CBD Reduces Cravings For Alcohol Among People With Drinking Problems, New Study Shows
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Results of a new study indicate that a single, 800-milligram dose of CBD can help manage certain alcohol cravings among people with alcohol use disorder (AUD), supporting the use of the marijuana component as a potential treatment option for problem drinkers.
Published this month in the journal Molecular Psychiatry, the research says people who were given cannabidiol reported “significantly lower alcohol cravings” resulting from stress or exposure to alcohol-related cues.
“These results suggest that CBD can modulate central neurobiological mechanisms underlying alcohol craving and alcohol use and alleviate disease symptoms, such as craving,” wrote the report’s seven-author research team, from the Department of Addictive Behavior and Addiction Medicine at the University of Heidelberg, in Germany.
“CBD’s effects on craving appear clinically meaningful,” they added, “as alcohol craving is a core symptom of AUD and a potential marker for predicting the transition from moderate to severe AUD, emphasizing its role in AUD. Thus, pharmacotherapies targeting craving-related pathologies in AUD might be effective in reducing symptom burden and progression of the disease.”
The study involved 28 people with AUD who were asked to abstain from drinking for 24 hours before participating. Participants were screened for recent use and tested for pregnancy, if applicable, and withdrawn from the research if either came back positive.
Individuals were administered 800 mg CBD or a placebo, and after about three hours were tested through a “combined stress and cue exposure” in a bar laboratory setting—a practice that’s generally accepted as a way to induce alcohol cravings. Their brains were then scanned for functional activity as well as structure using magnetic resonance imaging (MRI).
Results indicated that CBD, compared to placebo, reduced alcohol cue-induced brain activity while having no significant effect on activity when participants were presented with neutral cues, “suggesting that the observed effects of CBD were specific for the presentation of salient alcohol cues.”
Participants in the CBD group also reported lower alcohol cravings, while those receiving the placebo “reported significantly higher alcohol craving during the cue-reactivity fMRI paradigm compared to participants receiving CBD.”
“The results of this randomized double-blind placebo-controlled trial show that administration of 800 mg CBD reduces alcohol cue-induced bilateral NAc activity and alcohol craving in individuals with AUD,” the report says, noting that the effects were observed three hours after CBD administration, “indicating rapid onset of CBD’s actions” when CBD concentrations in blood plasma are at their highest.
CBD’s “craving-reducing effects” among people with alcohol use disorder “were specific to alcohol cue-induced craving,” the team observed, “suggesting that CBD—via its effects on NAc activation—might attenuate alcohol-specific motivational salience in AUD and not appetitive behavior per se.”
“The observed potential of CBD to reduce cue-induced NAc activity and alcohol craving, together with its good safety profile, supports the potential of CBD to treat individuals with AUD,” the research concludes. “New pharmacological treatment options that target central neurobiological disease mechanisms and core symptoms of AUD, such as craving, could complement existing treatment options and reduce relapse risk and the enormous disease burden inflicted by AUD.”
Authors noted that the new study’s findings align with other preclinical data and randomized trials in individuals with opioid use disorder, adding: “For the first time, the current [randomized controlled trial] provides evidence for the significant effects of neurobiological disease mechanisms and symptoms in AUD.”
In addition to past investigations into CBD and opioids, separate study plans backed by a grant from the National Institute of Drug Abuse intend to test whether hemp-derived CBD might offer an offramp for people with marijuana use disorder, potentially enabling them to reduce their consumption of THC.
Authors of that recently published plan, from the University of Colorado in Boulder and Denver, note that unlike THC, CBD “has no intoxicating effects, and little abuse liability among cannabis users.” They also pointed out that past research has indicated CBD could reduce heroin-seeking behavior, cravings and anxiety in people with opioid dependence.
Another federally funded study published earlier this year found that marijuana helps people with substance misuse disorders stay off opioids or reduce their use, maintain treatment and manage withdrawal symptoms.
Researchers at the University of Southern California set out to investigate the relationship between cannabis consumption and injecting opioids, recruiting 30 people in Los Angeles at a community site near a syringe exchange service program and methadone clinic to analyze the relationship.
“Participants reported using cannabis substitution or co-use to manage the pain from withdrawal symptoms such as body aches and generalized discomfort which led to decreased opioid injection frequency,” those researchers found.
The study, published by the journal Drug and Alcohol Dependence Reports, was partially funded by the National Institute on Drug Abuse (NIDA) and supports a sizable body of scientific literature indicating that access to marijuana can offset the harms of the opioid epidemic, either by helping people limit use or giving them an offramp altogether.
Another recent study out of Ohio found that a large majority of medical marijuana patients in the state say cannabis has reduced their use of prescription opioid painkillers as well as other, illicit drugs.
A separate report published recently in the journal BMJ Open compared medical marijuana and opioids for chronic non-cancer pain and found that cannabis “may be similarly effective and result in fewer discontinuations than opioids,” potentially offering comparable relief with a lower likelihood of adverse effects.
And federally funded study published in May concluded that even some cannabis terpenes may have pain-relieving effects. That research found that an injected dose of the compounds produced a “roughly equal” reduction in pain markers in mice when compared to a smaller dose of morphine. Terpenes also appeared to enhance the efficacy of morphine in mice when the two drugs were given in combination.
Another study, published late last year, found that marijuana and opioids were “equally efficacious” at mitigating pain intensity, but cannabis also provided more “holistic” relief, such as by improving sleep, focus and emotional wellbeing.
The same month, research published in the Journal of Dental Research found that pure CBD could alleviate acute dental pain about as well as an opioid formula commonly used in dentistry.
A study published last summer linked medical marijuana use to lower pain levels and reduced dependence on opioids and other prescription medications. Another, published by the American Medical Association (AMA) in February, found that chronic pain patients who received medical marijuana for longer than a month saw significant reductions in prescribed opioids.
About one in three chronic pain patients reported using cannabis as a treatment option, according to another AMA-published report last year. Most of that group said they used cannabis as a substitute for other pain medications, including opioids.
Other research published last year found that letting people buy CBD legally significantly reduced opioid prescription rates, leading to 6.6 percent to 8.1 percent fewer opioid prescriptions.
A 2022 research paper that analyzed Medicaid data on prescription drugs, meanwhile, found that legalizing marijuana for adult use was associated with “significant reductions” in the use of prescription drugs for the treatment of multiple conditions.
Another recent paper, combining an academic literature review with a survey of university students, concluded that marijuana more broadly could be an effective tool in reducing harm caused by opioid use disorder, while acknowledging that “perceptions and knowledge vary.”
“Upon a review of the literature, it is reasonable to conclude that cannabis has some efficacy in the setting of opiate maintenance, as well as other therapeutic uses,” that paper said, adding that in light of public concerns over opioid overdoses and the possibility of marijuana being rescheduled, “there is a distinct possibility that cannabis use in harm reduction models will increase.”
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