Medical Cannabis and Liver Cirrhosis: What Research Shows
Liver cirrhosis means scar tissue has taken the place of healthy liver tissue, and many people living with it ask whether medical cannabis could ease the itching, pain, nausea or broken sleep that come with it. Research on cannabinoids and liver scarring exists, but almost all of it is animal and laboratory work: cannabis does not treat or reverse cirrhosis. Every form that reaches the blood is processed by the liver and can interact with your medicines, so the decision belongs in a conversation with your hepatologist and a licensed physician.
Built on peer-reviewed research published from 2001 to 2026: hospital-records studies, animal and laboratory work, and reviews
Living with cirrhosis: the symptoms that wear you down
A diagnosis of cirrhosis usually arrives with a list of numbers: enzymes, platelets, a stiffness score, and a lot of advice about what not to do. What fills the days is something else. Tiredness that sleep does not fix. Skin that itches for no visible reason. Meals that end after three bites. For many people the hardest part is not one big symptom but the way several small ones stack up.
Itching, cramps and nights without sleep
Feeling tired or weak and itching of the skin are among the first symptoms people with cirrhosis notice [1]. The itch tends to be worse at night, on the palms and soles, and scratching does not stop it. Add muscle cramps in the legs and a mind that will not settle, and the night shortens to a few broken hours. The next day starts already behind.
Nausea and meals you can’t finish
Loss of appetite and weight changes are part of the same early picture [1]. A liver that stores less energy and a belly that fills with fluid both make a full plate feel impossible, and the body that most needs protein gets less of it. That is why doctors take an untouched dinner seriously, and why the diet section below talks about a late-evening snack rather than about cutting back.
The fear of making it worse
Then comes the worry that sits under everything: will this make my liver worse? It is a fair question, because many ordinary remedies are on the “ask first” list with cirrhosis: pain relievers such as NSAIDs and acetaminophen, sleep aids, herbal products and dietary supplements [2]. The choice narrows, and every new idea, cannabis included, gets measured against the organ that is already struggling.
What is known for these symptoms · Check if this is your case
What is liver cirrhosis?
Cirrhosis is a condition in which the liver is slowly damaged and healthy tissue is replaced by scar tissue. Over time the scarring keeps the liver from working as it should [3]. It is not a single disease with a single cause: alcohol, hepatitis B and C, and fatty liver disease are the most common roads to it, and years of injury from any of them can end in the same place.
How does cirrhosis affect the liver? The liver filters blood, makes the proteins that help blood clot, produces bile to digest fat, stores energy and clears medicines and toxins. Scar tissue is stiff and has no working cells, so each of those jobs shrinks. Stiffness also pushes back on the blood flowing in from the gut, which raises pressure in the veins around the stomach and esophagus, the start of most serious complications.
A healthy liver
- Soft, smooth tissue that blood flows through easily.
- Makes clotting proteins and albumin, which keeps fluid inside the blood vessels.
- Clears medicines, alcohol and ammonia from the blood.
A liver with cirrhosis
- Firm, lumpy tissue with bands of scar that slow the blood.
- Makes fewer clotting proteins and less albumin, so bruising and fluid buildup come easier.
- Clears medicines and toxins more slowly, so drugs act longer and stronger.
Quick answers
Is liver cirrhosis contagious?
No. Scar tissue cannot pass from one person to another. Some causes of cirrhosis can, though: hepatitis B and hepatitis C are viruses that spread through blood, and hepatitis B also through sex. Treating or preventing those infections is one of the most effective ways to stop cirrhosis before it starts [1].
Is liver cirrhosis genetic?
Usually not. Most cirrhosis comes from alcohol, viral hepatitis or fatty liver disease. A smaller share comes from inherited conditions such as Wilson disease, which lets copper build up in the liver [1]. If several relatives have liver disease, mention it to your doctor: genes can also change how fast fatty liver turns into scarring.
Healthy liver vs cirrhosis on a scan
On ultrasound, CT or MRI a healthy liver has a smooth edge and even texture. With cirrhosis the surface turns knobby, the liver can shrink or change shape, and the spleen may enlarge. Elastography adds a number: it measures how stiff the liver is, and stiffer means more scarring [5].
Is cirrhosis liver failure? Stages and decompensation
No, cirrhosis is not the same as liver failure, but it can lead there. As cirrhosis gets worse, the liver begins to fail [3]. Many people live for years with cirrhosis while the remaining healthy tissue still does the work, and yes, you can have good liver function with cirrhosis for a long time. Doctors describe that phase as compensated. Once the liver can no longer keep up and complications appear, it is called decompensated cirrhosis, and that is the point at which the words “liver failure” start to apply.
Why does the failure happen at all? Each new injury (another year of drinking, an untreated virus, more fat in the liver) replaces more working tissue with scar. Once too little is left, the jobs listed above stop getting done: fluid leaks into the belly, bleeding comes easier, and toxins the liver used to clear reach the brain.
| Stage | What you may notice | What the doctor checks |
|---|---|---|
| Compensated | Often nothing at all, or tiredness, itching and a poor appetite. Many people learn they have cirrhosis from a routine blood test or scan. | Liver tests, platelets, liver stiffness, a scan for varices, and liver cancer screening at regular intervals. |
| Decompensated | A swollen belly or legs, yellow skin or eyes, easy bruising, vomiting blood or black stools, confusion and sleepiness during the day. | Child-Pugh and MELD scores, kidney function, sodium, fluid and infection checks, and whether a transplant evaluation makes sense. |
Complications of decompensation
Ascites: fluid in the belly
High pressure in the liver veins and low albumin push fluid into the abdomen. The belly swells, breathing can feel short, and the fluid can become infected. Treatment usually combines limiting sodium with medicines that remove fluid, and sometimes draining it with a needle [2].
Varices and bleeding
Blood that cannot pass through the stiff liver detours through veins in the esophagus and stomach, which swell into varices. They can burst and bleed heavily. Doctors look for them with an endoscopy and prescribe medicines that lower the pressure in those veins [2]. Vomiting blood or passing black stools is an emergency.
Hepatic encephalopathy: confusion from the liver
When the liver cannot clear toxins such as ammonia, they reach the brain. It starts with brain fog, a reversed sleep pattern or trouble with handwriting and can progress to deep confusion. Doctors prescribe medicines that lower those toxins [2]. Anything that sedates, sleeping pills, opioids, alcohol, THC, can make it worse.
Jaundice
Yellow skin and eyes mean bilirubin is building up because the liver no longer clears it [1]. Dark urine and pale stools often come with it. New jaundice, especially with a fever or belly pain, needs a doctor the same day.
How long can you live with cirrhosis?
There is no single answer, and anyone who gives you a number without your test results is guessing. What matters is whether the cirrhosis is compensated or decompensated, whether its cause has been stopped, and how well the liver still works. People whose cause is removed, who stop drinking, clear hepatitis C or lose weight, often stay compensated for many years.
Doctors use two scores to put that into numbers. Child-Pugh combines bilirubin, albumin, clotting time, fluid in the belly and confusion into classes A, B and C, from mildest to most severe. MELD (Model for End-Stage Liver Disease) uses blood tests, bilirubin, clotting time, creatinine and sodium, to estimate short-term risk, and transplant programs use it to set priority on the waiting list. Is liver cirrhosis deadly? It can be, mostly through its complications; that is exactly why the scores exist, and why it is worth asking your hepatologist which class and which MELD score you have today, and what would change them.
Liver cirrhosis causes and symptoms
How does liver cirrhosis occur? Almost always slowly, over years of steady injury. The most frequent causes are alcohol-related liver disease, fatty liver disease (especially in people with obesity or diabetes) and chronic hepatitis B or C [1].
Alcohol
Years of heavy drinking inflame the liver and lay down scar. Stopping completely is the single most effective step at any stage, because it lets the remaining tissue recover.
Hepatitis B and C
Long-term viral infection keeps the liver inflamed for decades, often without symptoms. Hepatitis C can now be cured with antiviral pills; read more on hepatitis C and medical cannabis.
Fatty liver disease (MASLD/MASH)
Fat builds up in liver cells and, in some people, turns into inflammation and scarring. It is tied to weight, blood sugar and cholesterol, and it is the fastest-growing cause.
Autoimmune and inherited causes
Autoimmune hepatitis, bile duct diseases and inherited conditions such as Wilson disease are rarer roads to the same place [1]. Long-term heart failure can also scar the liver.
Early symptoms
Early cirrhosis is often silent. When symptoms come, they are easy to blame on something else [1]:
- tiredness or weakness that does not lift;
- itching of the skin;
- a smaller appetite and weight changes you cannot explain;
- nausea or a dull ache under the right ribs;
- later, bruising and bleeding easily, swelling in the legs or belly, yellow skin, and confusion or memory lapses.
Cirrhosis and liver cancer
Can liver cirrhosis cause cancer? It raises the risk of hepatocellular carcinoma, the most common liver cancer, whatever caused the scarring. Early liver cancer rarely causes symptoms of its own, which is why doctors recommend checking for it at regular intervals, usually with an ultrasound and sometimes a blood test [2]. Weight loss, new pain under the ribs or a sudden turn for the worse in a stable liver are reasons to ask about it sooner. Cancer is also a qualifying condition in many state programs; see cancer and medical cannabis.
Could medical cannabis be worth discussing for your cirrhosis symptoms?
Fourteen short questions about your diagnosis, your symptoms and the medicines you take. Your answers stay on this page and show what to bring to your hepatologist and to a physician.
14 questions · about a minute · your answers stay in this browser
How long from fatty liver to cirrhosis?
Usually years, often decades, and for most people with fatty liver, never. Fat in the liver (now called MASLD, metabolic dysfunction-associated steatotic liver disease) is very common and on its own rarely harms the liver. In some people it turns into inflammation, called MASH (formerly NASH), and only then does scar start to build. How fast that happens depends on weight, blood sugar, alcohol, genes and time, which is why no honest page can give you one number. Liver cirrhosis due to NASH is the same cirrhosis as from any other cause; what differs is that the cause, weight and metabolism, can often be changed.
Where are you on this path?
Choose the stage your doctor named to see what it means and what to ask.
Choose a stage above to see what happens at it.
At this stage: fatty liver (MASLD)
Fat makes up more of the liver than it should, without much inflammation. Most people feel nothing; it shows up on an ultrasound or in slightly raised liver enzymes.
Can it go back? Yes. Weight loss, more movement and better blood sugar control can clear fat from the liver.
What to ask your doctor: Is there any sign of inflammation or stiffness, and when should I repeat the test?
At this stage: MASH (inflammation)
Fat-laden cells are now inflamed and injured. This is the stage that opens the road to scarring, though many people stay here for years.
Can it go back? Often, yes, when the metabolic causes are treated and alcohol is avoided.
What to ask your doctor: How much fibrosis do I have, and which treatments for weight, diabetes or the liver itself apply to me?
At this stage: fibrosis
Bands of scar tissue are forming, but the liver structure is still mostly intact. Elastography or a biopsy grades how far it has gone.
Can it go back? Early and moderate fibrosis can partly regress once the cause is removed; advanced fibrosis is harder to reverse.
What to ask your doctor: What is my fibrosis stage, and how often will you recheck it?
At this stage: compensated cirrhosis
Scar has reshaped the liver, but the healthy part still keeps up. Many people feel well and live with this stage for a long time.
Can it go back? The scar usually stays, but stopping the cause can keep cirrhosis from getting worse [2].
What to ask your doctor: What is my Child-Pugh class, do I have varices, and how often will you screen me for liver cancer?
At this stage: decompensated cirrhosis
The liver can no longer keep up: fluid, bleeding, jaundice or confusion have appeared. Care becomes closer and more frequent.
Can it go back? Some people stabilize when the cause is stopped and complications are treated; for others, a transplant is discussed.
What to ask your doctor: What is my MELD score, should I be evaluated for a transplant, and which medicines should I avoid?
Fatty liver, CBD and THC
Can CBD help fatty liver? Nobody can say yet. None of the studies behind this page tested CBD or THC in people with fatty liver disease. What exists is laboratory work on the cannabinoid receptors in liver cells and in animals with scarred livers, summarized in what research says about cannabinoids and liver fibrosis. Over-the-counter CBD is not an approved treatment for anything liver-related, and the FDA lists liver damage, severe drowsiness and harmful drug interactions among the risks found in clinical studies of CBD [6]. This page does not discuss CBD doses; that question belongs with the physician who knows your liver tests.
How is liver cirrhosis diagnosed?
Usually by putting several tests together rather than by one. Blood work shows how the liver is doing, imaging shows its shape and stiffness, and a biopsy settles the question when the other results disagree [5].
Blood tests
Liver enzymes (ALT, AST, alkaline phosphatase), bilirubin, albumin, clotting time (INR) and platelets. Enzyme levels that are higher or lower than normal can be a sign of liver damage, and low platelets often point to scarring [5].
Ultrasound and elastography (FibroScan)
Ultrasound shows the liver surface, size and blood flow. Elastography, such as FibroScan, measures how stiff the liver is, and stiffer tissue means more scarring [5].
MRI and CT
Cross-sectional scans show a nodular liver, an enlarged spleen and fluid in the belly. They are also used to look for liver cancer when an ultrasound is unclear.
Biopsy
A thin needle takes a small piece of liver to look at under a microscope. It is used when other tests are uncertain or the cause is unclear [5].
Child-Pugh and MELD in plain words
Once cirrhosis is confirmed, two scores describe how serious it is. Child-Pugh sorts you into class A, B or C from five findings: bilirubin, albumin, clotting time, fluid in the belly and confusion. MELD turns bilirubin, clotting time, creatinine and sodium into a single number; the higher it is, the sicker the liver, and the higher a person sits on a transplant waiting list. Ask for both numbers and write them down: they are the shortest summary of your liver you can bring to any appointment.
How to treat liver cirrhosis: can it be cured?
Is liver cirrhosis curable? Not in the usual sense: doctors do not have specific treatments that cure cirrhosis, and the scar usually stays. But treating the cause can keep cirrhosis from getting worse and help prevent liver failure [2]. So the honest answer to “can liver cirrhosis be treated” is yes: the disease, its cause and its complications are all treated, even when the scar remains.
What can improve
- Inflammation settles once the cause is stopped.
- Liver tests, energy and appetite often get better.
- Complications such as fluid and confusion can be controlled with treatment.
What usually stays
- The scar itself and the changed shape of the liver.
- The need for regular checks, including liver cancer screening.
- Care with medicines, alcohol and supplements for life.
Treating the cause
How to manage cirrhosis of the liver starts with what caused it. For alcohol, that means stopping completely, with help if needed. For hepatitis B, antiviral medicines keep the virus down; hepatitis C can be cured with antiviral pills. For fatty liver disease, weight loss and control of blood sugar and cholesterol. For autoimmune hepatitis, medicines that calm the immune system [2]. Each of these is the closest thing to “how to correct cirrhosis of the liver” that medicine has.
Can liver function improve with cirrhosis?
Yes, often. When the injury stops, the remaining liver cells regenerate and function can recover noticeably; some people move from a worse Child-Pugh class to a better one. How long does the liver take to recover? Changes are measured in months to years rather than weeks, and the scar does not vanish. Earlier fibrosis, before cirrhosis, has the best chance of partly reversing.
The standards for this care are written by specialist societies: the American Association for the Study of Liver Diseases publishes practice guidance on ascites, varices, hepatic encephalopathy, nutrition and fatty liver disease [8], and the European Association for the Study of the Liver publishes guidelines for decompensated cirrhosis [9]. These standards are the same worldwide; whether you are treated in the United States, India or elsewhere, the best treatment is a hepatologist following them.
Liver transplant and cannabis use
A liver transplant is considered when cirrhosis has reached end-stage liver failure and other treatments are no longer enough [2]. The hepatologist refers you to a transplant center, which runs its own evaluation: blood tests and scans, a heart and lung check, a social and psychological review, and a look at alcohol and substance use. If you are accepted, you are placed on a national waiting list, and your MELD score largely sets your priority.
Transplant centers set their own cannabis rules
There is no single national rule on cannabis for transplant candidates. Some centers accept medical cannabis with a physician’s recommendation, some ask candidates to stop before listing, and many run drug screens during evaluation and while you wait. A positive test that was not disclosed can delay or pause listing at some centers, even in states where medical cannabis is legal. The only reliable answer is your own center’s written policy.
- Does the center accept medical cannabis with a state card, and does it matter which form?
- Do you test for cannabis during evaluation and on the waiting list, and how often?
- What happens if a test is positive while I hold a medical card?
- After a transplant, how would cannabis interact with my anti-rejection medicines?
Liver cirrhosis diet: what to eat and foods to avoid
With cirrhosis, eating is part of treatment. The scarred liver stores less energy, so the body breaks down muscle between meals, and many people lose strength without noticing. The aim is enough calories and enough protein, less sodium when fluid is a problem, and no alcohol at all [10]. A registered dietitian can turn that into meals you actually like.
What do you want to check?
Choose a topic to see what the guidance says.
Choose a topic above to see what the guidance says.
Alcohol: stop completely, whatever caused the cirrhosis, because alcohol causes more liver damage [10]. That includes beer, wine and the alcohol in some tinctures and cough syrups – read the label.
Salt: your doctor may recommend limiting sodium in food and drinks, especially if fluid builds up in the belly or legs [10]. Most sodium comes from packaged, canned and restaurant food rather than the salt shaker.
Protein: most people with cirrhosis need enough protein, not less of it, to keep their muscles [10]. Cutting protein to prevent confusion is an old idea; ask your hepatologist before limiting it.
Late-evening snack: a snack before bed or an early breakfast shortens the overnight fast, so the body does not break down muscle for fuel [10].
Raw shellfish: avoid raw or undercooked shellfish, fish and meat, and unpasteurized milk [10]. Raw oysters can carry Vibrio bacteria, and liver disease raises the risk of a severe infection [11].
Supplements and zinc: talk with your doctor before taking any dietary or herbal supplement [10]. Is zinc safe for liver cirrhosis? Some people with cirrhosis run low on zinc and a doctor may prescribe it after a blood test, but taking it on your own is not the same thing.
Life with cirrhosis day to day
Life with cirrhosis of the liver is mostly routine: regular meals, a weekly look at your weight and ankles, the medicine list kept current, and appointments that do not get skipped. Small signals matter: a belt that suddenly feels tight, sleep that flips to the daytime, a family member saying you seem slower. Keep a short note of them for the next visit. Vaccines against hepatitis A and B, flu and pneumonia are worth asking about too.
Why cannabinoids come up in liver scarring
The body makes its own cannabis-like molecules and has receptors for them, together called the endocannabinoid system. The liver has very little of this system when it is healthy. When it scars, the system wakes up: in fibrosis, the enzymes that make these molecules and the CB1 receptor become more active while the enzymes that break them down slow, which helps switch on the cells that lay down scar [7]. That is why researchers think the receptors could become drug targets.
Two switches in the scarring liver
Choose a receptor to see what the studies found.
Choose a receptor above to see what the studies found.
CB1: the switch that seems to push scarring
CB1 becomes more active as scar forms. In cirrhotic rats, silencing the CB1 gene in the liver cut CB1 protein by 64% and the share of fibrotic tissue by 44% [12]. In mice, CB1 also drew inflammatory white cells into the injured liver [13] and rose in a parasite-induced model of fibrosis [14].
In ratsIn mice
CB2: the switch that seems to protect
In mice bred without the CB2 gene, inflammation and scarring after a liver toxin were stronger than in normal mice [15]. A CB2-activating compound eased inflammation in rats with blocked bile ducts [16], and in cell cultures, plant compounds that raised CB2 levels calmed scar-making liver cells [17][18].
In miceIn ratsIn cell cultures
What does research say about cannabinoids and liver fibrosis?
Less than the headlines suggest. Strong study designs are rare here: there is no randomized trial of cannabis or cannabinoids in people with cirrhosis, and the studies in people are hospital records about the disease itself. Most of what is known about cannabinoids and liver scarring comes from rats, mice and cells. That work is careful and often encouraging, and it still cannot tell you what a product would do in your liver.
| Level | What exists for cirrhosis | What it can and cannot tell you |
|---|---|---|
| Studies in people (records) | National hospital databases on alcohol-related cirrhosis [4][19] and a survey of liver scarring among prison inmates [20]. None of them looked at cannabis. | How common and how serious the disease is; observation, not cause. Nothing about cannabinoids. |
| Animal studies | Rats and mice with chemically or genetically induced scarring, testing CB1 and CB2 receptors [12][15][21]. | Why scientists are interested and where things can go wrong; not what happens in patients. |
| Cell studies | Human and animal liver cells in dishes exposed to plant compounds acting on CB2 [17][18]. | A mechanism in one cell type; the weakest level for any decision. |
| Reviews | A narrative review of the endocannabinoid system in liver fibrosis [22] and a systematic review on palliative care in end-stage liver disease [23]. | A summary of what others found; only as strong as the studies underneath. |
Browse the studies yourself
Every study cited on this page, in plain words. Negative results and background studies are marked.
Two decades of hospital stays for alcohol-related cirrhosis
Stays rose from 46,186 in 1998 to 69,970 in 2018, while deaths in the hospital fell from 12.8% to 4.7% [4].
Coming back to the hospital within a month
The share of people with alcohol-related cirrhosis readmitted within 30 days grew from 24.9% in 2010 to 29.9% in 2018 [19].
Viral hepatitis and severe liver scarring
Hepatitis B was linked to higher odds of severe fibrosis (odds ratio 4.8, 95% CI 1.8-12.8), a reminder of how much viral hepatitis drives scarring [20].
A CB1 blocker made liver injury worse
In Mdr2-deficient mice, a CB1 blocker raised bile acids in the blood 2.5-fold and increased inflammation instead of easing it [21].
Seeing scar formation through an endocannabinoid enzyme
A PET tracer for the MAGL enzyme picked up changes in scarred mouse livers; it has not been tested in people [7].
Mice without CB2 scarred faster
After 16 weeks of a liver toxin, mice lacking the CB2 gene had more inflammation and more active scar-making cells [15].
Silencing CB1 in the liver
Gene silencing cut CB1 protein by 64% and fibrotic tissue by 44% compared with an inactive control [12].
CB1 and inflammatory white cells
In chronic liver injury, CB1 signaling drew neutrophils into the liver and drove their inflammatory response [13].
A CB2-activating compound
The research compound AM-1241 eased inflammation and cell death in the liver and stimulated repair cells [16].
Endocannabinoids and the heart after bleeding
Endocannabinoids released by immune cells in the heart blunted its response to blood loss in cirrhotic rats [24].
CB1 rises in parasite-driven fibrosis
In schistosome infection, CB1 increased in scar-making liver cells, tied to oxidative stress [14].
Inflammation, endocannabinoids and heart function
The inflammatory signal TNF-alpha and endocannabinoids together weakened heart function in cholestatic mice [25].
Orange polyphenols and CB2
An orange extract raised CB2 protein by 55% and lowered inflammatory and scarring signals in human liver cell lines [17].
A turmeric compound acting through CB2
Bisdemethoxycurcumin pushed activated scar-making cells to die off, and blocking CB2 reversed the effect [18].
The endocannabinoid and apelin systems in liver fibrosis
A summary of how both signaling systems help drive scarring and why they are studied as drug targets [22].
Quality of palliative care in end-stage liver disease
Experts agreed on markers of good comfort care for people with advanced cirrhosis, from symptom relief to planning ahead [23].
No studies of this type are cited on this page.
What kinds of studies is this evidence built on?
How to read it: each row is one kind of study, and the bar shows how many published studies on cannabinoids and liver cirrhosis are of that kind. Stronger designs are at the top. Gray bars are commentary, animal and lab work, which cannot answer whether something helps patients.
Show as a table
| Design | Studies |
|---|---|
| Meta-analyses | 1 |
| Systematic reviews | 1 |
| Cohort studies | 6 |
| Cross-sectional studies | 1 |
| Narrative reviews | 10 |
| Animal studies | 9 |
| Cell and lab studies | 2 |
| Who was studied | Studies |
|---|---|
| People in clinical studies | 2 |
| People observed, not treated | 33 |
| Whole populations | 2 |
| Animals | 5 |
| Cells and molecules | 2 |
| Not classified | 21 |
Where the evidence conflicts
The tidy story (block CB1, boost CB2, and scarring eases) does not hold up everywhere. Two animal studies point the other way, and they matter because they show how much depends on the kind of liver disease.
A CB1 blocker made liver injury worse
Mice lacking the Mdr2 gene develop a bile-flow disorder (cholestasis) much like some human bile duct diseases. A CB1 blocker given to them at 3 mg/kg every other day (a lab dose described here only to explain the experiment) raised bile acids in the blood 2.5-fold and increased inflammation and bile duct reactions [21].
In miceNegative result
Same receptor, opposite results
In toxin-scarred livers, turning CB1 down reduced fibrosis [12]; in cholestatic mice it caused harm [21]. CB2 points one way so far: mice without it scarred faster [15]. One receptor can be a target in one disease and a hazard in another.
In miceIn ratsNegative result
Why mouse results don’t carry over to people
Lab cirrhosis is made in weeks with a single chemical or a single missing gene; human cirrhosis builds over decades from alcohol, viruses or metabolism, usually alongside other illnesses and several medicines. The animals in these studies were young and often all male. The compounds were research tools injected at controlled doses, not plant products swallowed or inhaled. Each of those differences can flip a result, which is exactly what the two studies above show.
What science doesn’t know yet
For cirrhosis, the gaps are bigger than the findings. The researchers who wrote these studies name the same limits again and again.
- No randomized trials in people with cirrhosis. Not one study cited here gave cannabis or a cannabinoid to patients and compared them with a control group.
- No safe form or dose is known. Nobody has worked out which products, if any, are reasonable for a scarred liver, or how much.
- No human data on interactions in cirrhosis. How THC and CBD change the levels of common cirrhosis medicines in a liver that already clears drugs slowly has not been measured.
- Narrow animal models. Key experiments used only male mice and one chemical toxin, and removed receptors by genetics rather than with a drug [15].
- Mechanisms still unclear. Why a CB1 blocker harmed cholestatic mice is not yet understood [21], and lab findings in cell lines still need testing in living animals [17].
- Records without details. The hospital databases count stays, not people, and cannot say how severe each case was or which treatments were given [4][19].
Is cannabis safe if you have cirrhosis?
Not as a blanket yes or no. No study has established that any cannabis product is safe for a scarred liver, and none has shown it is uniquely dangerous either. What can be said is where the risks sit, and they sit in three different places. Some belong to inhaling, some to every form, and one to sharing. Which apply to you depends on your stage, your medicines and the form in question, which is why the answer is worked out at an appointment rather than on a page.
Ways to use cannabis: what each form avoids
Cannabis is not only smoked. People also vape it, eat it, take capsules, hold drops under the tongue or put it on the skin, and most combine more than one. This section explains the differences; it does not recommend a form.
How is it used, or how would it be?
Choose the closest form.
Choose a form above to see what is specific to it. What is true of every form is below.
Specific to smoking
Joints, blunts, pipes and bongs burn plant material, and the smoke irritates the throat and lungs. The effect starts within minutes and the amount taken is hard to measure.
Specific to vaping and dabbing
Dry-herb vaporizers, oil pens and cartridges avoid burning, but hot aerosol still travels the same airways. Concentrates used for dabbing (wax, shatter, rosin) are very strong, which makes the amount even harder to control.
Shared devices
A joint, pipe or vape passed between people passes on colds and other infections too.
Specific to edibles and capsules
Gummies, chocolates, drinks, capsules and swallowed oils avoid smoke entirely. They go through the liver before reaching the blood, start slowly, often an hour or more, and last for hours, longer still when the liver clears them slowly. The classic mistake is a second piece “because the first did nothing.”
Specific to tinctures and sprays
Drops held under the tongue and mouth sprays avoid the lungs and are measured by the drop or spray. Part of each dose is still swallowed and goes through the liver, and some tinctures are made with alcohol – check the label.
Specific to topicals and patches
Creams and balms act mainly where they are applied, and little reaches the blood. Transdermal patches are different: they deliver cannabinoids into the bloodstream, so the liver and medicine questions apply to them in full.
Specific to prescription cannabinoids
Dronabinol (Marinol, Syndros) and nabilone (Cesamet) are prescription THC-type medicines; Epidiolex is prescription CBD for certain seizure disorders. They are filled at a pharmacy, not bought with a medical card. Epidiolex can raise liver enzymes, so its label calls for liver blood tests before and during treatment, and adjusted doses in moderate or severe liver impairment [26].
True of every form
- THC and CBD composition matters more than the form: a risk of THC says nothing about a CBD-only product, and the other way around.
- Whatever reaches the blood is processed by the liver and can change levels of other medicines.
- THC adds to drowsiness and confusion, which matter most in decompensated cirrhosis.
- No driving after use.
Choosing a form, if any, is a conversation for the appointment.
Show all forms as a table
| Form | What it avoids | What remains |
|---|---|---|
| Smoking | A delayed onset | Smoke in the airways, shared devices, a hard-to-measure amount, liver processing, interactions |
| Vaping & dabbing | Burning plant material | Hot aerosol in the airways, very strong concentrates, shared devices, liver processing, interactions |
| Edibles & capsules | Smoke, vapor and shared devices | Passing through the liver first, slow and long effect, risk of a repeat dose, interactions |
| Tinctures & sprays | Smoke, vapor and shared devices | Partly swallowed dose, alcohol in some products, liver processing, interactions |
| Topicals | Most of what reaches the blood | Skin reactions; little effect beyond the skin |
| Transdermal patches | Smoke, vapor and swallowing | Liver processing, interactions, drowsiness |
| Prescription cannabinoids | Unknown product content | Drowsiness, interactions, liver test monitoring for Epidiolex [26] |
Pain, nausea, appetite, itching and sleep: what is known
These are the symptoms people with cirrhosis most often bring to a doctor, and the ones they ask about cannabis for. None of the studies behind this page tested cannabis for symptom relief in people with cirrhosis. Some of these symptoms have been studied in other conditions; that research lives on their own pages, linked below, and it does not automatically apply to a scarred liver.
Choose a symptom above to see what is known.
Pain
Common pain relievers are a problem with cirrhosis: NSAIDs such as ibuprofen can harm the kidneys and raise bleeding risk, and acetaminophen and opioids need a doctor’s limits [2]. Back pain and belly pain can also come from fluid or an enlarged spleen.
No studies in cirrhosis
Research in other conditions: chronic pain and medical cannabis.
Nausea
Nausea in cirrhosis can come from the liver itself, from fluid pressing on the stomach or from medicines. New vomiting, especially with blood, needs a doctor first.
No studies in cirrhosis
Research in other conditions: nausea and medical cannabis.
Appetite
A poor appetite in cirrhosis costs muscle, and muscle matters for how well people do. Small frequent meals and a late snack are the first steps.
No studies in cirrhosis
Bring it to your appointment: questions to ask your hepatologist.
Itching
Itching is often worst at night and comes from substances the liver no longer clears. It has its own prescription treatments, which are worth asking about before anything else.
No studies in cirrhosis
Bring it to your appointment: questions to ask your hepatologist.
Sleep
Sleeping in the day and lying awake at night can be an early sign of hepatic encephalopathy rather than plain insomnia, and sleep aids need a doctor’s approval with cirrhosis [2].
No studies in cirrhosis
Read more: is cannabis good or bad for sleep and insomnia and medical cannabis.
Whatever the symptom, the goal of any treatment is relief of that symptom, not treatment of cirrhosis, and the standard options come first.
Drug interactions and safety to discuss with your doctor
THC and CBD are broken down by a family of liver enzymes called CYP450, the same enzymes that clear many everyday medicines. CBD in particular can slow some of those enzymes, so another drug builds up in the blood. In cirrhosis the enzymes are already working with less tissue, so both effects can add up. Open each group below; the tag says whether the problem has been seen in patients or is expected from how the drugs work.
Seizure medicines: clobazam and valproate seen in patients
Prescription CBD raises the level of clobazam’s active form, adding to drowsiness, and liver enzyme rises were seen most often in people also taking valproate [26]. With cirrhosis, that pairing needs liver tests and a doctor watching.
Sedatives, sleep pills and alcohol seen in patients
Opioid pain relievers expected from how drugs work
Opioids are cleared by the liver and cause sedation and constipation, which can both trigger confusion in cirrhosis. THC adds sedation on top. If you take an opioid, the doctor prescribing it should know before any cannabis is considered.
Blood thinners expected from how drugs work
Warfarin and several newer blood thinners are cleared by the same liver enzymes CBD can slow, and cirrhosis already changes how blood clots. Harmful drug interactions are among the CBD risks the FDA lists [6]. Clotting tests may need to be checked more often.
Medicines for hepatic encephalopathy expected from how drugs work
People who have had episodes of confusion often take medicines that lower toxins reaching the brain [2]. Cannabis does not block those medicines directly, but THC’s effect on thinking can hide early warning signs or be mistaken for them, so a flare can be missed.
No medicines of this type are listed here.
Driving, falls and confusion
THC slows reaction time and judgment, and with a liver that clears it slowly the effect can last into the next day. Do not drive after use. Getting up at night is the riskiest moment for a fall, and a fall with low platelets or on a blood thinner can mean serious bleeding. Any new confusion while using cannabis is a reason to stop and call your doctor, not to wait it out.
When cannabis should not be considered without your hepatologist
For some people the answer is “not now,” or not without the doctor who follows the liver at the table. In these situations the risks rise and there is no research to lean on.
- Decompensated cirrhosis – fluid in the belly, jaundice or a recent bleed.
- Hepatic encephalopathy – any episode of confusion, now or in the past; THC can deepen it.
- Varices or active bleeding, especially on a blood thinner or with low platelets.
- Being evaluated for a transplant or on the waiting list – your center’s rules come first; see liver transplant and cannabis use.
- Pregnancy or breastfeeding – the FDA strongly advises against cannabis in any form [6].
- A history of psychosis; THC can bring it back. See cannabis and psychosis.
- Ongoing alcohol use – stopping alcohol is the first treatment for the liver, and the two together add sedation.
Transplant and cannabis · Questions to ask your hepatologist
Is liver cirrhosis a qualifying condition for a medical card?
It depends on your state. Every medical cannabis program keeps its own list of qualifying conditions, and a physician has to match a diagnosis in your records to that list, not a symptom. A few programs name cirrhosis outright. Many more do not use the word but list conditions that often come with it: hepatitis C, cachexia or wasting, chronic pain, severe nausea, and some let a physician certify any condition they judge debilitating.
The lists change as legislatures and health departments update them, so the current wording in your state is the one that counts. The physician confirms it at the evaluation, using your records.
Cirrhosis is named in your state
The simplest case. Bring the record of the diagnosis, a hepatologist’s note, a biopsy or elastography report, and the physician evaluates you against that listed condition.
A related diagnosis is listed
Hepatitis C, cachexia, chronic pain or nausea may be on the list where cirrhosis is not. What counts is that diagnosis in your records, not the symptom alone.
Neither is listed
A card may not be available yet where you live. Some states let physicians certify other debilitating conditions or accept petitions to add new ones.
What else has a doctor diagnosed?
State lists name diagnoses, not symptoms – choose what is in your records.
Choose a diagnosis above to see how it may count.
Hepatitis C: one of the most common causes of cirrhosis, and listed by name in several programs. Read hepatitis C and medical cannabis.
Chronic pain: the most widely listed condition across state programs. Read chronic pain and medical cannabis.
Nausea: severe or persistent nausea is listed in many programs, sometimes together with cachexia. Read nausea and medical cannabis.
Cancer: on nearly every state list, including liver cancer. Read cancer and medical cannabis.
Insomnia: listed in some programs; with cirrhosis, ask first whether the sleep problem is encephalopathy. Read insomnia and medical cannabis.
None of these: then the decision rests on your state’s wording and the physician’s judgment. Start with your state’s medical marijuana laws.
Medical card or recreational purchase
In states with adult-use sales, adults can buy without a card. A card still changes several things, though the details are set state by state.
| Aspect | With a medical card | Recreational |
|---|---|---|
| Taxes | Often lower; some states waive part of the cannabis tax for patients | Full state and local cannabis taxes |
| Possession and purchase limits | Often higher; set by your state | Set for adult-use buyers |
| Home cultivation | Allowed for patients in some states | Allowed for adults in some adult-use states |
| Products | Medical dispensaries and, in some states, medical-only products | Adult-use product range |
| Physician involvement | A licensed physician reviews your conditions and medicines | None |
| Document | State card or recommendation, recorded in a confidential registry | Government ID only |
Will a card save you money?
It can, but only where your state taxes patients less than recreational buyers, and how much depends on your state’s tax rates and how much you buy. Weigh that against the evaluation fee and any state registration fee. The breakdown is in medical vs. recreational cannabis taxes, and the wider differences in medical and recreational cannabis compared.
What your state’s program involves
Qualifying is the first of two steps. In most states a physician’s recommendation is followed by registration with the state health department, which issues the card and enters you in a confidential patient registry; in a few, the recommendation itself is what a dispensary asks for. Purchases happen at licensed dispensaries, some of which deliver, and products there are lab-tested and labeled with their THC and CBD content, useful when you need to know exactly what you are taking.
Many state laws also let a patient name a registered caregiver who may buy and handle products on their behalf, which matters to someone who cannot drive during a flare of encephalopathy; who qualifies, how many patients one caregiver may serve and how to register are set by each state. Cards from one state are not automatically valid in another; see which states accept out-of-state cards. Legal status, possession limits, home growing and taxes are listed state by state on the laws and regulations pages.
Questions to ask your hepatologist before an evaluation
A good evaluation is a conversation about one or two specific symptoms, the medicines you already take and what would count as “better.” With cirrhosis, the doctor who follows your liver should be part of it: talk to them first, then bring their answers to the physician who evaluates you.
What to bring
Tap each item as you get it ready.
Questions worth asking
- Which of my current medicines could interact with THC or CBD, and what would we watch for?
- Is my cirrhosis compensated, and does my stage change the answer?
- Have I had any signs of hepatic encephalopathy, and how would cannabis affect that?
- If anything is considered, which forms avoid inhaling, and which would you rule out?
- What would count as “better” within a few weeks, and which liver tests should we repeat?
- What should make me stop right away, and whom do I call?
An evaluation makes sense if
- A specific symptom, itching, pain, nausea, sleep, has not settled with the usual steps.
- Your cirrhosis is stable and your hepatologist knows you are asking.
- Your full medicine list can be reviewed.
- Your state’s program covers cirrhosis or a related diagnosis.
It is not the right step if
- The hope is to heal or reverse the scarring.
- You have had confusion, bleeding or new jaundice that has not been checked.
- You are on a transplant list and have not asked your center.
- You are still drinking alcohol.
This page summarizes published research for education. It does not replace a physician’s advice. Cannabis does not treat or reverse cirrhosis, and a scarred liver clears medicines more slowly, which raises the risk of interactions.
How to get a medical card with liver cirrhosis online
Everything happens online, so there is nowhere to travel, which matters when fluid, fatigue or a driving restriction make trips hard. Four steps take you from the first form to a card.
Fill in the intake form
Your state, your diagnoses and every medicine you take. Have the record of the cirrhosis diagnosis ready to upload.
See a physician licensed in your state
A one-on-one appointment online. You agree on the time with the physician; keep an hour free rather than a minute.
Receive your signed recommendation
If the physician approves, the signed recommendation arrives in your account.
Register with your state
Where required, you submit the recommendation to the state program, which reviews it and issues the card.
Which documents help most? A note or letter from your hepatologist or primary care doctor that names cirrhosis, recent liver tests, and anything that documents a related diagnosis such as hepatitis C or chronic pain. If the physician decides a card is not the right step now (because of a recent bleed or confusion, for example), you will hear why, and what to sort out with your hepatologist first.
Who sees you
Across 250 reviews from patients in the states where we are licensed. We do not sort them by score and do not hide the low ones.
- 150,000+patients evaluated – everyone who has been through an appointment with us, in every state where we are licensed
- Since 2017doing only this: online evaluations for medical cannabis programs, and nothing else on the side
A physician licensed where you live reviews your records and medicines one on one. Your recommendation and documents stay in your account and documents, how the medical card works explains the evaluation in detail, and the physicians who see patients are listed on our physicians page. Programs for veterans and for people with low income are available in some states.
Where are you in this?
Choose the situation closest to yours.
Choose your situation above to see the next step.
First evaluation: start with the questions on whether this fits your case, then choose your state to book the appointment.
Renewing my card: cards last for a period set by your state, and the renewal evaluation is the moment to tell the physician what has changed: a new stage, a new medicine, a transplant listing. Renewal steps and timing are on your state’s page:
Renewal pages by state
Arizona · Arkansas · California · Connecticut · Delaware · Illinois · Iowa · Louisiana · Massachusetts · Michigan · Missouri · New York · Ohio · Oklahoma · Pennsylvania · Texas · Virginia · West Virginia
Moved to another state: a card from your old state usually does not carry over; see which states accept out-of-state cards, then choose your new state.
On a transplant list: ask your transplant center before anything else; what to ask is in liver transplant and cannabis use.
Already a patient: your recommendation and documents are in your account. Lost the card? See what to do if your card was lost.
Questions people ask about liver cirrhosis and cannabis
How long can a patient with cirrhosis live?
It varies too much for one number. People with compensated cirrhosis whose cause has been stopped often live for many years; once complications such as fluid, bleeding or confusion appear, the outlook changes and a transplant may be discussed. Your Child-Pugh class and MELD score are the best guide, and your hepatologist can explain what yours mean. More in stages and decompensation.
Can liver cirrhosis be cured?
Not usually. There is no specific treatment that cures cirrhosis, but treating the cause can keep it from getting worse and help prevent liver failure [2]. A transplant replaces the liver when nothing else is enough. Cannabis does not cure or reverse cirrhosis.
Is cirrhosis of the liver considered liver failure?
Not on its own. Compensated cirrhosis means the liver is scarred but still doing its job. Liver failure describes the point where it no longer can, which is what decompensated cirrhosis moves toward [3].
Can CBD help fatty liver?
There is no evidence that it does in people. None of the studies behind this page tested CBD in patients with fatty liver disease; the research is on cannabinoid receptors in animals and cells. The FDA lists liver damage among the risks found in clinical studies of CBD [6]. See fatty liver, CBD and THC.
Is delta-8 or hemp CBD safer for the liver?
No one has shown that. Delta-8 THC products have not been evaluated or approved by the FDA for safe use, they are intoxicating like ordinary THC, and they are often made with chemicals that are not controlled [27]. Hemp CBD sold in stores is not tested the way state-licensed medical products are, so the label may not match what is inside, a real concern for a liver that clears substances slowly.
Is zinc safe for liver cirrhosis?
Only with your doctor’s say. Some people with cirrhosis run low on zinc and may be prescribed it after a blood test, but any supplement, zinc included, should be cleared with your doctor first [10]. More in the cirrhosis diet section.
Can cirrhosis cause back pain, anemia or diarrhea?
It can be linked to all three. Fluid in the belly and an enlarged liver or spleen can cause back and flank pain. Anemia is common, from slow bleeding of varices, low iron or folate, or an enlarged spleen. Diarrhea is often a side effect of medicines used for hepatic encephalopathy, and it can also mean infection. Each is worth raising with your doctor rather than treating on your own.
My dog has liver cirrhosis, does any of this apply?
Please talk to your veterinarian. Dogs process cannabinoids differently from people, THC can be toxic to them, and nothing on this page applies to animals.
Is an online evaluation legitimate?
Yes, where state law allows telemedicine for medical cannabis. The physician who sees you holds a license in your state and reviews your records and medicines one on one, just as in an office. How the process works is explained on the medical card page.
Can I use my medical card in another state?
Sometimes. A few states accept cards from other states, often with limits, and most do not. Check which states accept out-of-state cards before you travel, and never cross state lines with cannabis.
I lost my card. What now?
Your recommendation stays in your account, and most state programs can reissue a card. The steps are in what to do if your medical card was lost.
Who finds out? Privacy, firearms and work
Your health information is protected by federal privacy law, HIPAA, which limits how doctors and health plans may share it [28], and state patient registries are confidential. Two exceptions are worth knowing. Federal law still treats marijuana as a controlled substance: the federal firearm purchase form asks whether you are an unlawful user of marijuana, and the ATF has said that includes people using it under a state medical program [29]. And at work, protection depends on your state: some protect patients from being fired for off-duty use, while federal jobs and safety-sensitive roles generally do not accept a card.
Will cannabis show on a transplant drug test?
Yes. Standard drug screens detect THC, often for days to weeks after regular use, and a medical card does not change the result. Transplant centers set their own rules on what a positive test means, so ask yours before any use. See liver transplant and cannabis use.
More research on cannabis and liver cirrhosis
This page cites a selection of studies. Our research library holds every study we track on cannabis and liver cirrhosis, from laboratory work to clinical trials, and lets you filter them by cannabinoid, study type and year.
- studies
- 89
- in people
- 41
- clinical trials
- 0
References
29 sources
- 1. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Cirrhosis.
- 2. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for Cirrhosis.
- 3. National Institute of Diabetes and Digestive and Kidney Diseases. Cirrhosis.
- 4. Trends and Outcomes of Alcoholic Liver Cirrhosis Hospitalizations in the Last Two Decades: Analysis of the Nationwide Inpatient Sample. DOI: 10.14740/gr1517 PMID: 35572473
- 5. National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of Cirrhosis.
- 6. U.S. Food and Drug Administration. What You Should Know About Using Cannabis, Including CBD, When Pregnant or Breastfeeding.
- 7. [18F]MAGL-4-11 positron emission tomography molecular imaging of monoacylglycerol lipase changes in preclinical liver fibrosis models. DOI: 10.1016/j.apsb.2021.07.007 PMID: 35127387
- 8. American Association for the Study of Liver Diseases. Practice Guidelines.
- 9. European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. 2018.
- 10. National Institute of Diabetes and Digestive and Kidney Diseases. Eating, Diet, & Nutrition for Cirrhosis.
- 11. Centers for Disease Control and Prevention. About Vibrio Infection.
- 12. Hydrodynamics-based liver transfection achieves gene silencing of CB1 using short hairpin RNA plasmid in cirrhotic rats. DOI: 10.1371/journal.pone.0228729 PMID: 32053633
- 13. Neutrophil Chemotaxis and NETosis in Murine Chronic Liver Injury via Cannabinoid Receptor 1/ Gαi/o/ ROS/ p38 MAPK Signaling Pathway. DOI: 10.3390/cells9020373 PMID: 32033504
- 14. Upregulation of cannabinoid receptor-1 and fibrotic activation of mouse hepatic stellate cells during Schistosoma J. infection: role of NADPH oxidase. DOI: 10.1016/j.freeradbiomed.2014.03.015 PMID: 24657416
- 15. Knockout of the Cannabinoid Receptor 2 Gene Promotes Inflammation and Hepatic Stellate Cell Activation by Promoting A20/Nuclear Factor-κB (NF-κB) Expression in Mice with Carbon Tetrachloride-Induced Liver Fibrosis. DOI: 10.12659/MSM.931236 PMID: 34413280
- 16. AM-1241 CB2 Receptor Agonist Attenuates Inflammation, Apoptosis and Stimulate Progenitor Cells in Bile Duct Ligated Rats. DOI: 10.3889/oamjms.2019.194 PMID: 30976335
- 17. Anti-Inflammatory and Anti-Fibrotic Effects of a Mixture of Polyphenols Extracted from “Navelina” Orange in Human Hepa-RG and LX-2 Cells Mediated by Cannabinoid Receptor 2. DOI: 10.3390/ijms26020512 PMID: 39859241
- 18. Bisdemethoxycurcumin Induces apoptosis in activated hepatic stellate cells via cannabinoid receptor 2. DOI: 10.3390/molecules20011277 PMID: 25594342
- 19. Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018: Rates and healthcare burden associated with readmissions. DOI: 10.4254/wjh.v13.i12.2128 PMID: 35070013
- 20. HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa. DOI: 10.1186/s12879-016-1601-4 PMID: 27267370
- 21. Peripherally Restricted CB1 Receptor Inverse Agonist JD5037 Treatment Exacerbates Liver Injury in MDR2-Deficient Mice. DOI: 10.3390/cells13131101 PMID: 38994954
- 22. Roles of the Hepatic Endocannabinoid and Apelin Systems in the Pathogenesis of Liver Fibrosis. DOI: 10.3390/cells8111311 PMID: 31653030
- 23. Palliative Care Quality Indicators for Patients with End-Stage Liver Disease Due to Cirrhosis. DOI: 10.1007/s10620-016-4339-3 PMID: 27804005
- 24. Blunted cardiac response to hemorrhage in cirrhotic rats is mediated by local macrophage-released endocannabinoids. DOI: 10.1016/j.jhep.2015.01.021 PMID: 25640062
- 25. Mechanisms of TNFalpha-induced cardiac dysfunction in cholestatic bile duct-ligated mice: interaction between TNFalpha and endocannabinoids. DOI: 10.1016/j.jhep.2010.03.011 PMID: 20626112
- 26. U.S. Food and Drug Administration. EPIDIOLEX (cannabidiol) oral solution: prescribing information. 2018.
- 27. U.S. Food and Drug Administration. 5 Things to Know about Delta-8 Tetrahydrocannabinol – Delta-8 THC. 2022.
- 28. U.S. Department of Health and Human Services. Health Information Privacy: Your Rights Under HIPAA.
- 29. Bureau of Alcohol, Tobacco, Firearms and Explosives. Open Letter to All Federal Firearms Licensees on marijuana use. 2011.