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Medical Marijuana, Alcoholism and Your Liver


Nicole Cutler

Mar 10th, 2011

Medical marijuana initiatives are becoming increasingly popular, and people hoping to recover from alcoholism may be one of the benefactors. Those with chronic liver disease must abstain from alcohol to regain their health, but using medical marijuana to achieve this goal has a major drawback.

Medical Marijuana, Alcoholism and Your Liver

In the U.S., more than 25 percent of the states have passed legislation permitting the use of marijuana for medical purposes. Although the laws in each state differ, medical marijuana is primarily prescribed for those with cancer, HIV/AIDS, epilepsy, glaucoma and chronic pain. However, several physicians also consider cannabis to be a viable option for treating alcoholism. While marijuana may represent a useful harm reduction method for quitting drinking, alcoholics who have liver damage may be doing more harm than they think by substituting marijuana for alcohol.

The first and most immediate directive given to a patient diagnosed with chronic liver disease is to abstain from drinking alcohol. Such an order is usually absolute, leaving no room for an occasional social drink. Regardless of the type of liver disease, alcohol is a known liver toxin and can quickly accelerate the severity of liver disease. Some people have no problem passing on alcohol, but others can’t imagine a more difficult task. For those with chronic liver disease who are dependent on alcohol, anything that might aid their quest for abstinence is worth consideration.

Some long-term alcohol abusers find that quitting drinking under a physician’s guidance is their best choice for preserving their liver’s function. Abstinence based support groups such as Alcoholics Anonymous and/or addiction treatment regimens can help many people quit drinking, but relapse is common. Unfortunately, relapsing with liver disease can set that person on a downward spiral of worsening liver disease.

Medical Marijuana*
Medical marijuana is the use of cannabis and its chemical constituents as a physician-recommended form of medicine or herbal therapy. As of December 2010, the following states have laws governing medical marijuana: Alaska, California, Nevada, Oregon, Colorado, Washington, Montana, New Mexico, Michigan, Maine, New Jersey, Vermont, Rhode Island and the District of Colombia. More than a dozen other states are considering the idea. In one of the 14 states that have passed medical marijuana legislation, an option for those who are unable to abandon alcohol may be “Marijuana Maintenance” – the substitution of cannabis for alcohol.

*Please note that the laws for legally obtaining a prescription and using medical marijuana vary per state.

Harm Reduction
Marijuana Maintenance operates on the principle of harm reduction, whereby alcohol is substituted with a less toxic and harmful substance. A well-known principle in addiction treatment, harm reduction utilizes practical strategies that reduce the negative consequences of substance abuse by emphasizing safety as a path to abstinence. Harm reduction strategies meet substance users “where they’re at,” addressing conditions of use along with the use itself.

There have not been any successful, placebo-controlled, double-blind studies of cannabis as a substitute for alcohol for individuals with alcohol dependence. Nonetheless, in a 2003 study published in the Journal of Cannabis Therapeutics, Tod Mikuriya, MD claimed marijuana to be an effective means of harm reduction in the treatment of alcoholism. While Mikuriya’s claims are largely based on anecdotal reports, he makes the case that cannabis has fewer side effects than alcohol, fewer side effects than prescription drugs and is less costly than most prescription drugs for the uninsured. Some addiction specialists believe that while Marijuana Maintenance may not be optimal, it is the lesser of two evils for those who must stop drinking and have been unsuccessful in previous attempts.

The Liver Suffers
Marijuana Maintenance may seem like a feasible choice for individuals who meet the following conditions:

·    Alcoholics who live where medical marijuana is legal.

·    Those who must quit drinking for their liver’s sake

·    People who have previously failed alcohol treatment programs.

Unfortunately, the pioneers of using cannabis to ease off alcohol were not aware of the recent research demonstrating marijuana’s harmful impact on the liver. As published in a January 2008 edition of Clinical Gastroenterology and Hepatology, San Francisco researchers found that daily cannabis use is strongly associated with moderate to severe liver fibrosis. Fibrosis is scarring of the liver, and is the most prevalent indicator of worsening liver disease.

In light of the damage regular cannabis use can inflict on the liver, Marijuana Maintenance does not appear to be a good choice for those with chronic liver disease. While deciding between the lesser of two evils may point to alcohol as capable of causing more damage more quickly to liver cells than marijuana, neither substance is liver friendly. Making decisions about how to best manage chronic liver disease can be difficult and requires weighing many factors. Even though a handful of doctors may suggest marijuana to help kick a liver-harming drinking habit, keep searching for a better alternative that will help you achieve abstinence without causing additional injury to your liver.

Ferguson, Andrew, How Marijuana Got Mainstreamed, Time, November 22, 2010; p 30-38., Can marijuana be used as medicine?, National Institute on Drug Abuse, Retrieved December 12, 2010,, 2010., Medical Cannabis, Retrieved December 12, 2010, Wikimedia Foundation, Inc., 2010., HAMS: Harm Reduction for Alcohol, Retrieved December 12, 2010, The HAMS Harm Reduction Network, Inc., 2010., Alternative Treatment for Alcohol Abuse; Marijuana (cannabis), Dr. Sean Breen, Retrieved December 12, 2010, Medical Cannabis of Southern California, 2010., Principles of Harm Reduction, Retrieved December 12, 2010, Harm Reduction Coalition, 2010., Cannabis as a Substitute for Alcohol: A Harm-Reduction Approach, Tod H. Mikuriya, Retrieved December 12, 2010, Journal of Cannabis Therapeutics, 2003., Influence of cannabis use on severity of hepatitis C disease, Ishida JH, et al, Clinical Gastroenterology and Hepatology, January 2008., What are the Different Medical Marijuana Laws?, Felicia Dye, Retrieved December 12, 2010, conjecture corporation, 2010.

  • Brian Wolf

    You did not reference the “recent studies” that indicate liver toxicity related marijuana use.

    • wolfgang

      Hey Brian, are you from Texas and lived in L.A. Did you have a roomate named Art.I’m your other roomate.

    • Doug Sullivan

      I could be wrong about this but I think the toxic affect of pot they are talking about is from smoking it, not an ingested form of oil, all smoke carries carcenigens.

  • justa guy

    The leap from “…associated with…” to the causative “…damage…regular use can inflict on the liver…” is tenuous at best.  Those who used cannabis daily in the 2008 “study” may also have consumed alcohol, or some other liver damaging substance.  

    By what mechanism does mj impact the liver?  How is it the FDA approved cannabis pill Marinol test results show no impact to liver function?

    To be blunt, your conclusion is specious and unjustified.  How sad. 

  • bobbyearle

    Not true.

    You are LYING! There are no studies that show that cannabis use increases fibrosis. The study you cite showed that people with HEPATITIS C can have potential fibrosis issues with daily cannabis use. HCV is a LIVER disease.

    You just lied.

    And that matters. I’ve lost 40lbs in 2 months from severe Ulcerative Colitis. My GI has NOTHING to offer me in order to eat. I am dying and cannabis is the ONLY thing that enables me to eat (and only a few hundred calories a day). Without cannabis, I can’t even drink water to swallow my medications, at this point.

    So please be more careful with sharing medical information. Be sure that it’s accurate and doesn’t omit anything important. Like here, where the study was with HCV

    • thesecondarything

      Still alive?

    • Cristóbal Andrés Salinas Rodrí

      if you haven’t already, you should give “Betaine HCL w/ Pepsin” a try

  • Bobby Earle

    “Unfortunately, the pioneers of using cannabis to ease off alcohol were not aware of the recent research demonstrating marijuana’s harmful impact on the liver.”

    Unfortunately, you are not aware of the recent research demonstrating marijuana’s POTENTIAL impact on the liver WITH PEOPLE WHO HAVE HCV. Please make the clarification. You are border line lying.

  • rendragnz

    If cannabis really was associated with liver disease, you would have thought someone would have noticed a connection by now, as it has been used for thousands of years.

    Was the author being just lazy or actually corrupt in not mentioning hepatitis in her article?

    Big business spends a lot of money to keep cannabis illegal. Google “cannabis protects against diabetes” or “cannabis protects against cancer” or just “cannabis protects against” and spend a few hours reading studies.

    Follow the money. If you or any one you love has been affected by these diseases you might get rather angry. Imagine how much money the health sector would lose if you could grow your own medicine that was more effective and less toxic than theirs.

  • joe

    Marijuana smoking does not appear to cause progression of liver fibrosis in the Canadian HIV/HCV Co-infection Cohort study

    April 2012

    Authors:Brunet L, Moodie EE, Rollet K, Tyndall M, Potter M, Conway B, Walmsley S, Pick N, Cooper C, Cox J, Klein MB for the Canadian Co-infection Cohort (CTN222)
    Location: 21st Annual Canadian Conference on HIV/AIDS Research (CAHR 2012) Montreal


    The literature on the effect of cannabis
    on liver diseases is conflicting. Cell cultures and animal model studies
    conclude that cannabidiol could have a therapeutic effect on liver
    injuries. However, cross-sectional studies of chronic HCV
    patients suggest that daily cannabis use is associated with fibrosis
    and steatosis. This study aims at estimating the causal effect of
    marijuana use on liver fibrosis progression in the Canadian Co-infection Cohort study.


    co-infected individuals were followed-up every six month. At each
    visit, they provided information on marijuana use which was then
    categorized as (1) did not use, (2) used occasionally, (3) used daily,
    ≤4 joints/day, and (4) used daily, >4 joints/day, based on the
    median. To account for time-dependent confounding, marginal structural
    pooled logistic regression models were used to assess the effect of
    marijuana use on progression to significant fibrosis (APRI>=1.5).
    Baseline (age, sex, ethnicity, low income, duration of HCV infection) and updated characteristics (CD4 cell count, HIV
    viral load, antiretroviral therapy, alcohol use, illicit opioid use and
    other IDU) were included in the inverse probability of treatment
    weights calculation.


    A total of 843 patients contributed 3,914 person-visits and
    161 progressed to significant fibrosis. At baseline, 52% had smoked
    marijuana in the past 6 months (median: 2 joints/day [IQR: 1-4]), of
    whom 37% smoked daily; 40% smoked to relieve symptoms, 42% to increase
    appetite, and 46% for fun. There was no causal association between
    progression to liver fibrosis and smoking occasionally (OR: 0.81 [95%
    CI: 0.49-1.34]), smoking ≤4 joints daily (OR: 0.47 [0.19-1.15]), or
    smoking >4 joints daily (OR: 1.26 [0.61-2.63]), compared to
    individuals who did not smoke.


    Marijuana smoking does not have a causal effect on
    progression to liver disease in co-infected individuals.
    Self-medication, causing time-dependent confounding, could have lead to
    the association observed in previous cross-sectional studies.

  • caplays

    I do not consider this anything other than an article made to sell their products. When your references for facts include wikipedia, an extremely unreliable source.

  • nigger

    What a fucking idiot! Nicole Cutler go fuck yourself.

    • DirkBennedict


  • Anis Mg

    you are big Liar , cannabis extracts have a great anti inflamatory benefits on the liver , if ingested and vaped it can heal the liver in less than one month and for sure while completly not drinking boose.

  • Harmon Yea

    Three years to correct bad journalism, yet the “edit” button goes unclicked. You’d figure someone specializing in the science of B*****it, aka acupuncture, would be more supportive of alternative medicine… being a part of it and all. Keep on helping to keep God’s gift from the people, Nicole Cutler.

  • Meriinenq Hansline

    Actavis prometh Codeine Cough Syrup ,Cannabis oil and medical Marijuana .ONLY Interested Buyers ordering now should send a message and a friend request. Email ( OR text us with what you need (801) 690-7463

    • Ashley Villa

      i will try mj any form . i dont know what to believe but i wanna try that without scary feeling so which is true .. i hope it works for me i have a deseases coz of western medicine .. i have a healthy routine but still suffering in side effects i take one year ago so im careful to take anythinbg that will not harm my liver again.any opinion will be much appreciated.

  • Somebody

    “As published in a January 2008 edition of Clinical Gastroenterology and Hepatology, San Francisco researchers found that daily cannabis use is strongly associated with moderate to severe liver fibrosis.” -From the article above

    It is worth noting that the tests were conducted on patients who had Hepatitis-C.:
    “Researchers found that HCV patients who used cannabis daily were at
    significantly higher risk of moderate to severe liver fibrosis, or
    tissue scarring.” -Live Science

    That being said, this does not necessarily mean that those without Hepatitis-C do not risk fibrosis of the liver if they are chronic chronic users.

  • Lilly Von Schtupp

    Wow! This is great news! If you believe that medical Cannabis is going to harm your liver; I just happen to have available for only $150 a Deed to the Golden Gate Bridge. Hundred-fifty bucks and it’s yours!

  • Teodoro Cervantes-Leon

    The risks of liver harm by cannibis, even if acknowledged, are not reasons for an alcoholic to switch to cannibis. ETOH is a liver killer. Documented. Serious. Among it’s there many health issues, including stroke and cancer. By all means if cannibis gets you off ETOH, switch. This article is hype and poorly supported.

  • Kristoffer

    This article is misinformation to the point of being nefarious. Clearly the author feels that marijuana is evil and is trying her best to save society, truth be damned. I cannot smoke marijuana because I regularly get drug tested for work. However, I am very aware of the medical effects of marijuana, and one thing it definitely does not harm is the liver. I nearly sprained my neck shaking my head reading this article.

  • Star

    This is utter BULLSHIT! I have autoimmune hepatitis and cirrhosis, and Cannabis has been my only saving grace after conventional medication messed me up worse than the disease itself! Since beginning my own care, ALL lab work, CT scans and ultrasounds continue to be normal, my LFT (liver function tests) are routinely above average for my conditions, and I actually feel better to boot. And if that’s discounted as being “anecdotal,” consider the fact that this article claims no (standard) medical study has been done on Cannabis but then claims a study shows decreased liver function from Cannabis use. So…which is it? LIES.

  • Marybeth Davis

    Here is an absolute truth that I myself have witnessed numerous times. I am a registered nurse and I know what I have seen with patients and family members with alcoholic liver disease. THC (edible and otherwise) definitely causes an elevation of the ammonia levels in alcoholics with liver disease, thus causing encephalopathy in those with severe liver disease and thus psychotic behavior. The person with erratic behavior in society then is prey to brutality, sexual abuse and a host of other problems depending on were they are and who is involved. If police are called, a person likely ends up in jail, if paramedics get involved and there is a trip to the ER then either the misdiagnosis of psychosis alone rather than ammonia induced psychosis. Or the person is paced in a dirty detox unit or locked mental hold room in the ER. If ammonia levels are checked they are discharged to the streets or elsewhere after the lactulose and IV fluids clear them temporarily. Unfortunately marijuana is very poorly metabolized and remains in the system and those who suffer the adverse effects of it are sleepless for days, and erratic behavior persists approximately a week, during which the person is at risk in a society that has no idea what to do with them. Yet, those who love their marijuana at all costs will defend and argue and refuse to believe this is what caused the hell they lived and so the cycle will continue and continue, all the while denial abut marijuana remains a subtle enemy. That is one reason clean and sober is advocated. The process and cycle of addiction is complex but those in recovery who find a serenity without street substances and substitutes seem to have something that is unmistakably beautiful and clear that is evident as soon as one lays eyes on them.