A study showed those with alcohol use disorder were less likely to develop cirrhosis or liver cancer if they took cannabis. The study included those with Cannabis use disorder and those who take it for social intent.

“In a massive study that included 320,000 individuals with an alcohol use disorder* (of which over 26,000 were non-dependent cannabis users and 4,300 were dependent cannabis users), the scientists revealed that cannabis use protected against developing alcoholic liver disease.

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

You won’t see this study referenced on a government’s health website. It’s not an easy optic to package for public health.

Cannabis, a generic term, represents hundreds of compounds varying from plant to plant. Studying the effects of cannabis has a minefield of challenges. It’s akin to studying all the drugs contained on your pharmacy shelves within a plant. Read Dr. Mitch Earleywine’s book to grasp the complexity and challenges of cannabis research.

So, next time you read “Cannabis causes or is associated with a particular outcome”, you must ask many questions. A note of caution in research: association is not causation.

To study this plant one must consider the following:

  1. Route of administration – topical, oral, sublingual, smoked, vaped etc.

  2. Timing and frequency of use

  3. Dose of each cannabinoid given, eg. THC or CBD or others

  4. Was the cannabinoid a synthetic copy of the THC molecule or was it plant derived?

  5. Was the dose of the cannabinoid, ie THC, given to subjects far exceeding a typical therapeutic dose?

  6. Ratios of all the cannabinoids and terpenoids within that formulation or herb. ie. THC to CBD ratios and the effects of the other terpenoids (ie. linalool and others found in other plants giving cannabis its taste and smell)

  7. Pattern of usage

  8. Intent and rationale

  9. Perceived or self-described and defined effects from the person’s perspective

  10. Set and setting

  11. Form of the cannabinoid formulation – herb, shatter, wax, oil, tincture

  12. Age – different ages may exhibit differences in metabolizing the compounds

  13. Sex: hormones vary during stages of life, (eg. menopause) and may affect outcomes. Differences between male and female hormones may also affect cannabis metabolism and effects.

  14. Effects of co-administration of other pharmaceuticals, drugs etc will affect outcomes.

  15. The status and function of the person’s own endocannabinoid system. This new system discovered in the early nineties, keeps balance within the body. It is somewhat analogous to your endorphin system.

  16. Do they also have other health issues such as medical or mental health challenges?

  17. Do study subjects have a history of significant trauma? Lower or higher IQ? Social or economic challenges? Educational differences? Racial or gender inequities?

  18. Who published the study and are there potential conflicts of interest? Is the mission of the research institution is to find only harms? Thus, does the researcher’s pay-check depends on finding harms? Do they block or deny funding for research for benefits?

There are many more points to consider besides the above points. Does the outcome of the above study give licence to drink and smoke cannabis with abandon?

The study above doesn’t examine other potential harms or benefits of co-use. Questions to ask may include what effect does co-use have on the brain, positive or negative? Alcohol may increase plasma levels of THC and if so, what are the potential outcomes? Co-use may decrease overall alcohol consumption. Or it may increase alcohol consumption due to cannabis having an anti-nausea effect.

As with all research on cannabis, it is not a binary subject. Study results are another part of a puzzle for examination and further study. One must get accustomed to the muddy waters. Stay curious, open, critical and get accustomed to the lack of absolutes.

Elucidating both harms and benefits of cannabis are far from clear. As with any drug, even accepted drugs like Tylenol, one must always assume no drug is completely safe and is a risk vs benefit analysis for each person.

Authoritative bodies should give full context to each of their statements on cannabis. Each statement needs to include level of evidence and issues with research methods. There is no greater need than now for transparency on both harms and benefits. This will promote trust.

For further inquiry: See Cannabidiol as a novel candidate alcohol use disorder pharmacotherapy: a systematic review ”

Paraphrased: In both rodent and cell culture models, CBD exerted a neuroprotective effect against adverse alcohol consequences on the hippocampus.

In rodent models, CBD attenuated alcohol‐induced hepatotoxicity, specifically, alcohol‐induced steatosis.

Findings from preclinical rodent models indicated CBD attenuated cue‐elicited and stress‐elicited alcohol‐seeking, alcohol self‐administration, withdrawal‐induced convulsions, and impulsive discounting of delayed rewards.

See USA Government patent on cannabinoids: https://patents.google.com/patent/US6630507B1/en

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