# Cannabis and Alcohol Use and Their Effects on Hematological and Biochemical Parameters: Evidence From the Accra Psychiatric Hospital, Ghana

## TL;DR

This study examines how cannabis and alcohol use affect blood and liver health in psychiatric patients in Ghana, finding significant liver enzyme changes in dual users.

## Contribution

The study provides novel evidence on the biochemical effects of cannabis and alcohol use in a psychiatric population in Ghana.

## Key findings

- Dual users of cannabis and alcohol had significantly higher hemoglobin levels compared to non-users and alcohol-only users.
- Substance users showed elevated liver enzymes (AST, GGT, bilirubin) indicating potential hepatic stress, especially in dual users.
- Cannabis-only users had lower total cholesterol than non-users, while no significant differences were found in HDL-C or triglycerides.

## Abstract

Substance use, particularly cannabis and alcohol consumption, presents a growing public health challenge in Ghana, with significant implications for both mental and physical health. While the adverse psychological effects of these substances have been extensively studied, their biochemical impact remains inadequately explored, particularly in psychiatric settings. The rising prevalence of substance‐use disorders among individuals receiving psychiatric care necessitates a comprehensive evaluation of the physiological consequences associated with cannabis and alcohol use. This study investigated these biochemical effects in patients at Accra Psychiatric Hospital.

The study sought to determine the impact of the use of cannabis and alcohol on hemoglobin level, lipid profile, and liver function analysis.

This cross‐sectional study at Accra Psychiatric Hospital assessed the impact of cannabis and alcohol use on hemoglobin levels, lipid profile, and liver enzymes among 184 participants. Using stratified purposive sampling, data collection involved structured interviews, and blood analysis. Hemoglobin concentration, lipid profile, and liver enzyme activity were measured using standard laboratory techniques. Statistical analysis was conducted with SPSS and GraphPad Prism, with significance set at p < 0.05.

The study compared 92 non‐users with 92 substance users (alcohol‐only, n = 21; cannabis‐only, n = 50; dual users, n = 21). Hemoglobin levels were similar between non‐users and single‐substance users, but significantly higher in dual users compared with non‐users (p = 0.017) and alcohol‐only users (p = 0.027). Cannabis‐only users had significantly lower total cholesterol than non‐users (4.53 ± 0.98 vs. 5.30 ± 1.23 mmol/L, p < 0.001), while LDL‐C was higher in non‐users than in all substance user groups (p < 0.05). No group differences were found for HDL‐C, triglycerides, and VLDL. Liver function analysis revealed significantly higher AST in all substance user groups, with dual users recording the highest levels (81.14 ± 72.26 U/L, p < 0.001 vs. non‐users). GGT was markedly elevated in alcohol‐only and dual users compared with non‐users (p < 0.001). Both direct and indirect bilirubin were significantly higher in all substance user groups (p < 0.05), and albumin levels were significantly lower in non‐users than in all substance user groups (p < 0.001).

The findings indicate that while single‐substance use of alcohol or cannabis had limited impact on hemoglobin and lipid profiles, dual use was associated with elevated hemoglobin and marked liver enzyme abnormalities. Elevated AST, GGT, and bilirubin in substance users, particularly dual users, suggest potential hepatic stress, warranting targeted public health interventions and monitoring. It is recommended that routine liver function screening be incorporated into healthcare services for individuals with a history of alcohol and cannabis use to enable early detection and management of hepatic impairment.