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Peginterferon-Ribavirin, Failed it twice. Incivek, Failed it. Sovaldi Olysio, failed it. Harvoni, failed it... Transplant Patient Zepatier and Sovaldi...we'll find out!

Tuesday, April 21, 2015

Hep C and Mary Jane

Medical Marijuana and HCV have a very interesting relationship, in every forum I've ever been involved in, I hear dozens advocating for its use. Some claim it helps the liver, some claim it alleviates side effects, others claim it helps them cope with the psychological effects of treatments and liver stress.

But it's not that simple. So let's talk about some Marijuana myths and facts regarding HCV.

Myth number 1: Smoking doesn't harm the liver.

As i went over in a previous blog, smoking doesn't directly cause an issue, but it can worse effects of fibrosis, and the bottom line here is that HCV will cause the fibrosis while long term smoking will worsen in it.

Short term smoking doesn't necessarily harm the liver in any substantial way.

Myth number 2: Smoking weed has Cannabinoids (CBDs) which can help fight HCV.

Nope. CBDs don't work that way, they can help fight against hepatocellular carcinoma (liver cancer). But it's not substantial enough  to make it beneficial for liver disease, nor is there enough information to say that CBDs have created any positive benefit for liver disease.

Myth number 3: Edibles, because they're not smoked, are ideal for  those with HCV who may already have respiratory and blood pressure issues.

Also false. remember that at the end of the day, your liver still gets to process all of that stuff, and most of the time THC and CBD filled cookies, candies, brownies or whatever else is cool these days aren't necessarily made with the best product.

There is a way to mitigate this, and essentially that' using lab-tested companies like Venice Cookie Company,  or Cheeba Chews, Someone even had the genius to make weed pizza

The dangers that comes normally with stuff somebody made are  usually unknown dosages, and unknown THC agent. (What? yea, depending upon where stony Joe decided to pick up his latest supply he could be buying some Mexican cartel weed with a sketchy past, including the possibility of it being cut with something far more nefarious)

In San Diego there was a huge hullabaloo about dispensaries, a massive crack down a few years ago because these shops were literally taking in garbage bags from completely unverified sources in a don't ask don't tell policy. They also operated in areas illegally zoned... there were lots of problems.

Now, they're coming back and have more transparency than a glass window, it's downright impressive how much detail those dispensaries must fork over to the state (besides patient lists).

But i digress, the point is that edibles from these sources, and from lab-tested companies offer safer products that may be less harmful to your liver. It's a lot like bathtub moonshine Vs. Everclear in many cases. Either way there is harm to the liver, one is just a lot worse.

Edibles overall are the best method of consumption for someone with liver disease because they don't impact the lungs and heart as much. However there have been no comprehensive studies on the effects on the GI tract as it relates to HCV.

FACT: It can help ease symptoms in a less harmful way than most painkillers.

There have been some studies regarding marijuana and HCV.

 But not many, because patients who use it sparingly often don't disclose this fact to their doctor (also a bad idea). If you happen to smoke, and also have HCV, tell your doctor, it's relevant, and they are not allowed to disclose this to anyone else. HIPPA has some interesting regulations and it's key that you mention your frequency of use: sporadically for pain, occasionally to help with sleep, or minimal amounts daily to help with appetite, whatever it may be. There are lots of justifications people have for it, but that doesn't make it better or worse for you in the long run.

Especially since a lot of people with HCV will end up using it to cope with the pain and symptoms. Since any other painkiller is processed through the liver, they see it as an alternative. For a long time, people who failed interferon tried all kinds of natural, homeopathic and alternative medicines to help their HCV, weed is just a common one. Recently thanks to newer treatments many do not turn to weed, since they often can't.

FACT: Marijuana use is not allowed for those on a liver transplant wait list.

If you are stage 4 (like myself) with HCV, don't smoke, don't consume marijuana in any shape. The benefits of the pain it can alleviate do not outweigh the risk of having its use influence your likelihood of transplant negatively. Livers are not plentiful, and HCV is one of the biggest causes for liver transplantation. Smoking before, during(the wait), and after the transplant can and will affect your recovery.

FACT: There is completely legal marijuana, and it's FDA approved.

The big name ones in the US are Marinol and Sativex. So if you're nervous about talking with your doc, Marinol is a drug to ask about. For the Ents reading this: It's also a schedule III.
As for Sativex, it's some pharma scam that doesn't even work properly, but it's legal in the UK.  Sativex is on fast track, but it won't be big time here in the US until the end of 2015, if it even passes FDA approval.

OPINION: If you have Model for End-stage Liver Disease (MELD) score do not smoke.

The repercussions of its physical's effects deal with a lot of unknowns, and transplant lists ban its use. While it can help with the onslaught of symptoms and side effects from the medications one must take: Lactulose,  Diuretics, and to avoid muscle wasting by eating...

Essentially, the balancing act of damage being done, possibly being removed from a transplant list  vs. degree of "normal" life they can maintain  is something some HCV patients have considered.

Want to know more about the medical marijuana industry? Check your Netflix, there's a slew of documentaries on the subject.

I still have yet to see enough evidence either way to push it into one category. Hopefully with so many states having legalized marijuana, we could see more studies and more evidence.

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