Cannabis use was associated with 40% lower risk of alcohol-related liver disease among heavy drinkers
In a matched cohort of over 33,000 people with alcohol use disorder, those with cannabis use disorder had a 40% lower risk of developing alcohol-associated liver disease and lower mortality.
Quick Facts
What This Study Found
Compared to non-cannabis users, those with CUD had a 40% lower ALD risk (HR 0.60), 17% lower decompensation risk (HR 0.83), and 14% lower mortality (HR 0.86). Cannabis users without CUD had lower ALD risk but similar decompensation and mortality.
Key Numbers
33,114 matched per group. CUD vs non-CU: ALD HR 0.60, decompensation HR 0.83, mortality HR 0.86. CU vs non-CU: ALD risk lower but decompensation and mortality similar.
How They Did This
Propensity-matched cohort using TriNetX (2010-2022). Adults with AUD categorized into CUD, cannabis use, and non-cannabis use. Outcomes over 3 years via Cox regression.
Why This Research Matters
Alcohol-associated liver disease is a leading cause of liver death with limited treatments. The dose-response pattern suggests cannabinoid system modulation may genuinely protect against alcohol liver injury.
The Bigger Picture
Preclinical data suggest CBD reduces alcohol-induced liver injury. This large clinical dataset supports the hypothesis that the cannabinoid system could be a therapeutic target for ALD.
What This Study Doesn't Tell Us
Observational; cannot prove causation. Healthy user bias possible. CUD based on ICD coding. Concurrent factors not captured.
Questions This Raises
- ?Which cannabinoid drives the protective effect?
- ?Would targeted cannabinoid drugs replicate this without cannabis-related harms?
Trust & Context
- Key Stat:
- 40% lower risk of alcohol-related liver disease with cannabis use disorder (HR 0.60)
- Evidence Grade:
- Large propensity-matched cohort with dose-response pattern, but observational design and potential healthy user bias limit causal conclusions.
- Study Age:
- Published in 2025, data 2010-2022.
- Original Title:
- The Cannabinoid System as a Potential Novel Target for Alcohol-Associated Liver Disease: A Propensity-Matched Cohort Study.
- Published In:
- Liver international : official journal of the International Association for the Study of the Liver, 45(11), e70401 (2025)
- Authors:
- Fakhoury, Butros, Jahagirdar, Vinay, Rama, Kaanthi, Hudson, David, Wang, Wei, Díaz, Luis Antonio, Arab, Juan Pablo
- Database ID:
- RTHC-06434
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Can cannabis protect the liver from alcohol damage?
This study found heavy drinkers who also used cannabis had 40% lower rates of alcohol-related liver disease, but causation cannot be established.
Should people with alcohol problems use cannabis?
This study does not recommend cannabis use. The findings suggest the cannabinoid system may be a target for developing new liver disease drugs.
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Cite This Study
https://rethinkthc.com/research/RTHC-06434APA
Fakhoury, Butros; Jahagirdar, Vinay; Rama, Kaanthi; Hudson, David; Wang, Wei; Díaz, Luis Antonio; Arab, Juan Pablo. (2025). The Cannabinoid System as a Potential Novel Target for Alcohol-Associated Liver Disease: A Propensity-Matched Cohort Study.. Liver international : official journal of the International Association for the Study of the Liver, 45(11), e70401. https://doi.org/10.1111/liv.70401
MLA
Fakhoury, Butros, et al. "The Cannabinoid System as a Potential Novel Target for Alcohol-Associated Liver Disease: A Propensity-Matched Cohort Study.." Liver international : official journal of the International Association for the Study of the Liver, 2025. https://doi.org/10.1111/liv.70401
RethinkTHC
RethinkTHC Research Database. "The Cannabinoid System as a Potential Novel Target for Alcoh..." RTHC-06434. Retrieved from https://rethinkthc.com/research/fakhoury-2025-the-cannabinoid-system-as
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.