Quick answer
Quick answer
Yes, in many places. 1 state program name cirrhosis on the official list, and 14 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.
Understanding cirrhosis
Living with cirrhosis can mean fatigue, muscle cramps, itching, poor appetite and frequent medical visits, and many people struggle with sleep and anxiety. Treatment focuses on the cause of liver damage, stopping alcohol, medicines to control fluid and confusion, careful nutrition and, for some, a liver transplant.
Symptoms patients hope to ease
- Painful muscle cramps, often at night
- Persistent itching
- Abdominal discomfort from fluid buildup
- Nausea and poor appetite
- Trouble sleeping
- Anxiety and stress about the illness
Does cirrhosis qualify in your state?
- AL AlabamaNot listed by name
- AK AlaskaDoctor's discretion
- AZ ArizonaNot listed by name
- AR ArkansasNot listed by name
- CA CaliforniaDoctor's discretion
- CO ColoradoDoctor's discretion
- CT ConnecticutNot listed by name
- DE DelawareDoctor's discretion
- FL FloridaDoctor's discretion
- HI HawaiiDoctor's discretion
- IL IllinoisNot listed by name
- KY KentuckyNot listed by name
- LA LouisianaDoctor's discretion
- ME MaineDoctor's discretion
- MD MarylandNot listed by name
- MA MassachusettsNot listed by name
- MI MichiganNot listed by name
- MN MinnesotaDoctor's discretion
- MS MississippiNot listed by name
- MO MissouriDoctor's discretion
- MT MontanaNot listed by name
- NV NevadaNot listed by name
- NH New HampshireNot listed by name
- NJ New JerseyNot listed by name
- NM New MexicoNot listed by name
- NY New YorkDoctor's discretion
- ND North DakotaListed as “Decompensated cirrhosis caused by hepatitis C”
- OH OhioNot listed by name
- OK OklahomaDoctor's discretion
- OR OregonNot listed by name
- PA PennsylvaniaNot listed by name
- RI Rhode IslandNot listed by name
- SD South DakotaNot listed by name
- UT UtahNot listed by name
- VT VermontNot listed by name
- VA VirginiaDoctor's discretion
- WA WashingtonNot listed by name
- DC Washington, D.C.Doctor's discretion
- WV West VirginiaNot listed by name
What the research says
Not enough research. Cannabis can affect the liver's handling of other medicines, so doctors are cautious here.
- There is little research specifically on cannabis for cirrhosis, and patients typically use it for related symptoms like cramps, itching, poor appetite and sleep.
- Because the liver breaks down THC and CBD, people with cirrhosis may have higher and longer-lasting levels than expected, but this has not been well studied.
- In clinical trials of the prescription CBD medicine Epidiolex, higher amounts of CBD were linked to raised liver enzymes in some people.
- Older studies linking daily cannabis use to faster liver scarring in hepatitis C have not been consistently confirmed, but the question is not fully settled.
Sources: National Academies of Sciences, Engineering, and Medicine, The Health Effects of Cannabis and Cannabinoids (2017); FDA approvals; published trials. General information, not medical advice.
How doctors approach cirrhosis
If cannabis is used at all, doctors usually suggest very small amounts and slow changes because a damaged liver clears it more slowly.
High-dose CBD products are generally avoided because CBD itself can raise liver enzymes.
Topical products may be considered for localized aches since little reaches the bloodstream.
Any plan should be shared with your liver doctor, who may want to check liver blood tests after you start.
Risks and precautions
- Cannabis can cause drowsiness and confusion that may mimic or worsen hepatic encephalopathy, the confusion caused by liver failure.
- A damaged liver processes many medicines more slowly, so cannabis and other drugs may build up and cause stronger effects.
- Never combine cannabis with alcohol, which further damages the liver, and use extra care with sedatives and opioids.
- Liver transplant programs often have rules about cannabis use, so ask your transplant team before starting.
- Cannabis can cause dizziness and falls, which are more dangerous if you bleed easily because of liver disease.
- Not recommended during pregnancy or breastfeeding, and never drive while impaired.
What to bring to your evaluation
Notes from your hepatologist or gastroenterologist confirming cirrhosis and describing complications.
Recent liver blood tests and imaging or biopsy results.
A complete medicine list, including diuretics, lactulose, rifaximin and any sleep or pain medicines.
Information on whether you are being evaluated for, or are listed for, a liver transplant.
A government photo ID and proof that you live in your state.
Don't have records handy? Many patients are evaluated on their history alone.
Start my free checkHow to get certified for cirrhosis
Answer a few questions
Pick your state, tell us your symptoms and what you've already tried. Review your answers and contact you to schedule your video visit.Meet your doctor by video
Join from your phone or laptop. Have a photo ID ready. The doctor reviews your history and decides whether cannabis is right for you.Get certified and registered
Pay the evaluation fee, then submit your state registry form. The doctor files your certification. We walk you through the state form line by line.
Cirrhosis: 9 common questions
Does cirrhosis qualify for a medical marijuana card?
Yes, in many places. 1 state program name cirrhosis on the official list, and 14 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.
Which states list cirrhosis as a qualifying condition?
As of our latest check of each state's official list: North Dakota. Providers can also certify it in Alaska, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maine and 6 more, which don't use a fixed list. Lists change, so confirm on your state's page before you apply.
Can I get certified for cirrhosis online?
Yes, in 11 of those states — including California, Delaware, Hawaii, Louisiana, Maine and 6 more — your first evaluation can happen by video with a provider licensed there. In 4 others, such as North Dakota, Alaska, Colorado and 1 more, the first visit must be in person, and renewals can usually be done online.
Is cannabis safe if I have cirrhosis?
There is very little research on cannabis in people with cirrhosis, so safety is uncertain. A damaged liver breaks down THC and CBD more slowly, which can make effects stronger and longer. If you choose to use it, do so only with your liver doctor's knowledge and in very small amounts.
Can CBD harm my liver?
In clinical trials of prescription CBD, higher amounts raised liver enzymes in some people, especially when taken with valproate. That is a reason for caution when the liver is already damaged. Avoid high-dose CBD products and ask your doctor whether liver blood tests should be checked after starting.
Can cannabis help with muscle cramps from cirrhosis?
Muscle cramps are common and painful with cirrhosis, and some people try cannabis for them. There are no good studies on this use. Ask your liver team about other options first, such as checking your electrolytes and adjusting medicines.
Can cannabis make liver-related confusion worse?
Yes, it can. Cannabis can cause drowsiness, slowed thinking and confusion, which can look like or add to hepatic encephalopathy. If you or a family member notice new confusion, unusual sleepiness or personality changes, stop using cannabis and contact your doctor right away.
Will using cannabis affect my liver transplant eligibility?
It might. Transplant programs set their own rules, and some require a period without cannabis or ask you to report any use. Talk with your transplant team before starting so your use does not affect your place on the list.
Can I drink alcohol while using medical cannabis with cirrhosis?
No. Alcohol is harmful for anyone with cirrhosis, and combining it with cannabis increases drowsiness, confusion and fall risk. If you are working to stay alcohol-free, let your doctor know so cannabis use can be planned with your recovery in mind.