Cirrhosis is the last stage of chronic liver disease. Over time, damage to the liver causes permanent scarring that inhibits liver function and can eventually cause it to shut down completely.
The liver has always been revered throughout history; it was thought to be the source of blood and even used by some ancient cultures to predict the future. It is not a surprise that the seriousness of cirrhosis or a “hard liver” was known thousands of years ago, as far back as 400 BCE.1
Currently, liver disease affects 1.8% of US adults. In 2021, chronic liver disease, including cirrhosis, was America's 9th leading cause of death.
There is no cure for cirrhosis, but scientists continue to study ways to slow its progression and potentially reverse the damage. In a 2021 proof-of-concept study, researchers explored a new cell therapy that could possibly improve the treatment of liver diseases like cirrhosis.2
What Causes Cirrhosis?
When your liver tries to repair itself, it creates scar tissue that hinders blood flow and the liver’s vital processes. Cirrhosis is diagnosed when scar tissue consumes most of the liver and cannot function properly. Common causes of cirrhosis include:
- Alcohol use disorder
- Infection with hepatitis B or hepatitis C
- A buildup of fat in the liver related to obesity, diabetes, high blood pressure, and high cholesterol (non-alcoholic fatty liver disease)
Other liver-damaging conditions, including certain inherited diseases, autoimmune diseases, defective bile ducts, and heart failure, may also be responsible for causing cirrhosis.
Cirrhosis Signs & Symptoms
If you have early-stage cirrhosis, you may experience one or more of the following symptoms:
- Decreased appetite
- Feeling weak or fatigued
- Fever
- Nausea and vomiting
- Weight loss
- Abdominal discomfort on the upper right side
These symptoms aren’t always apparent at this stage; if they do appear, they can be easily mistaken for other medical conditions.
As cirrhosis progresses and liver function worsens, you may experience one or more of the following symptoms:
- Easily bruising and bleeding
- Confusion, cognitive decline, personality changes, or sleep disorders
- Edema in your lower legs or feet
- Fluid buildup in your abdomen
- Itchy skin
- Dark urine
- Jaundice
- Stool that is light in color or has blood present
- Redness in palms
- Loss of periods in women
- Decreased sex drive, shrunken testicles, or gynecomastia
A cirrhosis diagnosis means that liver disease is already late stage, so cirrhosis is classified under two types:
- Compensated cirrhosis: Cirrhosis has occurred, but no symptoms are present, and a diagnosis may only be possible through a liver biopsy. People in this stage have a 50% chance of surviving at least 9-12 years.
- Decompensated cirrhosis: The liver has been damaged enough that symptoms are apparent and verifiable without a biopsy. At this stage, at least one complication is present, hospital care is needed, and at least 50% will survive under two years. In some cases, a liver transplant can add more than one to five years.3
Cirrhosis can also lead to many other medical complications.
Can Cannabis Can Help Alleviate Cirrhosis Symptoms?
Research into cannabis and cirrhosis has centered around the endocannabinoid system's role in liver disease and how cannabis may impact some of its complications.
- In a 2018 article, researchers determined that the endocannabinoid system can interact with liver disease positively and negatively.4 More research is needed to determine how this knowledge may influence future therapies and whether cannabis should be recommended for people with liver disease.
- A 2017 cross-sectional study analyzed cannabis use and liver disease in almost 6 million people. Researchers observed a lower number of specific risk factors for non-alcoholic fatty liver disease in people who used cannabis.5
- Cannabis does not appear to worsen the scarring that leads to cirrhosis, according to a 2019 scientific review. This study focused on people with liver disease caused by hepatitis C (HCV), HIV, and other causes besides alcohol.6
- In another 2018 study published in the Canadian Journal of Gastroenterology and Hepatology, experts noted cannabis-related improved outcomes and reduced complications in people with liver cirrhosis caused by HCV. At the same time, cannabis use did not impact the rate of death. These findings underscore the need for more research to determine exactly why this may be.7
While it is not certain whether medical cannabis can fight cirrhosis, it appears to have some impact on this liver disease. Further research is significantly called for, mainly because cannabis use has the potential to exert both positive and negative effects on liver disease.
Cannabis may be able to mitigate factors that can lead to or worsen cirrhosis, but it doesn’t seem to change the mortality rate. More conclusive research is needed.
More than 80% of people with cirrhosis report pain, and cannabis is often used for pain relief.8,9 Cannabis doesn’t appear to worsen cirrhosis, but consult a healthcare provider before adding it to your treatment plan. It is also important to be aware of eating habits when using cannabis not to increase your risk of liver damage.
Legality and Doctor’s Recommendation
To determine if your state considers cirrhosis a qualifying condition for medical cannabis, check out our Laws & Regulations section for the medical cannabis rules for your state.
If you find that your state recognizes cirrhosis or its symptoms as a qualifying medical condition, you can seek a doctor’s recommendation to get your medical cannabis card in your state.
How NuggMD Can Help
NuggMD is the nation's leading medical cannabis technology platform, serving patients in over half the United States. We’ve connected over 1,300,000 patients with their new medical cannabis doctors face-to-face via our state-of-the-art telemedicine platform.
We believe that every human has the right to explore the benefits of medical cannabis and are fully committed to helping each patient explore all their options in their journey to wellness. For further information on whether you qualify for medical cannabis, select your state.
Frequently Asked Questions About Cannabis & Cirrhosis
Does smoking cannabis affect your liver?
Using cannabis appears to have some effect on liver disease, but scientists have not been able to determine a method to produce a positive outcome conclusively. In people with cirrhosis, cannabis use doesn’t seem to worsen liver damage, but more study is needed. If you have cirrhosis, use caution and consult with your healthcare provider before smoking cannabis.
Can you use cannabis when you have pain from liver disease?
Pain is common in people with liver disease, and cannabis has been studied for its ability to help with certain types of chronic pain. Before using cannabis for liver disease, consult with your healthcare provider to be made aware of any possible risks or medication interactions.
How does cannabis affect cirrhosis from fatty liver disease?
Studies have shown that cannabis use is associated with a decreased number of health complications that often lead to fatty liver disease, but we are unable to make definitive statements about the development of cirrhosis from fatty liver disease and cannabis.
References
- Mousa OY, Kamath PS. A History of the Assessment of Liver Performance. Clin Liver Dis (Hoboken). 2021;18(Suppl 1):28-48. Published 2021 Oct 29. doi:10.1002/cld.1100
- Takeuchi S, Tsuchiya A, Iwasawa T, et al. Small extracellular vesicles derived from interferon-γ pre-conditioned mesenchymal stromal cells effectively treat liver fibrosis. npj Regenerative Medicine. 2021;6(1). doi:https://doi.org/10.1038/s41536-021-00132-4
- Rai R. Liver transplantatation- an overview. Indian J Surg. 2013;75(3):185-191. doi:10.1007/s12262-012-0643-0
- Dibba P, Li AA, Cholankeril G, et al. The Role of Cannabinoids in the Setting of Cirrhosis. Medicines (Basel). 2018;5(2):52. Published 2018 Jun 9. doi:10.3390/medicines5020052
- Adejumo AC, Alliu S, Ajayi TO, et al. Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: A cross-sectional study. PLoS One. 2017;12(4):e0176416. Published 2017 Apr 25. doi:10.1371/journal.pone.0176416
- Farooqui MT, Khan MA, Cholankeril G, et al. Marijuana is not associated with progression of hepatic fibrosis in liver disease: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2019;31(2):149-156. doi:10.1097/MEG.0000000000001263
- Adejumo AC, Adegbala OM, Adejumo KL, Bukong TN. Reduced Incidence and Better Liver Disease Outcomes among Chronic HCV Infected Patients Who Consume Cannabis. Can J Gastroenterol Hepatol. 2018;2018:9430953. Published 2018 Sep 23. doi:10.1155/2018/9430953
- Klinge M, Coppler T, Liebschutz JM, et al. The assessment and management of pain in cirrhosis. Curr Hepatol Rep. 2018;17(1):42-51. doi:10.1007/s11901-018-0389-7
- Lee G, Grovey B, Furnish T, Wallace M. Medical Cannabis for Neuropathic Pain. Current Pain and Headache Reports. 2018;22(1). doi:https://doi.org/10.1007/s11916-018-0658-8
The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.
