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Liver Int. 2018 Aug;38(8):1475-1486. doi: 10.1111/liv.13696. Epub 2018 Feb 10.

Cannabis use is associated with reduced prevalence of progressive stages of alcoholic liver disease.

Author information

1
North Shore Medical Center, Salem, MA, USA.
2
Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
3
Johns Hopkins Medicine, Howard County General Hospital, Columbia, MD, USA.
4
Department of Medicine, Englewood Hospital and Medical Center, Englewood, NJ, USA.
5
School of Public Health, University of Massachusetts Lowell, Lowell, MA, USA.
6
Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
7
Department of Pediatrics, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
8
INRS-Institut Armand-Frappier, Institut National de la Recherche Scientifique, Laval, QC, Canada.

Abstract

BACKGROUND:

Abusive alcohol use has well-established health risks including causing liver disease (ALD) characterized by alcoholic steatosis (AS), steatohepatitis (AH), fibrosis, cirrhosis (AC) and hepatocellular carcinoma (HCC). Strikingly, a significant number of individuals who abuse alcohol also use Cannabis, which has seen increased legalization globally. While cannabis has demonstrated anti-inflammatory properties, its combined use with alcohol and the development of liver disease remain unclear.

AIM:

The aim of this study was to determine the effects of cannabis use on the incidence of liver disease in individuals who abuse alcohol.

METHODS:

We analysed the 2014 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (NIS) discharge records of patients 18 years and older, who had a past or current history of abusive alcohol use (n = 319 514). Using the International Classification of Disease, Ninth Edition codes, we studied the four distinct phases of progressive ALD with respect to three cannabis exposure groups: non-cannabis users (90.39%), non-dependent cannabis users (8.26%) and dependent cannabis users (1.36%). We accounted for the complex survey sampling methodology and estimated the adjusted odds ratio (AOR) for developing AS, AH, AC and HCC with respect to cannabis use (SAS 9.4).

RESULTS:

Our study revealed that among alcohol users, individuals who additionally use cannabis (dependent and non-dependent cannabis use) showed significantly lower odds of developing AS, AH, AC and HCC (AOR: 0.55 [0.48-0.64], 0.57 [0.53-0.61], 0.45 [0.43-0.48] and 0.62 [0.51-0.76]). Furthermore, dependent users had significantly lower odds than non-dependent users for developing liver disease.

CONCLUSIONS:

Our findings suggest that cannabis use is associated with a reduced incidence of liver disease in alcoholics.

KEYWORDS:

alcohol; cannabis; drug abuse; liver disease

PMID:
29341392
DOI:
10.1111/liv.13696

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