Alcohol Use Disorder, commonly known as alcoholism, is a debilitating condition that affects millions of people worldwide. It ravages individuals, destroys families, and drains the economy.
According to a JAMA Psychiatry paper, 12.7% of the US population was dealing with AUD. It's more prevalent in men than in women, with 9.2 million men suffering from the condition compared to 5.3 million women. Additionally, the rate of alcoholism in the US rose by almost 49% in the 2000s.
The CDC estimates that excessive alcohol use costs the US $249 billion annually.
And while these numbers paint a grim picture, they don’t tell the full story; numbers rarely do. Instead of looking at the global impact of AUD, we’ll look at what it does to an individual and how we can help.
What is Alcohol Use Disorder?
AUD is a chronic brain condition characterized by an overdependence on alcohol despite adverse social, health, or occupational consequences. A person suffering from AUD cannot control their drinking and has to drink more to get the same effect.
If your drinking has significant, adverse consequences on your life, you most likely have AUD.
To diagnose someone with AUD, experts use an 11-point checklist outlined in the DSM, the Diagnostic and Statistical Manual of Mental Disorders. Current guidelines dictate that anyone who satisfies 2 of the 11 points in the same 12- month period gets diagnosed with AUD. The severity of a person’s AUD depends on how many points they satisfy.
What does AUD do to the body?
AUD wreaks havoc on every system in our bodies, but it primarily destroys the brain and the liver.
A study by Jingzhong Ding et al. found that excessive alcohol intake was associated with brain atrophy. The study involved 1909 participants who underwent cerebral MRI examination.
The researchers found that both moderate and chronic alcohol intake was associated with a reduction in brain size. However, they were not sure how alcohol caused brain atrophy. They suggested it could either be directly by adversely affecting neurons and cell constituents or indirectly by causing cardiac issues, which reduce blood flow to the brain.
Brain atrophy destroys the infrastructure that your cells use to communicate. This can result in memory loss, difficulty speaking, and loss of motor skills and the symptoms get more severe as the atrophy progresses.
Because the liver is the primary center for ethanol metabolism, it is the main victim of heavy drinking. Alcohol damages liver tissues more than any other tissues. Excessive alcohol use causes several hepatic lesions such as steatosis, cirrhosis, and hepatitis.
Steatosis is the initial response to chronic alcohol intake and is characterized by fat deposition in the liver cells. Unchecked steatosis can transform into steatohepatitis. It is characterized by chronic liver inflammation and fat accumulation in the hepatocytes.
Liver fibrosis occurs when healthy liver tissues become scarred and can’t function properly. Unchecked liver fibrosis progresses to liver cirrhosis characterized by excessive scar tissue in the liver until it eventually stops functioning. The American Liver Foundation estimates that roughly 10% to 20% of chronic drinkers will develop liver cirrhosis.
Although liver cirrhosis is treatable, it isn’t curable.
CBD and Alcohol Use Disorder
CBD, cannabidiol, is a versatile component of the hemp plant that has become a global phenomenon because of its many benefits. Research shows that CBD helps people sleep better, manage their daily stresses, and deal with inflammation. There’s a lot of interest in CBD, and many papers have been written about it.
One paper, a narrative review by Julia De Ternay et al., focused on whether CBD could help people with Alcohol Use Disorder. They reviewed several papers published between 1974 and June 2018.
Four of the studies they reviewed provided evidence that, in rodent models, CBD could reduce alcohol intake, motivation to take ethanol, relapse, and anxiety and impulsiveness related to ethanol consumption. One of these papers, Adrián Viudez-Martínez et al., showed that CBD use reduced ethanol preference in mice from 75% to 55%. It also reduced ethanol consumption from 6 grams per kg of body weight daily to 3.5g.
CBD and the liver
Other studies focused on the liver and showed that CBD could reduce alcohol- induced liver steatosis and fibrosis. These studies focused on CBD’s immunomodulatory, antioxidant, and lipid metabolic regulation properties.
In one study, Lim et al., the researchers focused on hepatic stellate cells, HSCs. When HSCs are activated, they multiply rapidly and produce excess collagen, the protein that forms scar tissue. This results in the accumulation of scar tissue in the liver, causing fibrosis. Several experts have suggested that inducing HSC death could reverse fibrosis.
When CBD was introduced to liver cells of mice fed with ethanol, it triggered a stress response that caused the selective death of activated HSCs. The researchers believed that CBD could be a therapeutic agent to treat liver fibrosis.
CBD and the brain
Finally, Julia and her team reviewed papers focused on how CBD could reduce alcohol-induced brain damage. These papers focused on how the neuroprotective, antioxidant, and immunomodulatory properties of CBD could counteract the neurodegenerative properties of alcohol.
One study, Carol Hamelink et al., focused on the antioxidant properties of CBD. The researchers fed male Sprague-Dawley rats an alcohol-free liquid diet for three days then an ethanol diet for four days. The 4-day ethanol diet simulated an alcohol binge. Additionally, in a double-blind manner, the rats received either CBD, 20 or 40mg/kg, or other neuroprotectants such as antioxidants and NMDA receptor antagonists.
Carol and her team then examined the brains of the rats to assess alcohol- induced neurodegeneration. The rats that had taken CBD had less neuron damage in all regions of the brain.
CBD also demonstrated an antioxidant effect comparable to tocopherol and butylated hydroxytoluene, two of the antioxidants used in the study.
I know that was a lot to digest, so a quick recap before I share my final thoughts.
Alcohol Use Disorder damages all our systems, particularly our brains and livers. CBD has several properties that might be beneficial for people living with AUD. Research has shown that CBD can
● Reduce alcohol preference and consumption
● Protect liver cells from scarring
● Protect the brain from neuron death
Although these studies were carried out in animal models, they present a compelling case for human trials. And while more research needs to be carried out, CBD might be the answer to the prayers of millions affected by AUD.