A large-scale study involving more than 66,000 U.S. adults has found that heavy drinkers who also used cannabis faced lower rates of liver disease compared to those who consumed large amounts of alcohol without using marijuana.
While researchers caution that this doesn’t mean people should start using cannabis, they suggest the CBD compound found in the plant might offer protective benefits for livers under stress from alcohol.
Dr. Juan Pablo Arab, senior author of the study and director of alcohol sciences at the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health at Virginia Commonwealth University (VCU) in Richmond, explained: “CBD appears to calm inflammation and reduce some of the chemical signals that drive liver scarring. Our findings show that real-world cannabis use may have some of these same protective effects in people who drink heavily.”
The research team published their findings recently in the journal Liver International.
The Alcohol-Liver Connection
Excessive alcohol consumption has long been recognized as toxic to liver health. Alcohol-associated liver disease (ALD) ranks among the leading causes of liver-related deaths globally.
Study Design and Participants
The VCU research team monitored liver health outcomes in a group of over 66,000 individuals across three years. All participants had received diagnoses of alcohol use disorder between 2010 and 2022.
Researchers organized participants into three categories: those who had also been diagnosed with cannabis use disorder; those who used cannabis without developing dependence; and those who didn’t use cannabis at all.
Key Findings
The results revealed striking differences in liver health outcomes. Among patients diagnosed with cannabis use disorder, ALD rates were 40% lower compared to the group that used no marijuana. This same cannabis disorder group also showed a 17% reduced risk of severe liver complications and a 14% lower risk of death from any cause.
Even heavy drinkers who used marijuana at non-dependent levels demonstrated some degree of protection against liver disease, according to the study.
Potential Mechanisms
Researchers acknowledge uncertainty about exactly how cannabis might protect the liver. They referenced earlier animal studies indicating that CBD could reduce inflammation and oxidative stress within the organ.
Since excessive fat accumulation in the liver represents a primary driver of ALD, the team suggested that CBD might help liver cells metabolize fat more effectively.
Important Cautions
Despite the encouraging findings, the authors strongly emphasize that heavy drinkers should not interpret these results as a green light to start using cannabis. Marijuana carries its own health risks, particularly for younger individuals, they noted.
Dr. Butros Fakhoury, study co-author and VCU Health hospitalist, clarified: “This study shows an association, not cause and effect. Cannabis may have protective properties, but we still don’t know exactly how much, what form or what dose might be safe or effective. The goal isn’t to promote cannabis use, but to understand which parts of it might hold promise as medicine.”
Next Steps
The research team plans to investigate CBD’s liver-protective potential specifically through controlled clinical trials.
The authors highlighted that CBD itself doesn’t cause intoxication and has already received U.S. Food and Drug Administration (FDA) approval for treating certain seizure disorders, suggesting a pathway for potential medical applications if future research confirms its liver-protecting properties.
This study opens an intriguing avenue for research into novel approaches for protecting liver health in people struggling with alcohol use disorder, though much more investigation is needed before any clinical recommendations can be made.