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A new study shows that cannabidiol (CBD) can reduce the craving for alcohol in people suffering from alcoholism. CBD is a natural component of the cannabis plant and has no intoxicating effects. With their ICONIC study, the scientists provide the first evidence that this cannabis active ingredient could help with alcohol problems. The team recently published the results of their study in the journal Molecular Psychiatry.
Scientists at the Central Institute of Mental Health (CIMH) have investigated how CBD affects alcohol cravings and brain activity in people with alcohol use disorder.
First clinical study with CBD
Alcohol-related diseases are associated with a high level of suffering and are among the most common and devastating diseases worldwide. Despite this, only a few drugs have been approved for their treatment. Currently, the majority of patients relapse even when treated with relapse prevention medications, highlighting the need for the development of new pharmacological treatments. Preclinical studies have shown that CBD could be promising, as it was able to significantly reduce alcohol consumption in laboratory animals. However, there has been a lack of clinical trials in humans. The ICONIC study (Investigation of the effects of Cannabidiol ON cue-InduCed alcohol craving and nucleus accumbens activation) fills this gap.
The scientists investigated how CBD influences the craving for alcohol triggered by alcohol stimuli and brain activity in the nucleus accumbens (NAc) – the NAc is a brain region associated with reward and addiction.
Tests also in a bar-like environment
The double-blind, randomised and controlled study comprised 28 people aged between 18 and 60 with mild to severe alcohol-related illness and was conducted at the CIMH in Mannheim. The researchers divided the participants into two groups. One group was given a single dose of 800 mg CBD, while the other received a placebo. The test subjects then took part in various tests in which they were exposed to alcohol stimuli or stress, for example. They were shown alcohol-related images or asked to enter an environment that resembled a bar. They assessed their craving for alcohol using questionnaires. Their brain activity was measured using a magnetic resonance tomograph.
CBD influences reward centre in the brain
The study shows that those who received CBD reported a significantly lower craving for alcohol compared to the placebo group. The authors also found that the NAc, i.e. the “reward centre of the brain”, was significantly less activated in people who took CBD. Lower activity in the NAc is associated with a lower craving for alcohol and a lower likelihood of relapse. The authors were also able to show that higher CBD levels in the blood were associated with a lower alcohol craving and less activation in the NAc.
“Our study provides initial and clear evidence that cannabidiol can help to reduce the craving for alcohol and change the brain activity associated with addiction,” says Prof. Dr. Dr. Patrick Bach, research group leader at the Addictive Behaviour and Addiction Medicine at the CIMH, summarising the results. Scientist Sina Vetter adds: “However, further research activities are needed to answer important questions – which were not the subject of the study – such as whether the results are generally applicable and whether the effect of CBD remains stable over time.”
The research team is currently preparing a study that will also build on the findings of the ICONIC study. In the ICONICplus study, it will investigate the added value of treatment with CBD and naltrexone compared to established standard treatments for alcohol addiction.
Zimmermann S., Teetzmann A., Baeßler J., Schreckenberger L., Zaiser J., Pfisterer M., Stenger M., Bach P.: Acute cannabidiol administration reduces alcohol craving and cue-induced nucleus accumbens activation in individuals with alcohol use disorder: the double-blind randomized controlled ICONIC trial. Molecular Psychiatry. 2024, doi: 10.1038/s41380-024-02869-y
https://www.nature.com/articles/s41380-024-02869-y
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