the limited scope of this study. It only looked at people with a history of alcohol abuse and dependence, not the general public. It included a particular spectrum of liver diseases tied to alcohol use.
Can Cannabis Heal Liver Disease?
If you believed everything written about cannabis for liver disease, you'd be forgiven if you expected cannabis to cure it. Depending on the diagnosis, some liver disease is very treatable, but none are curable.
To cure a liver disease would mean to reverse the tissue damage on the organ, and this isn't possible yet. There are many positive studies about cannabis and liver disease, leading many to explore it as a way to heal the condition. Let's be clear, there may be benefits of cannabis use for liver disease, but they are far from proven, and they won't reverse the damage already done.
So far the results suggest THC and CBD may have benefits for fibrosis, a condition which eventually develops into full-blown cirrhosis. For example, in rodent studies, THC suppresses something called hepatic myofibroblasts. Myofibroblast cells don't exist in healthy livers, but proliferate (thrive and multiply) in damaged tissue, including in a failing liver. To reduce the proliferation of these cells may help slow down the progression of the disease. THC may also reduce the appearance of another type of cell, stellate cells. Other research has named stellate cells as a key solving liver fibrosis.
But it's not just THC; CBD may also have benefits given a little more research and a little more time. In the later stages of the disease, typically following liver failure, patients may develop a severe complication called hepatic encephalopathy. This symptom "is a deterioration in brain function observed in people with acute liver failure of chronic liver disease," because, "The brain is a very sensitive organ and relies on a healthy liver in order to properly function." In small human studies, CBD has helped improve cognitive and motor functions as well as reduce neuro-inflammation in this advanced stage of liver disease.
Does Cannabis Help Recovering Alcoholics?
For anyone with alcohol-related liver diseases, and who are currently treating the condition in combination with abstinence, cannabis may not be a safe bet. Yes, cannabis seems to help with opioid addiction, but there are less certain conclusions about cannabis for recovering alcoholics.
Few studies have looked at the complete substitution of cannabis for alcohol, but many studies show cannabis can increase alcohol consumption for those with alcohol abuse issues. Furthermore, another study found in people battling both alcohol use disorder and depression; cannabis seemed to make it worse.
If you are someone with an alcohol use disorder and hoping to use cannabis to help treat liver disease, you should speak with a physician first. While cannabis may help reduce the development of cirrhosis, it might make your recovery from alcohol dependence more challenging.
Suggested Dose or Cannabis Consumption Method for People with Liver Disease
The best bet if you are looking for a recommended dose of medical cannabis for the treatment of liver disease is to speak with your doctor. There are so many different types of liver disease, and so many leading causes, it would be unwise to suggest a one-size-fits-all dose.
The only suggestions (which apply to all medical cannabis applications) are to start low and increase dosage slowly. Did you know your liver is the organ responsible for processing cannabinoids if ingested? It's crucial to introduce cannabis under the guidance of a healthcare professional.
If you already have reduced liver function, a dose suitable for a healthy liver may play out much differently for you. The importance of having a doctor around to monitor your liver function while experimenting with treatment cannot be overstated enough.
Using cannabis to treat liver disease has a lot of momentum today, thanks to recent medical breakthroughs - but that doesn't make the topic less complicated. The authors of "Cannabis in liver disorders: a friend or a foe?" summarize the research clearly, and concisely. Let’s leave off with their valuable opinion on cannabis and liver disease:
“Constituents of cannabis, such as cannabidiol and Δ9-tetrahydrocannabinol, have shown anti-inflammatory, antioxidant, and hepatoprotective effects both in in vitro and clinical studies, and appear to have potential in the symptom management and treatment of various liver diseases that were previously considered difficult to manage conservatively … All in all, the recent trends in research, clinical experiences, as well as the legislature, has opened up new avenues towards the widespread clinical application of cannabis and its derivatives as well as modifiers of the components of the endocannabinoid system. More research is required to fully exploit these new evidences."
The cannabis industry is young and thriving with new discoveries and progress being made daily. We hope that cannabis in the near future will be able to provide more relief from ailments like liver disease. As always, if you enjoy our content and are interested in learning more about how cannabis could help you or a loved one, subscribe to our newsletter and follow us on social.