Risk Of Hepatitis C-Related Liver Damage Increased By Regular Marijuana Use
Main Category: Liver Disease / HepatitisAlso Included In: Alcohol / Addiction / Illegal Drugs; HIV / AIDS
Article Date: 29 Jan 2008 - 3:00 PDT
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Patients with chronic hepatitis C (HCV) infection should not use marijuana (cannabis) daily, according to a study published in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute. Researchers found that HCV patients who used cannabis daily were at significantly higher risk of moderate to severe liver fibrosis, or tissue scarring. Additionally, patients with moderate to heavy alcohol use combined with regular cannabis use experienced an even greater risk of liver fibrosis. The recommendation to avoid cannabis is especially important in patients who are coinfected with HCV/HIV since the progression of fibrosis is already greater in these patients.
"Hepatitis C is a major public health concern and the number of patients developing complications of chronic disease is on the rise," according to Norah Terrault, MD, MPH, from the University of California, San Francisco and lead investigator of the study. "It is essential that we identify risk factors that can be modified to prevent and/or lessen the progression of HCV to fibrosis, cirrhosis and even liver cancer. These complications of chronic HCV infection will significantly contribute to the overall burden of liver disease in the U.S. and will continue to increase in the next decade."
This is the first study that evaluates the relationship between alcohol and cannabis use in patients with HCV and those coinfected with HCV/HIV. It is of great importance to disease management that physicians understand the factors influencing HCV disease severity, especially those that are potentially modifiable. The use and abuse of both alcohol and marijuana together is not an uncommon behavior. Also, individuals who are moderate and heavy users of alcohol may use cannabis as a substitute to reduce their alcohol intake, especially after receiving a diagnosis like HCV, which affects their liver.
Researchers found a significant association between daily versus non-daily cannabis use and moderate to severe fibrosis when reviewing this factor alone. Other factors contributing to increased fibrosis included age at enrollment, lifetime duration of alcohol use, lifetime duration of moderate to heavy alcohol use and necroinflammatory score (stage of fibrosis). In reviewing combined factors, there was a strong (nearly 7-fold higher risk) and independent relationship between daily cannabis use and moderate to severe fibrosis. Gender, race, body mass index, HCV viral load and genotype, HIV coinfection, source of HCV infection, and biopsy length were not significantly associated with moderate to severe fibrosis.
Of the 328 patients screened for the study, 204 patients were included in the analysis. The baseline characteristics of those included in the study were similar to those excluded with the exception of daily cannabis use (13.7 percent of those studied used cannabis daily versus 6.45 percent of those not included). Patients who used cannabis daily had a significantly lower body mass index than non-daily users (25.2 versus 26.4), were more likely to be using medically prescribed cannabis (57.1 percent versus 8.79 percent), and more likely to have HIV coinfection (39.3 percent versus 18.2 percent).
The prevalence of cannabis use amongst adults in the U.S. is estimated to be almost 4 percent. Regular use has increased in certain population subgroups, including those aged 18 to 29.
Hepatitis is an inflammation of the liver. Hepatitis C is the most common form of hepatitis and infects nearly 4 million people in the U.S., with an estimated 150,000 new cases diagnosed each year. While it can be spread through blood transfusions and contaminated needles, for a substantial number of patients, the cause is unknown. This form of viral hepatitis may lead to cirrhosis, or scarring, of the liver. Coinfection of hepatitis C in patients who are HIV positive is common; about one quarter of patients infected with HIV are infected with hepatitis C. The majority of these patients, 50 to 90 percent, were infected through injection drug use. Hepatitis C ranks with alcohol abuse as the most common cause of chronic liver disease and leads to about 1,000 liver transplants yearly in the U.S.
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About the AGA Institute
The American Gastroenterological Association (AGA) is dedicated to the mission of advancing the science and practice of gastroenterology. Founded in 1897, the AGA is one of the oldest medical-specialty societies in the United States. Comprised of two non-profit organizations - the AGA and the AGA Institute - our more than 16,000 members include physicians and scientists who research, diagnose and treat disorders of the gastrointestinal tract and liver. The AGA, a 501(c6) organization, administers all membership and public policy activities, while the AGA Institute, a 501(c3) organization, runs the organization's practice, research and educational programs. On a monthly basis, the AGA Institute publishes two highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology. The organization's annual meeting is Digestive Disease Week®, which is held each May and is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. For more information, please visit http://www.gastro.org/.
About Clinical Gastroenterology and Hepatology
The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit http://www.cghjournal.org/.
Source: Aimee Frank
American Gastroenterological Association
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MLA
15 Feb. 2012. <http://www.medicalnewstoday.com/releases/95434.php>
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http://www.medicalnewstoday.com/releases/95434.php.
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Visitor Opinions In Chronological Order (8)
Marijuana Is Not 'soft Drug'.
posted by Peter O'Loughlin on 30 Jan 2008 at 4:19 amAs more and more evidence emerges about the dangers of cannabis, it becomes apparent that it is anything but the 'soft drug', that pro drug legalisers, and so called 'drug advisory agencies', have for so long been perpetuating myths for so long.
One of the most dangerous myths touted is that cannabis is not addictive, nothing could be further from the truth, a fact that was established as long ago as 1998, (1) but suppressed in the UK by those with vested interests in legalsing and therefore spreading the use of marijuana.
Another fact that was suppressed and was available before cannabis was downgraded is that each year in America more teenagers enter treatment with a primary diagnosis of cannabis dependence than all other illicit drugs combined. (2) Since cannabis has been down graded in the UK, more and more kids have been presenting for treatment, with the current numbers approaching 500 a week. Facts like that do not prevent politicians and 'pushers' telling us that cannabis use is declining.
A third important fact that was known before the decision to downgrade was made, is that no less than sixty per cent of teens presenting for drug abuse treatment in America acknowledge that cannabis is their primary drug of choice.
So why was it downgraded? Well since the politicians, and those who press for legalisation appear incapable of telling the truth, that's something they will never reveal. This writer posits that the Government was keen to be seen to be reducing drug crime and therefore by downgrading it, without 'presumption of arrest' for posession, was able to conveniently move it out of the crime figures, thus allowing them to claim their policies were reducing drug crime.
As for the pro durg legalisers and the so called 'advisory agencies', who also pressed for legalisation and continue to do so, one can only conclude that they have vested interests in those companies who would be licensed to produce and distribute it. Whether those interests are disguised as 'funding for research', or other euphemisms for 'pushing' is unknown. What is interesting is those same people push for 'education of drugs based on the facts', so that people can make an 'informed choice'. How strange they do not include the above facts in their 'Information Fact Sheets'
Marijuana: Facts for Teens. National Institute on Drug Abuse, 1998. http://www.nida.nih.gov/ Crowley, T. J.;
Macdonald, M. J.; Whitmore. E. A.; and Mikulich, S. K. Cannabis Dependence, Withdrawal, and Reinforcing
Effects Among Adolescents With Conduct Symptoms and Substance Use Disorders. Drug and Alcohol
Dependence, 1998.˙
Treatment Episodes Data Set 1992-2000, National Admissions to Substance Abuse Treatment Services.
SAMHSA. DASIS Series S-17, DHHS Pub. No. (SMA) 02-3727, 2002.
Treatment Episodes Data Set 1992-2000, National Admissions to Substance Abuse Treatment Services.
SAMHSA. DASIS Series S-17, DHHS Pub. No. (SMA) 02-3727, 2002.
Some Facts To Counter The Myths
posted by Niek Sprakel on 31 Jan 2008 at 9:09 amThe myths are being perpetuated primarily by narconazis:
http://www.erowid.org/plants/cannabis/cannabis_myth.shtml
Marijuana Is Not A Soft Drug
posted by Mary Brett on 31 Jan 2008 at 11:50 amAnother less-publicised harmful effect of cannabis is the long-term interference with all the brain functions due to the persistence of the fat-solubleTHC (the psychoactive ingredient) in the membranes of the nerve cells, 50% of it will be there a week later and 10% after a month.
The chemicals that carry messages between the cells (neurotransmitters) are severely disrupted, concentration, learning and memory are all impaired. As a teacher I have seen the deterioration in the academic work of my pupils, grades plummet and university places are lost. Few pupils, using cannabis even occasionally will achieve their full potential.
Not Only Users Are Affected
posted by Ann Stoker on 1 Feb 2008 at 5:43 amMore and more evidence is being publicised about the harms to users from the use of marijuana. I have worked for over 20 years with drug users and their families and would like to emphasise that the harms from the use of this drug are not only to the user. Parents and siblings are impacted by the changes in personality, the lost potential in academic success, the long periods of unemployment and the general lack of impetus to live life to the full that the user experiences.
Try telling a mother whose l7 year old son stays in bed until noon each day and has no interest in anything except smoking his spliffs that marijuana is not harmful.
Demonization And Criminalization Of Cannabis Must Stop
posted by Niek Sprakel on 1 Feb 2008 at 7:33 amI'm sick and tired of this demonization campaign in the media to incriminate cannabis. Prohibition of cannabis causes far more harm than cannabis itself. How can you even seriously expect people to respect the law when nobody has ever died as a consequence of abusing cannabis and adults can abuse all the alcohol they like without any legal consequences whatsoever. Alcohol is not just potentially lethal in case of chronic and acute intoxication but even the withdrawal effects are potentially fatal.
Drug laws are a complete joke and drug education will never be taken seriously when the government arbitrarily bans less harmful drugs like cannabis while allowing more harmful drugs like alcohol.
This figure of 500 people seeking help every week that has come up in the media lately is actually 14 each week according to DrugScope:
http://www.drugscope.org.uk/newsandevents/currentnewspages/Telegraph-cannabis-stats-response.htm
(same as http://tinyurl.com/yofe2j )
Just look at failed attempts to prohibit alcohol in the USA in the previous century and you see that prohibition is primarily effective at sponsoring organized crime. Cannabis is not a harmless drug (like alcohol) and should be regulated like alcohol to prevent kids from having access to it. If you prohibit it, that means it becomes a lucrative business opportunity for criminals who are only in it for the money and don't care about the age of their customers and they might offer more harmful alternative drugs (like meth, coke, smack or crack) besides cannabis.
All this babbling about cannabis and how it impairs learning and memory is a joke as well. Just look at Bob Marley and how he smoked massive amounts of ganja and was a very creative, outspoken and influential musician. There are numerous other examples of people who have frequently enjoyed and promoted cannabis who don't seem to be impaired but quite the opposite, they are motivated by their cannabis habit to achieve their full potential. It seems more likely people who enjoy cannabis see through the lies of the brainwash education system and turn their back on it.
Now I don't want to suggest that cannabis is harmless and can't be abused, but the bottom line is adults have the right to prefer cannabis instead of a more harmful and addictive drug like alcohol and the only viable strategy to prevent and reduce abuse of cannabis is to educate people about the effects and risks involved and ensure only adults have access to cannabis via licensed stores (similar to how alcohol and tobacco sales are regulated).
Yes, Cannabis Kills
posted by Katy Holford on 1 Feb 2008 at 3:35 pmMy son started smoking pot at school aged 15 - then dropped acid - more acid at university - stopped going to lectures - disappeared - eventually found locked in rented room - came home and went to bed for a year, catatonic - 'friends' smuggled him in occasional marihuana - swigged whole bottles of codeine cough linctus - became dependent on heroin - snorted coke - more heroin and died in the year 2000. Among last words to me, his mother, were, "Don't ever smoke pot," Mother dear. "As if I ever would!" I said.
Don't tell me cannabis doesn't kill. It winds its way to death. Tortuously.
Divorce Drugs From The Political Process.
posted by Philip Slattery on 2 Feb 2008 at 2:30 amThe recent program of demonising cannabis would seem to be almost entirely political driven. It always seems to rise in pitch just before the ACMD is due to deliberate. Most of these stories in the newspapers are based on opinions rather than on any peer reviewed scientific studies. In very nearly every such study cannabis is shown to be less harmful than drugs currently licensed for public consumption.
The argument over whether drugs should be available for public consumption has been run through many times and as a society we have agreed that on the whole it is better to allow it than to prevent it.
Our problem then it to decide which ones can be used. Cannabis is, as least from a scientific point of view, the least harmful of the drugs currently used, be they legal or illegal. I refer to tobacco, alcohol, cocaine, amphetamines, morphine derivatives and manufactured substances such as Ecstasy. I do realise that from a political point of view cannabis is a very dangerous subject, particularly for the Americans who are the main drivers of its prohibition. But that’s another story.
One problem I do concede with cannabis is that recently in the UK there has been a trend for the smugglers to adulterate it with all sorts of unsavoury fillers. I often wonder if this could be a reason for some of the reports of strange behaviour of cannabis users that was never seen historically. But it is a result of its prohibition and not of the substance itself.
Politicians hate drugs, not because they are drugs as such but because they can’t be seen to do the wrong thing. They can’t be sensible because they would be seen as ‘soft on drugs’ by the red top newspapers and they can’t be too hard as it would be a disaster. Perhaps it is time to remove drug policy from the politician’s hands and divorce it completely from the political process. After all doing that with the bank rate did produce a previously unheard of stability.
Cannabis Gives Me Respect
posted by Nancy Perrigon on 2 Feb 2008 at 1:46 pmCannabis is cool. I like it, it is relaxing and gives me respect. My classmates respect me because I am cool. That feels nice. Before I did not have that respect.
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