A recent study published in Molecular Psychiatry provides the first clinical evidence that cannabidiol (CBD) may help reduce alcohol cravings and lower activity in the brain's reward center in individuals with alcohol use disorder (AUD). The double-blind, randomized, controlled ICONIC trial (Investigation of the Effects of Cannabidiol on Cue-Induced Alcohol Craving and Nucleus Accumbens Activation) conducted by researchers at the University of Heidelberg in Germany, suggests that a single dose of CBD can curb alcohol cravings and quiet the brain's reward center, offering new hope for those battling AUD.
The ICONIC trial involved 28 participants aged 18 to 60 with mild to severe AUD. Participants were divided into two groups: one received a single 800 mg oral dose of CBD, while the other received a placebo. The 800 mg dose was selected based on prior studies suggesting higher doses are more effective in reducing alcohol cravings. Participants then underwent various tests, including stress and alcohol-cue exposure, where they viewed alcohol-related images or were placed in a bar-like environment. Alcohol cravings were assessed via questionnaires, and brain activity was measured using magnetic resonance imaging (MRI).
The study found that participants who received CBD reported significantly lower alcohol cravings during both stress and cue exposure compared to the placebo group. "Individuals receiving CBD showed lower bilateral cue-induced NAc activation... and reported significantly lower alcohol craving after a combined stress- and alcohol cue exposure session," the study reads. The nucleus accumbens (NAc), a brain region tied to reward and addiction, showed reduced activation in the CBD group. Lower activity in the NAc is associated with fewer cravings and a lower likelihood of relapse.
Dose-Dependent Effects and Safety
Higher CBD levels in the blood were also associated with reduced cravings and less activation in the nucleus accumbens, indicating a dose-dependent effect. Importantly, no adverse effects were reported, supporting CBD's potential as a safe treatment option.
Limitations and Future Directions
Researchers highlighted several limitations, including the focus on a single dose of CBD, leaving the long-term effects unknown. The sample size was also small, and most participants were not actively seeking treatment, which may not reflect the experiences of individuals with severe AUD. Additionally, the sample was relatively homogeneous, limiting broad applicability. "Presented results can thus not answer the question, whether CBD’s effect in AUD are robust over time," researchers said, calling for larger confirmatory trials.
Despite these limitations, this study offers early evidence that CBD may help reduce alcohol cravings and alter brain activity related to addiction in individuals with AUD. The research team is currently preparing the ICONICplus study to investigate the added value of treatment with CBD and naltrexone compared to established standard treatments for alcohol addiction.
