Effects of combining CBD and alcohol: Cannabis and alcohol use

Combining cannabis, CBD and alcohol

In the constant search for new experiences and approaches to wellness, more and more possibilities are opening up for the use of CBD. Among the latest developments are the addition of CBD drops in some cocktails, hemp beer, cannabis wine (weed wine) or wine with CBD.

This has generated curiosity about what happens when CBD and alcohol are mixed. The former, known for its multiple potential wellness benefits, and the latter, one of the most widely consumed recreational and psychoactive substances in the world.

This post aims to answer the question about what effects the combination of CBD with alcohol could have. We also see what happens if cannabis or marijuana (with THC) and alcoholic beverages are mixed.

Regarding the use of oral CBD, it is worth mentioning that in most European countries, CBD products, including CBD oils, are not regulated for consumption. Beverages, gummies and food products with CBD or other cannabinoids can only be found in the United States, Canada, Switzerland or the United Kingdom.

What happens when you mix CBD and alcohol together?

Both substances, CBD (cannabidiol) and alcohol, interact with our body through different systems. While CBD acts mainly on the endocannabinoid system, alcohol has effects on our central nervous system. In addition, both substances are metabolized in the liver.

It is thought that when consumed together, CBD and alcohol could produce an additive effect of sedation, but different scientific studies have not found this to be true.

Let’s see, first, what are the effects of the consumption of each substance individually:

Effects of consuming CBD on the body

CBD has been the subject of extensive scientific research for its potential therapeutic benefits, which include anti-inflammatory, anxiolytic and analgesic effects. Unlike tetrahydrocannabinol (THC), CBD does not produce psychoactive effects.

Unlike alcohol, the “immediate” effects of CBD on the body are not always obvious: cannabidiol can have a subtle effect.

On the other hand, the dose of CBD is determinant in its possible relaxing or stimulating effect (lower dose, more stimulating; and higher dose, more sedative).

Side effects of CBD are generally rare and not serious, and may include fatigue and diarrhea. In addition, CBD has potential drug interactions.

Effects of alcohol consumption on the body

Alcohol intoxication or binge drinking is mainly due to the depressant effects of alcohol on the central nervous system and how it modifies different neurotransmitters and signaling systems in the brain, including the endocannabinoid system.

Alcohol affects cognitive and motor skills, which are impaired. In addition, alcohol affects neurotransmitters such as dopamine, GABA, serotonin and glutamate, producing alterations in the perception of pleasure, relaxation, reward, euphoria and a sedative effect.

Inebriated people present difficulties in coordinating simple movements, such as walking or maintaining balance, lack of precision in movements and a significant decrease in attention and concentration. In the short term, it can result in problems with judgment and coordination.

In addition, alcohol alters glutamate and GABA receptors, modifying the process that neurons use to form memories, called “long-term potentiation”. This is what can cause memory loss when alcohol is consumed. Long-term excessive alcohol use can lead to a host of health problems, including liver disease, cardiovascular problems and an increased risk of addiction.

According to science, what happens when CBD and alcohol are mixed?

Science has not finished unraveling everything that happens when CBD is mixed with alcohol, but it has observed certain curiosities and allows us to debunk some common myths:

It appears that CBD may affect the way alcohol is assimilated.

Some researchers have reported that CBD when administered simultaneously with alcohol can reduce blood alcohol levels (1). However, when CBD is administered one hour before alcohol consumption, it does not appear to lower blood alcohol levels (2).

Although CBD can lower alcohol levels and this is observable in a breath test (1), CBD should not be considered as an antidote to alcohol consumption.

Regarding the effects of consuming CBD and alcohol at the same time, it seems that motor and psychomotor alterations are produced in the same way as if only alcohol were consumed. That is, unlike previously thought, CBD does not seem to increase the sedative or intoxicating sensation it produces with alcohol.

In other words, it does not appear that CBD intensifies the effects of alcohol (1) and most likely the feeling of increased drowsiness from the combination of CBD and alcohol is due to using a very high dose of CBD, or alcohol.

How does cannabis use affect binge drinking?

According to a small population study, consuming THC after drinking alcohol increases THC levels in the blood, i.e., the effect of THC is amplified (11). For this reason, depending on the sensitivity of each person, the use of marijuana and alcohol can lead to dizziness, nausea, vomiting and sweating, commonly referred to as “green-out” or “blancazo”, which are the result of acute intoxication.

Likewise, the use of marijuana with alcohol is linked to the development of mental illness, more so than the abuse of each substance individually.

What is the cannabis binge?

The term cannabis binge has been coined to explain the drowsiness, disinhibition, dry mouth, perceptual disturbances and coordination difficulties of THC. These effects may be exacerbated by the simultaneous use of alcohol and marijuana.

Is combining CBD with alcohol a good idea?

Current scientific evidence suggests that the combination of CBD does not generate an effect that puts people’s health at risk. However, both substances are metabolized in the liver, which may lead to adverse drug effects. Until further research is conducted, it is advisable to exercise caution and consult with a professional before mixing CBD and alcohol, especially for those who are taking other medications, for which it is not recommended.

How does CBD affect hangovers?

CBD could reduce hangovers due to its anti-inflammatory power and the fact that it can induce a feeling of well-being. Excessive alcohol consumption is linked to a process of dehydration and brain swelling, so CBD could alleviate the effects of this damage to the central nervous system.

THC in some doses seems to be a good treatment for nausea, so it is popularly said that at low doses it may help in the management of hangovers. However, there is no scientific evidence that THC represents a benefit after drinking alcohol.

Interactions of alcohol and the endocannabinoid system.

One of the curiosities about alcohol is that it also has effects on the endocannabinoid system. It appears that alcohol can modify the production of natural endocannabinoids produced by our body, such as anandamide and 2-AG (3, 4).

On the other hand, some of the effects of alcohol are associated with a decrease in glutamate neurotransmission in the brain, and there is evidence that these alterations occur through the effects of alcohol on the endocannabinoid system (5, 6).

Alcohol tends to reduce glutamate activity, which leads to a depressant effect on the central nervous system and may manifest itself in decreased cognitive functions, mood changes or lack of coordination or precision in movements.

Another effect of alcohol on the human body is that it induces the reduction of cannabinoid receptor expression (7). This means that alcohol indirectly reduces the amount of receptors for endocannabinoids in our body, altering the physiological processes that maintain the body’s health.

Although there is research supporting that alcohol exerts effects on the endocannabinoid system, the exact implications are not yet known.

CBD and alcoholism

CBD has been studied for its potential therapeutic benefit in the treatment of alcoholism, as it can intervene in psychological symptoms related to drinking, motivation, relapse, anxiety, and impulsivity to consume alcohol (8).

Likewise, CBD has potential benefits for alleviating the physical aspects resulting from alcoholism.

In some animal studies, it has been observed that CBD could alleviate one of the consequences of chronic alcohol consumption, such as liver damage, due to its outstanding anti-inflammatory properties and the great way in which it reduces oxidative stress (8).

CBD has been shown to help improve mental and liver function, which occurs from various liver conditions that can be caused by chronic alcohol consumption (9). CBD’s anti-inflammatory capacity gives it beneficial properties for liver diseases, making it a potential treatment for cocaine-induced liver toxicity (9) and fatty liver caused by excessive alcohol consumption (10). Although these findings have been found in preclinical models, and not in humans yet, they shed light on the possible potential of CBD in the treatment of the consequences of chronic alcohol consumption.

* You may be interested in: CBD to stop addictions

In conclusion…

The effects of combining CBD with alcohol differ greatly depending on the individual and the CBD product used, whether it contains THC, as well as the amount of alcohol consumed and various particularities, such as individual sensitivity.

In general, CBD does not seem to affect the feeling of drunkenness significantly, although it should be noted that both substances affect the endocannabinoid system and the release of neurotransmitters, and may have effects on mood and sense of well-being.

On the other hand, the consumption of cannabis with high THC levels in combination with alcohol can produce unpleasant effects such as nausea, vomiting and dizziness; and in the long term help the development of mental disorders.

In addition, most medications have contraindications with alcohol, and the use of CBD may increase the likelihood of adverse effects.

Both CBD and alcohol can generate a different response in the organism since they depend on the sensitivity of each person.

Note: This is an informational post, based on ongoing research. This information cannot and is not intended to diagnose, prevent or treat any disease or symptom. Its content can complement, but never replace, the diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines and are intended for external use. Consult with your physician before using CBD.

Referencias

Consroe, P., Carlini, E. A., Zwicker, A. P., & Lacerda, L. A. (1979). Interaction of cannabidiol and alcohol in humans. Psychopharmacology, 66(1), 45-50. https://doi.org/10.1007/BF00431988

Belgrave, B. E., Bird, K. D., Chesher, G. B., Jackson, D. M., Lubbe, K. E., Starmer, G. A., & Teo, R. K. (1979). The effect of cannabidiol, alone and in combination with ethanol, on human performance. Psychopharmacology, 64(2), 243-246. https://doi.org/10.1007/BF00496070

3. Basavarajappa, B. S., & Hungund, B. L. (1999). Chronic ethanol increases the cannabinoid receptor agonist anandamide and its precursor N-arachidonoylphosphatidylethanolamine in SK-N-SH cells. Journal of neurochemistry, 72(2), 522-528. https://doi.org/10.1046/j.1471-4159.1999.0720522.x

4. Ceccarini, J., Hompes, T., Verhaeghen, A., Casteels, C., Peuskens, H., Bormans, G., Claes, S., & Van Laere, K. (2014). Changes in cerebral CB1 receptor availability after acute and chronic alcohol abuse and monitored abstinence. The Journal of neuroscience : the official journal of the Society for Neuroscience, 34(8), 2822-2831. https://doi.org/10.1523/JNEUROSCI.0849-13.2014

5. Basavarajappa, B. S., Ninan, I., & Arancio, O. (2008). Acute ethanol suppresses glutamatergic neurotransmission through endocannabinoids in hippocampal neurons. Journal of neurochemistry, 107(4), 1001-1013. https://doi.org/10.1111/j.1471-4159.2008.05685.x

6. Kunos G. (2020). Interactions Between Alcohol and the Endocannabinoid System. Alcoholism, clinical and experimental research, 44(4), 790-805. https://doi.org/10.1111/acer.14306

7. Hirvonen, J., Zanotti-Fregonara, P., Umhau, J. C., George, D. T., Rallis-Frutos, D., Lyoo, C. H., Li, C. T., Hines, C. S., Sun, H., Terry, G. E., Morse, C., Zoghbi, S. S., Pike, V. W., Innis, R. B., & Heilig, M. (2013). Reduced cannabinoid CB1 receptor binding in alcohol dependence measured with positron emission tomography. Molecular psychiatry, 18(8), 916-921. https://doi.org/10.1038/mp.2012.100

8. De Ternay, J., Naassila, M., Nourredine, M., Louvet, A., Bailly, F., Sescousse, G., Maurage, P., Cottencin, O., Carrieri, P. M., & Rolland, B. (2019). Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain. Frontiers in pharmacology, 10, 627. https://doi.org/10.3389/fphar.2019.00627

9. Wang, Y., Mukhopadhyay, P., Cao, Z., Wang, H., Feng, D., Haskó, G., Mechoulam, R., Gao, B., & Pacher, P. (2017). Cannabidiol attenuates alcohol-induced liver steatosis, metabolic dysregulation, inflammation and neutrophil-mediated injury. Scientific reports, 7(1), 12064. https://doi.org/10.1038/s41598-017-10924-8

10. Yang, L., Rozenfeld, R., Wu, D., Devi, L. A., Zhang, Z., & Cederbaum, A. (2014). Cannabidiol protects liver from binge alcohol-induced steatosis by mechanisms including inhibition of oxidative stress and increase in autophagy. Free radical biology & medicine, 68, 260-267. https://doi.org/10.1016/j.freeradbiomed.2013.12.026

11. Hartman, R. L., Brown, T. L., Milavetz, G., Spurgin, A., Gorelick, D. A., Gaffney, G., & Huestis, M. A. (2015). Controlled Cannabis Vaporizer Administration: Blood and Plasma Cannabinoids with and without Alcohol. Clinical chemistry, 61(6), 850-869. https://doi.org/10.1373/clinchem.2015.238287

Masha Burelo
Investigadora en cannabinoides | Doctoranda en Neurociencia

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