Hepatitis C: An In-Depth Guide

What effect does marijuana (pot) have on hepatitis C?

Pot (marijuana, cannabis, hash) is a controversial topic for people with hepatitis C because sometimes it is helpful and sometimes it is harmful. Here's why:

  1. Legal issues: Many people, with or without hepatitis C, use pot and other street drugs. Pot, like other street drugs, is a controlled substance, which means it is illegal to possess or sell marijuana. However, some people can get permits to possess and use small amounts for personal medical use, although this process requires the sign-off of a doctor. Dronabinol (Marinol) and nabilone (Cesamet) are synthetic pill forms of marijuana available by prescription as an alternative to smoking pot.
  2. Help with side effects: People who are taking Hep C treatment that includes peg-interferon and ribavirin often experience difficult side effects, like nausea, low appetite, aches and pains. Using pot has helped people to manage these side effects and stay on Hep C treatment so they have a better chance of getting rid of the virus from their bodies.
  3. Liver health: Research into whether or not pot damages the liver is conflicting. Some research shows that pot damages the liver, while other research found that liver damage is not linked to pot use. We know that smoking cigarettes damages the liver (causes increased fibrosis), so it is possible that smoking pot would also cause damage. Using pot in a different way may be safer – cooking with it, for example. However, some of the chemicals in pot (called cannabinoids) may trigger changes to liver cells and lead to more liver damage (fibrosis) regardless of how pot is consumed.
  4. Passing on Hep C from one person to another: Using street drugs (especially by injection) can put people at risk for hepatitis C if they share drug use equipment. Smoking pot instead of injecting other drugs may protect from passing hepatitis C from one person to another.

So when is it safe to use pot? The answer to this question would change for each person. When making the decision about smoking pot, weigh the different risks and benefits and consider talking to a healthcare worker or community worker you trust.


  1. Bruent, L, et al. Marijuana smoking does not accelerate progression of liver disease in HIV-hepatitis C coinfection: a longitudinal cohort analysis. Clinical Infectious Diseases. 57(5):663-70, 2013 Sept.
  2. Hezode C, et al. Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C. Gastroenterology. 134(2):432-9, 2008 Feb
  3. Mallat, A, et al. Environmental factors as disease accelerators during chronic hepatitis C. Journal of Hepatology. 48(4):657-65, 2008 Apr.
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