CBD for Alcoholism
What is Alcoholism
Alcohol is the most commonly used addictive substance in the United States. Consumed in moderation, it can relax the human body. Consumed in excess, it can kill.
According to the Centers for Disease Control and Prevention, excessive alcohol consumption causes approximately 95,000 deaths per year, accounting for 1 in 10 total deaths among working-age adults aged 20 to 64 years in the United States alone. The most severe form of alcohol abuse, alcoholism is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.
Alcoholism is associated with many physical, mental, and behavioral symptoms, including both short- and long-term health effects. Short-term effects include injuries, violence, poisonings, sexually transmitted infections, unintended pregnancy, and poor pregnancy outcomes, while long-term effects include things like high blood pressure, heart disease, stroke, liver disease and even cancer.
Symptoms of Alcoholism
Alcoholism doesn’t discriminate based on ethnicity, age, or gender—and while heredity can play a part in the development of alcohol dependence, researchers have never isolated an alcohol addiction gene. Though there isn’t one singular cause for alcoholism, there are a few contributing risk factors that include:
- A family history of alcoholism
- Starting drinking at a young age
- Steady drinking, or binge drinking over time
- Depression and other mental health problems, especially anxiety, depression, schizophrenia or bipolar disorder
- A history of emotional or other types of trauma
- Having bariatric surgery
- Several social and cultural factors including having friends or a close partner that drinks regularly, and the influence of parents, peers and other role models
Alcohol use disorder can be mild, moderate, or severe, based on the number of symptoms experienced. Signs and symptoms may include:
- More than 15 drinks per week if you’re male, or over 12 drinks per week if you’re female
- Over 5 drinks per day at least once a week (binge drinking)
- Drinking alone
- Drinking more, or for longer, than planned
- Giving up important social, occupational, or recreational activities because of alcohol use
- Needing to drink more to feel the effects of alcohol
- Continuing to drink alcohol even though you know it's causing physical, social or interpersonal problems
- Using alcohol in situations where it's not safe, such as when driving or swimming
- Being unable to control alcohol intake
- Experiencing withdrawal symptom such as nausea, sweating, trouble sleeping, and shaking, when not drinking
- Not eating or eating poorly
- Neglecting personal hygiene
A study from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute of Health (NIH), and National Epidemiological Survey on Alcohol and Related Conditions (NESARC) identified the following five subtypes of alcoholics:
Young Adult Subtype: Accounting for 32% of alcoholics, this is the largest subtype. Young adult alcoholics tend to engage in binge drinking and rarely seek help for alcohol dependence.
Young Antisocial Subtype: Accounting for 21% of alcoholics, this subtype is largely comprised of males in their mid-twenties. Young antisocial alcoholics are more likely to smoke tobacco and marijuana, and more than half of them have antisocial personality disorder.
Functional Subtype: Accounting for 19% of alcoholics, this subtype includes middle-aged, working adults who have higher incomes, more education, and stable relationships compared to other alcoholics.
Intermediate Familial Subtype: Accounting for 19% of alcoholics, this subtype includes people who typically start drinking by age 17 and become alcoholics in their early 30s. Nearly half of all intermediate familial alcoholics have close relatives who are also alcoholics.
Chronic Severe Subtype: Accounting for only 9% of alcoholics, this is the smallest subtype. Chronic severe alcoholics drink more frequently than any other group, have a high divorce rate, and are likely polydrug users. 66% of them have sought help for alcoholism.
Alcoholism Medications and Treatments
The treatment of chronic Alcoholism conditions usually involves a combination of lifestyle changes, self-help, psychological interventions and sometimes medications with the main aim being total abstinence. The type of recommended treatment is often based on the severity of symptoms and the person's response to it.
There are a couple of different medications that may help with alcohol use disorder, including:
Naltrexone (ReVia) which is used only after someone has detoxed from alcohol. It works by blocking certain receptors in the brain that are associated with the alcoholic “high” that, in combination with counseling, may help decrease a person’s craving for alcohol.
Acamprosate is a medication should also be combined with therapy and is though to help re-establish the brain’s original chemical state before alcohol dependence and.
Disulfiram (Antabuse) is probably the most well known of the pharmaceutical interventions and is a drug that causes physical discomfort (such as nausea, vomiting, and headaches) any time the person consumes alcohol.
On pharmaceutical interventions usually include a combination of treatments that may occur in stages and in combination with each other. The first step is usually detoxification or withdrawal to rid the body of alcohol, although this may not always be necessary and is dependent on the severity and duration of drinking.
This is usually followed by some form of rehabilitation that may occur on an in-patient of out-patient basis and usually involves learning new coping skills and behaviours. Counselling to address emotional problems that may cause drinking in the first place is also included as part of this process. In addition, support group that include 12-step programs such as Alcoholics Anonymous (AA) is useful post rehabilitation to help avoid relapses. In addition, medical treatment for health problems associated with alcohol use disorder is also recommended.
CBD for Alcoholism
Research and Scientific Evidence for using CBD for alcoholism
The clinical evidence for Cannabidiol (CBD) as a viable treatment option for addiction disorders, including alcoholism, is promising.
Transdermal Delivery of Cannabidiol Attenuates Binge Alcohol-Induced Neurodegeneration in a Rodent Model of an Alcohol Use Disorder
In an early 2013 study published in the journal Pharmacology Biochemistry and Behavior, researchers investigate the potential of CBD attenuating alcohol-induced neurodegeneration in a rodent model of alcohol abuse disorder. Neurodegeneration in the entorhinal cortex assessed by Fluoro-Jade B (FJB).
The researchers aimed to advance the preclinical development of transdermal delivery of cannabidiol (CBD) for the treatment of alcohol-induced neurodegeneration by administering 1, 1.0%, 2.5% and 5.0% CBD gels to the skins of rats exposed to ethanol following the modified Majchrowicz binge model. A second experiment tested a next generation 2.5% CBD gel formulation, which was compared to CBD administration by intraperitoneal injection of 40.0 mg of CBD per kilogram per day (mg/kg/d).
Both experiments yielded similar results and found similar magnitudes of neuroprotection following both routes of administration; transdermal CBD decreased FJB+ cells in the entorhinal cortex by 56.1%. Similarly, IP injected CBD resulted in a 50.6% reduction in FJB+ cells. They concluded that the results demonstrate that using a CBD transdermal delivery system has the potential for being an effective treatment of alcohol-induced neurodegeneration.
Cannabidiol reduces ethanol consumption, motivation and relapse in mice
In another animal study, published in 2018 in the journal Addiction Biology, investigators studied the effects of cannabidiol (CBD) on ethanol reinforcement, motivation and relapse in mice.
They did this by using the two-bottle choice paradigm was performed to assess the effects of CBD (30, 60 and 120 mg/kg/day, IP) on ethanol intake and preference. In addition, an oral ethanol self-administration experiment was carried out to evaluate the effects of CBD of 30 mg/kg/day on the reinforcement and motivation for ethanol, the effects of CBD (60 and 120 mg/kg/day, i.p.) on ethanol-induced relapse as well as the effects of CBD (60 mg/kg) on blood ethanol concentration, hypothermia and handling-induced convulsions associated to acute ethanol administration. They also analysed gene expression in opioid, cannabinoid, and GPR55 receptors, all of which are implicated as interaction sites for CBD.
The data showed that CBD reduced ethanol consumption and preference in the two-bottle choice, significantly decreased ethanol intake and the number of effective responses in the oral ethanol self-administration, and reduced ethanol-induced relapse. Furthermore, the administration of CBD significantly reduced relative gene expression in the target sites.
The researchers deduced that, when taken together, these results indicated that CBD has the ability to reduce the reinforcing properties, motivation and relapse for ethanol, making it useful for the treatment of alcohol use disorder.
Cannabidiol as a novel candidate alcohol use disorder pharmacotherapy: a systematic review
Following on from this, a 2019 review study published in Alcoholism Clinical and Experimental Research investigated the pharmacotherapy of CBD for alcohol use disorder. Of the papers that met the criteria for inclusion, 8 used rodent models, 3 used healthy adult volunteers, and 1 used cell cultures.
They found that in both rodent and cell culture models, CBD exerted a neuroprotective effect against adverse alcohol consequences, especially in the hippocampal region which is implicated in conditioning, learning and memory as well as several models of drug dependency and abuse. Similarly, in rodent models, CBD was found to attenuate alcohol-induced hepatotoxicity, specifically, alcohol-induced steatosis. CBD was also found to attenuate cue-elicited and stress-elicited alcohol-seeking, alcohol self-administration, withdrawal-induced convulsions, and impulsive discounting of delayed rewards. In human studies, CBD was well tolerated and did not interact with the subjective effects of alcohol.
The reviewers concluded that, given its favorable effects on alcohol-related harms and addiction phenotypes in preclinical models, CBD appears to show promise as an effective pharmacotherapy for alcohol use disorder. However, they also warned that a clear limitation to the literature is the lack of human investigations, and that human preclinical and clinical studies are needed to determine whether these positive effects in animal models translate into clinically effective outcomes.
Anecdotal evidence suggests that in addition to CBD helping reduce the desire and need for alcohol that potentially aids with abstinence and prevents relapse, CBD also helps reduce many of the psychological and physical side effects associated with withdrawal, including tremors, aches, pains, anxiety and depression.
CBD as a Complementary Treatment
While the research suggesting that CBD can help reduce psychological, physiological and behavioral responses that cause alcoholism as well as, help with withdrawal and abstinence, it can also help attenuate many of the other symptoms people with alcoholism have to deal with.
Many people suffering from alcohol use disorder also report having sleep problems, feelings of anxiety and depression - both during alcohol use as well as during withdrawal. Although it is not always clear which came first, CBD may help. In one large case series study investigating the effects of CBD on anxiety and sleep, the results indicate that CBD helps improve sleep and/or anxiety in clinical populations. Similarly, CBD can further support people suffering from alcoholism by helping to promote REM sleep that is thought to help improve overall mood.
As mentioned, CBD may help with many of the symptoms of withdrawal, including nausea, pain and inflammation. Similarly, CBD may also be helpful in reducing many of the underlying causes of alcoholism, including psychological issues such as stress, anxiety, depression, schizophrenia or bipolar disorder and trauma.
Both scientific and anecdotal evidence indicates that CBD can help treat alcoholism with researchers having shown its potential to reduce addiction behaviours and urges, protect against alcohol induced neurological damage, as well as help prevent relapse via several mechanisms. However, it is also important to remember that alcoholism can be a serious, chronic condition that can have a short as well as long-term impact on health. If you or a loved one are suffering from alcoholism, talk to your medical practitioner. He or she can help put together a plan that includes CBD along with other treatment options to help you deal with it safely and effectively.