CBD Oil and Alcohol

by Apoorva Shivankar, M.D

CBD Oil and Alcohol

CBD and alcohol both are the roaring industries of the market world. Alcohol is more of a necessity for the modern world which considers it as a soulmate in celebrations as well as stress, sorrow, guilt and even insecurities.

No, I am not advocating alcoholism but then it’s the brutal truth of today’s society. On the other hand, CBD is becoming the market charm because of its never-ending list of amazing health-benefits in almost every field.

Can you imagine what will happen if these two lions come together as a package?

Will it explode the market with superb results or sink the boat with inadvertent results?

To your surprise, work has already started in this direction. With CBD popping up everywhere, you can easily get CBD-infused shots, beer, drinks or CBD cocktails in your nearby shops.

But be cautious:

Scientific works on the upsides, pitfalls, safety and necessity of this combo is still in infancy and demands intense research before validation.

So, what do we know by now?

We shall be covering this under the following headings:

  • Can we take CBD and alcohol together? Is the combination safe?
  • Why should we mix CBD and alcohol?
  • Can CBD help in hangover?
  • Does CBD play a role in curing alcoholism and alcohol withdrawal syndrome?

Before coming to the first question let’s discuss CBD in brief:

Cannabidiol (CBD) is a chemical extracted from hemp variety of cannabis plant which itself contains over 100 other cannabinoids. Apart from CBD, THC is the other major cannabinoid present in cannabis plants and is responsible for the characteristic ‘get you high’ effect of cannabis.

Hemp typically lacks this psychoactive THC (conc. <0.3%) and thus is legalized and in-demand variety due to the absence of psychoactive and intoxicating side-effects.

Hemp-derived CBD basically works by interacting with the Endocannabinoid system(ECS) to maintain a perfect internal balance (homeostasis) of the body. This ECS through its receptors and endogenous cannabinoids regulates almost every aspect of the human body including pain, cognition, memory, appetite, sleep, immunity and many more.

Any imbalance triggers an endocannabinoid release which later activates the receptors and releases signals to restore normalcy. Deficiency of endocannabinoids can lead to conditions such as anxiety, depression, insomnia, pain, etc. Enters CBD which levels up endocannabinoids by preventing their degradation and ECS gets back on track to restore homeostasis.

CBD is also known to activate serotonin (5-HT1A) receptors for some of its actions.

So, in short, what does CBD oil do when you drink it?

Simply speaking, it imparts FEEL-GOOD health effects by

  • Warding off stress, anxiety, depression, ache if any.
  • Promoting relaxation, calm sleep.
  • Keeping your skin young and body active.
  • Strengthening your immunity.

 

Coming back to our questions:

Can we take alcohol and CBD together?

Imagine you are taking CBD daily for sleep and have a booze party to attend, the concern immediately pops up in your mind.

Skip CBD or skip the party? Can I take both? Is it safe?

Familiar, isn’t it?

As per the current data available, we can say go ahead with both. Here comes why

  • Being a natural herb with no side-effects and good tolerability (as declared by WHO), taking CBD with alcohol doesn’t pose any compounding threat in the first place.

  • It is believed with experience that both alcohol and CBD complement each other and amplify their actions, whether taken together or some time apart. Alcohol is known to depress your central nervous system and CBD for its calming effect, both of them together can give a perfect long relaxation experience to your brain.

According to James Giordano, a professor of neurology and biochemistry at Georgetown University Medical Centre, CBD would exhibit a stronger effect if taken along with or within 4-6 hours of alcohol intake.

Next question is,

Should we combine CBD and alcohol purposefully? If yes, then why?

With the increasing growth and legalization of CBD products everywhere, how can the alcohol manufacturers stay behind? With an intent to give their market-value a boom, they immediately joined the bandwagon by producing CBD-infused drinks, shots, beer, beverages and CBD cocktails too. This makes it clear why the manufacturers mixed CBD with alcohol but do you know why you should prefer them over the pure ones?

Research provides you with the reasons:

  1. Way back in 1979, to check the CBD-alcohol combination effect, a double-blind study1 using 4 groups placebo (glucose capsule +orange juice),

cannabidiol (CBD capsule + orange juice),

alcohol (alcohol in orange juice + glucose capsule), and

alcohol-CBD (CBD capsule plus alcohol in orange juice)

was performed with 10 volunteer participants. Results showed that alcohol and alcohol-CBD groups produced similar alcoholic symptoms (motor and cognitive impairments) and only the alcohol-CBD group showed lower blood alcohol level.

Two important conclusions were drawn-

  • CBD lowers the blood alcohol levels.

 

  • same amount of pleasure can be experienced with lower blood alcohol levels in presence of CBD as seen in the alcohol-CBD group.

Lesser alcohol, lower the side-effects. Isn’t it a WIN-WIN situation?

  1. Another study3 published in the year 2013, showed that in rodents alcohol induced neurodegeneration caused by binge drinking can be attenuated and delayed by 50% with simultaneous topical CBD gel application or prior CBD injections.

  2. To take it further, a similar rodent study3 performed in 2014 showed that oral CBD 30 minutes prior to alcohol binge drinking successfully reduced oxidative stress and increased autophagy preventing alcohol-induced hepatic steatosis and resulting liver injury. In an explanation, the authors suggested that alcohol prevented the degradation of damaged liver cells by inhibiting natural autophagy.

    These damaged cells led to an accumulation of fat causing fatty liver disease and steatohepatitis. Prior addition of CBD can counter this by encouraging the removal of dead-damaged cells.

  3. In 2019, Frontiers in Pharmacology published a study4 showing the importance of CBD in improving the lung and cognitive status of participants with alcohol use disorder (AUD). By means of its antioxidant, anti-inflammatory, neuroprotective powers and the ability to induce autophagy, CBD reduced and even reversed the development and impact of alcohol-related lung and brain injury in chronic users.

    CBD by acting as a protective shield for the brain and lungs can be a boon for those badly addicted alcohol use disorder patients who find it difficult to give up alcohol.

These studies strongly advocated the use of CBD to mitigate alcohol-mediated harmful effects to the body. But again, how much of these benefits can be transferred from animal studies to humans is a BIG QUESTION.

What about alcohol hangover and withdrawals?

Remember the next morning headaches, confusion, nausea, vomiting, abdominal pains, anxiety and depression. These lingering hangovers are more notorious than actual alcohol intoxication.

Can CBD help here too?

Yes, why not. CBD addresses most of the hangover symptoms individually by its interaction with

  • The Endocannabinoid System.
  • Serotonin receptors (5-HT1A).

 

Headaches and alcohol-induced migraines:

Alcohol is a diuretic and hence cause dehydration. This dehydration causes inflammation in the structures in and around the brain causing pain. The analgesic and anti-inflammatory property of CBD works here gracefully.

Nausea and vomiting:

Alcohol irritates the stomach lining causing inflammation and increased acid secretions. Result: Nausea and vomiting. CBD by activating serotonin (5-HT1A) receptors in the brain stem reduces the serotonin release and blocks nausea and the urge to vomit.

For vomiting, CBD modulates ECS which controls the vomiting centres partially.

Anxiety and depression:

CBD serves as a strong anxiolytic and antidepressant by activating ECS and serotonin receptors.

Confusion:

CBD is a neuroprotector.

Can CBD cure alcoholism and alcohol withdrawal syndrome?

Drinking is ok, dependence is not,

And if you are someone who cannot resist alcohol craving, CBD is for you.

How? Keep reading,

CBD:

  • Curbs cravings- CBD dampens the super-excited brain areas responsible for cravings.
  • Diminishes the perception of alcohol-induced pleasure by altering serotonin-dopamine levels. Less pleasure leads to fewer cravings and more manageable behaviour.
  • CBD eases withdrawal symptoms: such as anxiety, stress, seizures, abnormal aches and pains via ECS interaction.
  • It also reduces the alcohol-induced lung and brain damage through its antioxidant and neuroprotective effects.

Fun-fact:

Though CBD seems to be benefitting alcoholics everywhere, do you know a condition where alcohol helps CBD. Any guesses?

The answer is ‘ETHANOL/ALCOHOL EXTRACTION OF CBD’. It’s one of the cheapest and considerably safe process wherein the alcohol is used to strip out CBD from the hemp plants.

Is CBD hard on the liver?

Recently, a statement issued by the Food and Drug Administration, ‘what you don’t know about CBD might hurt you’ and warning that it could cause serious health concerns, including liver damage, has created turbulence. But experts say there is nothing to panic about. This warning is the same as we get for other regular drugs too. It says, any drug when used excessively can be hepatotoxic, and this may include CBD too.

A recent study showing the CBD-induced liver toxicity is at first conducted in mice and secondly shows toxicity at doses equivalent to 200mg/kg in humans, which is very high.5

Medical advice is a must before use, especially in case of underlying hepatic pathology.

To conclude:

Yes, studies show that using CBD with alcohol can be beneficial. But keep in mind:

  1. CBD is not a cure for alcoholism. Combining CBD with alcohol will not make alcohol good, it will just make the alcoholic side-effects less bad.

  2. Research in this direction is still in infancy and mostly done on animal models, so can’t be used to draw conclusions. A lot more is yet to come.

 

FAQs:

Q. How long does it take for CBD oil to work orally?

Somewhere around 2-4 hours. As taken orally, CBD oil has to pass through the first- pass metabolism before getting absorbed into the blood-stream. Final duration depends on individuals’ weight, metabolism, type and form of oil used and the desired results.

Q. What drugs should not be taken with CBD?

CBD competes with the following drugs for liver enzymes involved in their metabolism, so they must not be taken with CBD or without medical advice.

  • Blood thinners like warfarin.
  • Amiodarone.
  • Thyroid drugs.
  • Antiseizure medications such as clobazam, lamotrigine, and valproate.

Q. How long after taking CBD oil can I drink alcohol?

Depends on what you want. CBD enhances the relaxation effects of alcohol. So, if you are in a mood of stretched leisure, drink within 2-4 hours; but if you do not wish the effect to stay longer, avoid drinking for the next 8-10 hours.

Q. Is CBD safe for recovering alcoholics?

Yes. CBD is completely safe as it curbs the cravings and also relieves the withdrawal symptoms like depression, fatigue, sleeplessness, restlessness among others.

 

References:

  1. Consroe P, Carlini EA, Zwicker AP, Lacerda LA. Interaction of cannabidiol and alcohol in humans. Psychopharmacology (Berl). 1979;66(1):45-50. doi: 10.1007/BF00431988. PMID: 120541.
  2. Daniel J. Liput, Dana C. Hammell, Audra L. Stinchcomb, Kimberly Nixon.

    Corrigendum to “Transdermal delivery of cannabidiol attenuates binge alcohol-induced neurodegeneration in a rodent model of an alcohol use disorder” [Pharmacol. Biochem. Behav. 111 (2013) 120–127]

  3. Yang L, Rozenfeld R, Wu D, Devi LA, Zhang Z, Cederbaum A. Cannabidiol protects liver from binge alcohol-induced steatosis by mechanisms including inhibition of oxidative stress and increase in autophagy. Free Radic Biol Med. 2014 Mar;68:260-7. doi: 10.1016/j.freeradbiomed.2013.12.026. Epub 2014 Jan 4. PMID: 24398069; PMCID: PMC4112960.

  4. De Ternay J, Naassila M, Nourredine M, Louvet A, Bailly F, Sescousse G, Maurage P, Cottencin O, Carrieri PM, Rolland B. Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain. Front Pharmacol. 2019 May 31;10:627. doi: 10.3389/fphar.2019.00627. PMID: 31214036; PMCID: PMC6554654.

  5. Ewing LE, et al. Hepatotoxicity of a Cannabidiol-Rich Cannabis Extract in the Mouse Model, Molecules 201924(9), 1694; https://doi.org/10.3390/molecules24091694

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