Medical Update: New Perspective on Marijuana for Hepatitis C

Canadian researchers investigating marijuana use for Hepatitis C provide a rational edge to the debate on how this drug affects the liver.

The most common illicit drug used in the United States, marijuana’s healthfulness is a hotly debated topic. People managing chronic Hepatitis C are among those seeking answers regarding the effect marijuana has on their liver’s wellness.

Compounded by legal issues surrounding marijuana’s legality, the confusion over its seemingly contradictory study results continues to fuel the battle between medical marijuana proponents and opponents. Tipping the scales slightly in favor of marijuana use by people with chronic Hepatitis C, a new study debunks previous clinicians’ conclusions that smoking marijuana contributes to liver injury.

Advocates of legalizing marijuana for medicinal uses cite this drug’s ability to relieve pain, reduce nausea and increase appetite. As of summer of 2013 in the United States, 18 states and the District of Columbia have passed legislation legalizing the use of medical marijuana.

Seven states including Arizona, Maine and Massachusetts cite Hepatitis C as an approved condition for medical marijuana use. However, other states with medical marijuana laws, such as Vermont, Montana and Colorado, omit Hepatitis C from the list of approved conditions for a prescription. Despite Hepatitis C’s omission in some state’s laws, most of the 18 states and D.C. have a clause allowing medical marijuana prescriptions for persistent pain and/or chronic disease.

Pushing the issue of legality aside, the primary concern regarding medical marijuana for people with Hepatitis C is – will using this drug help or harm my liver’s health? While solid arguments can be made for either side, the primary opposing views include:

  • Marijuana may help certain individuals persevere through challenging symptoms and complete antiviral therapy, improving their odds at successfully eliminating the Hepatitis C virus.
  • Heavy marijuana users are at significant risk of progressive liver damage, worsening their Hepatitis C prognosis.

In lieu of reviewing the studies supporting each of these views, they can be accessed here by reading the article “Pros and Cons of Medical Marijuana with Hepatitis C.”

Supporting the justification for smoking marijuana for Hepatitis C, research published in June 2013 in Clinical Infectious Disease found the connection between marijuana use and progressive liver damage to be unsubstantiated. Canadian researchers at McGill University evaluated the effect of marijuana smoking on liver disease progression in those co-infected with HIV and Hepatitis C:

  • The study included nearly 700 people with Hepatitis C without significant fibrosis or end-stage-liver disease who reported their marijuana usage.
  • At baseline, 53 percent of participants had smoked marijuana in the past 6 months, consuming a median of 7 joints per week; 40 percent smoked daily.
  • There was no evidence that marijuana smoking accelerated the progression of their illness to significant liver fibrosis.

There is no doubt that previous studies had found an increase in Hepatitis C progression towards cirrhosis and end-stage liver disease with heavy marijuana use; however, the researchers believed those assumptions were likely biased by reverse causality. This reverse causation implies that instead of marijuana causing a worsening of liver disease, patients used more marijuana to relieve their symptoms as their liver disease progressed.

Nobody is claiming that smoking marijuana is good for you; in fact, decades of studies have found the possibility this practice may do harm to the cardiovascular, respiratory and neurological systems. But looking at the facts regarding marijuana use for those with chronic Hepatitis C, the line holding marijuana as an illicit, liver-harming drug has become blurred. The biggest deterrent for prescribing medical marijuana (in those locations where it is legal) was the assumption that it increased liver fibrosis. Now that Canadian researchers have attributed this assumption to reverse causality, the argument against medical marijuana for Hepatitis C appears to be floundering.

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