Can Cannabinoids Help Alcohol-Related Liver Disease Too?
We do hear a lot about the effect of cannabis on the body, and the brain specifically. However, only in rare circumstances do we consider its effects when combined with other drugs including alcohol. Investigating the effects of alcohol or cannabis on its own is valuable; however, this doesn’t reflect the pattern with which it is used publicly. Hence, it is of great importance that we understand the effect of both substances on health (when combined). This challenge was taken up by a study conducted recently. The study aimed to investigate how the consumption of cannabis affects alcohol and liver disease.
Is There a Correlation Between Alcohol and Liver Disease?
The short answer: Yes. The long answer: Consistent intake of alcohol triggers liver disease by consistently raising the levels of inflammation. Alcohol has a negative effect on liver cells (known scientifically as hepatocytes). Alcohol damages the cells of the liver and causes an inflammatory response. Also, it interferes with activities in the walls of the intestine, resulting in the recruitment of inflammatory cells to repair the damage. These inflammatory cells migrate to the liver via the intestine where they cause an inflammation of the liver. Alcohol also alters the bacterial flora in the gut, resulting in the release of toxins into the bloodstream. The liver tries to metabolize these and then gets inflamed in the process.
These processes result in the onset & progression of alcoholic liver disease.
- The progression of alcoholic liver disease often disrupts the normal function of the gastrointestinal tract, resulting in excessive deposition of fat in the liver. This results in a condition called fatty liver or steatosis.
- The excess fat cells in the liver increase stress in the cells, resulting in persistent inflammation of the liver, even in the absence of alcohol. This is known as alcoholic hepatitis.
- This inflammation ultimately causes a permanent damage of the liver cells. The damage continues until such a point where very few cells remain, and the liver gets scarred with dead tissue. At this stage, the condition is termed cirrhosis. The function of the liver at this point becomes severely compromised.
- Finally, the inflammation, which has been persistent, also raises the risk for hepatocellular carcinoma, known informally as liver cancer.
These four processes feature the devastating alcoholic liver disease. At least 29 percent of people have abused alcohol at some point in their lives. Of these, 20 percent develop liver disease. Studies have shown that people with an alcohol use disorder are at higher risk of dying from a liver ailment. The question is … what if there is a way to minimize the risk of alcoholic liver disease in people who abuse the substance? Industrial hemp-derived cannabinoids may be the answer..
Research on the Effects of Industrial Hemp on Alcoholic Liver Disease
In a large cohort study involving 320,000 subjects with an alcohol abuse disorder (of which 260,000 were not cannabis-dependent, and 4,300 were dependent on cannabis), the researchers discovered that cannabis-use protected against the progression of alcoholic liver disease.
The protective effect of hemp was less significant in those who were alcohol dependent …
The study showed that regardless of whether people were consistent or inconsistent users of cannabis, cannabis protected against the progression of each of the four stages of liver disease. It was discovered that the greatest consumers of cannabis had the most protection against liver disease.
Use of cannabis was associated with …
- A 45% reduction in steatosis (fatty liver)
- A 40% reduction in hepatitis
- A 75% reduction in liver cancer (hepatocellular carcinoma)
- A 55% reduction in alcoholic cirrhosis
It must be understood that the protective effect of cannabis was highest in those who were certified alcohol abusers. It did not have a significant protective effect in those who met the criteria for alcohol dependence. Alcohol abuse refers to drinking too much too frequently. Dependence refers to an inability to cease drinking. In many cases, those that are dependent on alcohol end up taking an excess of it throughout their lives. It, therefore, seems that cannabis only protects against liver disease to a certain extent; the more you drink, the less protection it offers.
Industrial Hemp Protects Against Cancer of the Liver
Researchers have concluded that the protective effect of cannabis comes from its capability to prevent cirrhosis. This is a different mechanism, compared to killing or halting cancer directly. Studies have shown that 90 percent of carcinoma cases arise from cirrhosis. Industrial hemp acts as a barrier to this vital step, thus exhibiting its substantial therapeutic potential to prevent alcoholic liver disease.
Actually, the anti-inflammatory effects of cannabis to the liver are not straightforward. Tetrahydrocannabinol (THC), for instance, activates the CB1 and CB2 receptors, while cannabidiol (CBD) inhibits the actions of THC at CB1 receptors, and instead, activates CB2 receptors. This is an important distinction considering the fact that activation of CB1 receptors has pro-inflammatory effects on the liver, and results in liver ailments, while activation of the CB2 receptors protects against liver disease.
The anti-inflammatory effects of cannabinoids are already being utilized in analgesics as well as in multiple sclerosis, colitis, and arthritis.
- Beal, J.E., Olson, R., Laubenstein, L., Morales, J.O., Bellman, P., Yangco, B., Lefkowitz, L, Plasse, T.F. and Shephard, K.V. (1995, February). Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Journal of Pain and System Management, 10(2), 89-97. Retrieved from http://www.jpsmjournal.com/article/0885-3924(94)00117-4/pdf.
- Cirrhosis. (2014, August 16). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/cirrhosis/basics/definition/con-20031617.
- Cirrhosis. (2014, November 20). MedlinePlus. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/article/000255.htm.
- Mallat, A., Teixeira-Clerc, F., Deveaux, V., Manin, S., and Lotersztajn, S. (2011, August). The endocannabinoid system as a key mediator during liver diseases: new insights and therapeutic openings. British Journal of Pharmacology, 163(7), 1432-40. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165953/.
- Parker, L.A., Rock, E.M., Sticht, M.A., Wills, K.L., and Limebeer, C.L. (2015). Cannabinoids suppress acute and anticipatory nausea in preclinical rat models of conditioned gaping. Clinical Pharmacology and Therapeutics, 97(6), 559-61. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1002/cpt.98/full.
- Zduniak, K., Ziolkowski, P., Regnell, P., Tollet-Egnell, P., Åkesson, L., and Cooper, M.E. (2016). Immunohistochemical analysis of cannabinoid receptor 1 expression in steatotic rat livers. Experimental and Therapeutic Medicine, 11(4), 1227–1230. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812478/.