CBD versus Alcohol - Shared Pathways with Big Tolerance Differences
Our original discovery of CBD came from a brutal perimenopause with the founder. The story here.
This period of time is tied to falling progesterone and plummeting estrogen.
After going deep into the research, we found interesting connections with hormones and other very powerful neurotransmitters.
Interestingly, we noticed that most women start drinking daily (around pm, anyone??) during their 40's and this becomes a daily ritual.
Self-medication really once you understand the "why" for this drink
That's where CBD versus alcohol becomes very interesting.
It also goes to the heart of CBD for alcohol addition which we covered in depth.
For this review, let's compare CBD and alcohol.
We'll cover these topics:
- The shared pathways of CBD and alcohol
- CBD versus alcohol - the long term effect
- Can CBD replace alcohol
- CBD versus alcohol for the liver
- CBD versus alcohol for oxidative stress
- CBD and alcohol interactions
- CBD instead of alcohol
- Does CBD oil contain alcohol
- How much CBD to replace alcohol
- What's the best CBD to use instead of alcohol
Let's get started.
The shared pathways of CBD and alcohol
First, we need a quick introduction to how CBD and alcohol work...especially in the brain.
Let's start with CBD.
We have a whole review on how CBD works here but essentially, it functions like a feedback mechanism in very powerful pathways.
Here's a quick look at those pathways and the knock-on results.
This feedback approach is really important for long-term use as we'll cover later with tolerance.
What about alcohol?
Alcohol is very interesting chemically.
Essentially, it's a very simple molecule that acts as a lubricant to all things chemical in the brain.
This really comes into play with neurotransmitters, our primary chemical messengers.
In general, alcohol is a master catalyst which means it makes chemical processes happen more easily.
So...let's drill down into actual pathways that are shared between CBD and alcohol to see why this is such a big deal.
We'll on some big ones:
- GABA - our brain's brake pedal - the target of benzos
- Serotonin - master regulator of all human behavior and powerhouse for mood
- Dopamine - the reward circuit - key to addiction
- Cortisol - stress hormone
Let's just focus there so we don't fall down the rabbit's hole of brain chemistry.
As it is, these are powerful shapers of how you feel.
GABA is the primary calming agent in the brain.
It's also the target of benzos - the primary anti-anxiety and insomnia drug target.
That tells you a little how it feels.
The issue is that benzos are highly addictive and build tolerance very quickly since they push GABA in one direction.
CBD directly supports GABA function but doesn't push it too high which is why we don't see the usual side effect profile tied to too much (sedation, can' use machinery, etc).
All the research is on the prior two pages.
GABA is critical for the following:
- OCD and repetitive or negative thoughts
- Pain sensitivity
- Mental health in general
What about alcohol?
Alcohol mimics gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the brain
Goodness...a substitute for GABA.
Interestingly, for sleep, this boost of GABA gets converted later in the night to glutamate (the brain's "gas pedal").
That's why the quality of sleep is disrupted even if alcohol initially helps you fall asleep.
CBD does not have this effect since it's supporting GABA when it's low (feedback) and there's good research on CBD and sleep here.
Here's the fascinating piece for women...especially beyond age 40.
Progesterone directly drives GABA activity!
Progesterone drops by about 50% at age 40 and continues to decline from there.
This is why you see risk for mood issues, sleep, pain, autoimmune, dementia, etc all increase for women, and in some cases, women make up 80% of the diagnosis.
This is because progesterone calms immune response as well.
Check out progesterone to learn all about this powerful hormone but know that it directly promotes GABA and it's leaving the building.
Now the 40 something wine drinking makes more sense!
Let's turn to an even bigger player...serotonin.
CBD versus Alcohol for serotonin
Serotonin is commonly referred to as the "feel-good" neurotransmitter but that doesn't do it justice.
It's a master regulator of all human behavior!
Here's the tricky part with serotonin...it needs to stay in a tight range.
Too low can mean depression, anxiety, flat affect, and more.
Too high can be irritability, anger, low sexual function, and even serotonin syndrome...a dangerous condition.
SSRIs, the most common antidepressants, boost serotonin function (in one direction).
They work for about 30% of the people until they build tolerance.
Serotonin has its fingers in many pies across the brain!
Downstream, you have dopamine, our reward circuit player, and the key to motivation (and addiction).
Maybe, more importantly, is a chemical you probably haven't heard of...BDNF.
This is the brain's fertilizer and it's showing up in newer research for every mental health issue you can find.
BDNF is really the heart of depression (see CBD and depression).
Check out our serotonin review to learn more.
So...what about CBD versus alcohol for serotonin?
In countless studies, CBD has been shown to directly boost serotonin function WHEN LOW such as this one following chronic pain:
repeated treatment with low-dose CBD induces analgesia predominantly through TRPV1 activation, reduces anxiety through 5-HT1A receptor activation, and rescues impaired 5-HT neurotransmission under neuropathic pain conditions.
- Reduced pain (analgesia)
- Reduced anxiety (serotonin pathway)
More importantly, it "rescued" serotonin (5HT). Not boosted it. Not jacked it up.
Rescue. This goes to the heart of CBD's feedback mechanism which is why we don't see serotonin syndrome with very high levels up to 1500 mg.
What about alcohol?
Serotonin plays an important role in mediating alcohol’s effects on the brain. Alcohol exposure alters several aspects of serotonergic signal transmission in the brain.
Short term, alcohol increases serotonin function:
When activated by serotonin binding, the 5-HT3 receptor rapidly increases neuron activity by generating electrical signals (Lovinger and Peoples 1993). Acute alcohol exposure enhances the electrical signals generated by the 5-HT3 receptor.
In fact, low serotonin levels may factor into alcohol addiction to begin with.
Again...the self-medication piece.
Long term, alcohol builds tolerance which means your natural serotonin levels are actually lower than when you started!
Back out ladies…
Estrogen is a huge promoter of serotonin activity!
It drops off the cliff around the late '40s (see Dre's story here) and during big cycles (monthly, puberty, pregnancy, etc).
No wonder women in their 40's and 50's are drinking wine daily!
Check out CBD versus alcohol for perimenopause for the research.
The connection with caucasian women and red wine during this time in research is utterly fascinating.
Since serotonin drives dopamine, what's the difference there?
CBD versus alcohol for dopamine
Dopamine is the "do that again" chemical that functions as the basis for reward in the brain.
It's under the control of serotonin (all human behavior after all).
Interestingly, research on CBD and schizophrenia shows a very nuanced effect depending on the state of the brain area.
Research points to different dopamine levels affecting the so-called "positive" and "negative" symptoms of schizophrenia.
Too much dopamine in the striatum (paranoia, hallucinations, etc) and too little in the prefrontal cortex (key to depression, flat emotional response, etc).
The common antipsychotics hammer down dopamine across the board which means they can help with the positive symptoms but not the negative.
Check out the research on CBD and schizophrenia. It's maybe one of the most powerful and fascinating studies out there!
Powerful effects on both sets of symptoms without the nasty side effect profile.
This would point to different effects on dopamine depending on the brain area!
Again...it's a feedback mechanism
More importantly with dopamine is the research on CBD and addiction.
Powerful effects across all types of addiction which we cover in detail including alcohol addiction (which should make sense by now).
We did a big review on CBD and dopamine here.
Let's look at cortisol...one last stop.
CBD versus alcohol for cortisol
First, understand that serotonin is a powerful stress response offset.
Cortisol is a powerful hormone that drives everything you feel as "stress".
First, let's look at CBD.
CBD has been shown to calm the initial trigger of the stress response called corticotrophin-releasing factor (see CBD and CRF).
This starts the ball rolling and then cortisol takes the baton and runs with it.
CBD has also been shown to calm cortisol response (see CBD and cortisol).
Now...we need some cortisol just to feel "engaged". If you slam it too hard, good luck getting out of bed.
In fact...cortisol rolls on a natural cycle and peaks in the morning to get us going.
CBD has actually been shown to have different responses depending on where we are in the circadian cycle (see can you take CBD in the middle of the day).
What about alcohol and stress via cortisol?
The relationship with alcohol is tricky and depends on duration and amount.
Initially, alcohol reduces cortisol and stress:
Alcohol can change the way that the body deals with stress: it can decrease the hormone cortisol which the body releases to respond to stress, and it can prolong the feelings of tension produced by the stress
So...let's break that down:
- Initial alcohol exposure - calms cortisol and stress response
- Later on - extends how long stress lasts
Thinking of it as smoothing out the stress response...less but longer.
Now, longer-term use of alcohol has the opposite effect.
Both drinking and withdrawal from chronic drinking can raise circulating glucocorticoid levels, known as cortisol in humans and corticosterone in rodents
So..extended use actually makes stress worse especially when adding back in withdrawal.
And that folks, is the biggest difference between CBD and alcohol use.
Let's go there now.
CBD versus alcohol - the long term effect
To understand this, we have to introduce the stage that CBD works within and the nuanced approach it has even compared to THC.
The endocannabinoid system.
We all have one and share this key system with every animal.
It dates back about 600 million years evolutionarily speaking.
Just watch what it does:
The endocannabinoid system is tasked with balancing other key systems (wait for it):
- The nervous system - neurotransmitters like GABA, serotonin, and dopamine
- The endocrine system - hormones like cortisol
- The immune system - key to inflammation and oxidative stress
Here's what's interesting about CBD in this system. Let's take one example.
- Healthy cell with low inflammation - CBD has no effect
- Healthy cell with high inflammation - CBD reduces inflammation
- Cancerous or virally-infected cell - CBD INCREASES inflammation
Three different results for three different states.
The last one makes sense once you realize that the oxidative stress is our body's natural way to kill off wayward cells.
In fact, chemo and radiation are giant doses of oxidative stress!
Here's the important piece.
You don't want to push powerful pathways in one direction.
Here's the trajectory for increasing levels of GABA:
Barbituates, the predecessors to benzos had a known overdose risk and benzos also do but usually in conjunction with another medication that slows things down (like opioids).
SSRIs can cause serotonin syndrome and cause a litany of crazy side effects (see CBD versus SSRIs).
We don't either suite of side effects from CBD even at higher doses and prolonged use.
Here's the problem with pushing a powerful pathway like GABA (which makes up 60% of brain activity) or serotonin in one direction.
The brain pushes back!
That's the whole basis of tolerance...less and less effect from the same level of a drug.
It happens very quickly with benzos and more slowly with SSRI.
In fact, all addictive drugs combine two things:
- Spikes in dopamine ("do that again")
Research is shown that CBD does not build tolerance, is not addictive, is not hedonic (causes pleasure).
Unfortunately, the opposite on all three.
Alcohol builds tolerance so natural levels of GABA, serotonin, and dopamine will drop.
And continue dropping with use!
That's the basis for withdrawals. You feel so bad because the floor (alcohol) boost was just pulled out from underneath you.
Again, this is chronic use we're talking about.
A hangover may reflect a temporary depletion of serotonin but that generally comes back pretty quickly.
When you use alcohol long-term, the genes actually get turned on or off to reduce GABA, serotonin, and dopamine receptors and sensitivity.
It can take at least 30 days for this to reverse...longer depending on how much and how long.
Eventually, you're using alcohol not to feel good but just to avoid feeling bad since your natural serotonin/GABA levels are so suppressed.
In fact, with benzos, glutamate (the opposing fore to GABA) can get ratcheted up after long-term use and if you stop cold-turkey, you can get seizures!
Look...from our studies on addiction, most of this deals with people self-medication to fill in holes or pathways that don't function at optimum levels:
- THC or cannabis - anandamide, our "bliss" molecule
- Nicotine - acetylcholine
- Stimulants - glutamate or dopamine
- Opioids - GABA, serotonin, or opioids
- SSRI's - serotonin
- Alcohol?? GABA, serotonin, dopamine, and more!
Alcohol is interesting since it boosts almost all transactions due to its super small and interchangeable size in the brain.
If it didn't build tolerance, we wouldn't need to write the review!
Unfortunately, it does.
Let's go to more practical questions.
Can CBD replace alcohol?
If the prior few 1000's words do anything, it shows a work-around to support GABA and serotonin without tolerance and addiction.
Now, CBD won't give your pleasure or the giddy effect of alcohol.
That being said, CBD does support another pathway called anandamide.
Anandamide is our primary endocannabinoid and it's named after Anand, the Hindu goddess of bliss.
THC basically is a substitute for anandamide which is why there is a "high" feeling.
CBD doesn't produce this high because remember, it boosts pathways when low!
THC is an agonist which means it keeps pushing anandamide (CB1 activity really) pathways up up up.
CBD does have a direct effect on anandamide via the chemical that eats up anandamide which shows in many studies.
In the extreme:
Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia
Think of this level of anandamide as being "high enough".
You know that feeling when you go through the day and everything feels pretty good.
That's the role of natural anandamide and that's CBD's main effect.
Anandamide is also a wet blanket on excessive activity in the brain so we see impacts on anxiety, depression, movement disorders, seizures, etc.
Check out how to boost the endocannabinoid system to learn more.
We feel that endocannabinoid deficiency is going to be a big deal in the next few years as people realize that this system is the one that is faltering under our modern lifestyle.
Otherwise, CBD address some of the key "self-medicating" pathways such as GABA and serotonin.
For women, you have to look at progesterone and estrogen as those are probably the real drivers especially in your 40's or later.
Remember that progesterone boosts GABA and estrogen boosts serotonin.
Let's look at another aspect.
CBD versus alcohol for the liver
There are completely different effects on the liver between CBD and alcohol.
Alcohol is a known enemy of liver function.
Fatty liver is a known result from chronic alcohol use and there's zero positives of drinking for the liver.
Let's introduce our whole detox system!
Our primary detox pathway is called glutathione (see CBD and glutathione).
It's tasked with breaking down dangerous chemicals and getting them out of the body.
The reason for Tylenol being the leading cause of liver failure is that a metabolite from Tylenol (NAPQI.)exhausts the glutathione response and then the damage is done directly to the liver.
Alcohol use is just a slower version of this.
Glutathione (GSH) plays an important role in the detoxification of ethanol (EtOH) and acute EtOH administration leads to GSH depletion in the liver and other tissues.
What about CBD and glutathione?
CBD has been shown to directly support glutathione especially when under the gun from various insults such as:
Repeated doses of CBD in inflammatory conditions were found to increase the activity of glutathione peroxidase and reductase, resulting in a decrease in malonaldehyde (MDA) levels, which were six times higher in untreated controls
Let's cut to the chase with alcohol specifically:
Cannabidiol protects the liver from binge alcohol-induced steatosis by mechanisms including inhibition of oxidative stress and increase in autophagy
Essentially, CBD protected the liver from excessive alcohol by supporting glutathione and even removing (autophagy) damaged cells.
Check out CBD and glutathione to learn more.
NAC is also a powerful supporter of glutathione and essential for anyone who drinks.
CBD and NAC together may be powerful tools to protect from some of the ravages of chronic alcohol use.
Let's look at oxidative stress.
CBD versus alcohol for oxidative stress
When glutathione is exhausted or busy dealing with breaking down alcohol (a poison to the body), it takes its eye off the other major threat which is oxidative stress.
LIttle oxygenated assassins slicing and dicing anything they come in contact with including DNA, cell walls, etc.
This is at the heart of aging, cancer, and a host of issues.
Check out CBD and longevity to learn more.
Alcohol directly leads to an increase in oxidative stress system-wide (since glutathione is not compartmentalized to the liver).
This is why you see accelerated signs of aging in the skin as a sign with heavy drinkers.
What about CBD and oxidative stress?
It turns out that CBD is an even more potent antioxidant than the go-to's for this space:
In an in vitro glutamate neuronal toxicity model, CBD was shown to be more protective than either α-tocopherol or vitamin C and comparable to butylated hydroxytoluene (BHT);
Vitamin C and Vitamin E!
What about CBD and alcohol together?
CBD and alcohol interactions
A study looked at CBD alone, alcohol alone, or CBD and alcohol together.
The results were fascinating.
Compared to placebo, alcohol and alcohol plus CBD, but not CBD alone, produced significant impairments of motor and psychomotor performances, overestimations of time production and subjective responses indicating an accurate self-perception of their intoxication and deficits.
So CBD did not affect the impairment aspect of alcohol nor did it enhance it.
Here's the interesting part.
The combination of alcohol plus CBD resulted in significantly lower blood alcohol levels compared to alcohol given alone.
So CBD was able to help the body metabolize alcohol and get it out of the body!
That's the glutathione and liver aspect we described above.
Essentially, CBD supports the pathway that breaks down alcohol.
On a side note, CBD has been shown to counter many of the effects of THC in cannabis.
Newer research goes further:
Preliminary preclinical results suggest that CBD can attenuate alcohol consumption and potentially protect against certain harmful effects of alcohol, such as liver and brain damage.
Check out CBD and neuroinflammation to learn more about protecting the brain.
On a side note, CBD has been shown to reduce alcohol consumption and cravings!
Check out CBD and alcohol addiction to learn more.
So...what's the net net of all this?
CBD instead of alcohol
So, let's recap the main reasons we see behind alcohol use (chronic as opposed to recreational to frame it in a cannabis setting).
Remember, the basic theory is that long-term use starts because a given drug really fills in an existing hole, and then dopamine and tolerance seal the deal for addiction and withdrawals respectively.
In the case of alcohol:
- GABA - the key to anxiety and sleep but important for brains that run "hot" (too much glutamate) see CBD and glutamate
- Serotonin - the key to depression and mood with powerful stress response piece
- Cortisol - the stress hormone
So, if a person naturally feels "heightened or frazzled" (not enough GABA) or down and restless...even reckless (not enough serotonin), or unable to handle stress (cortisol)
Alcohol is going to feel really really good.
There are many reasons a person can be running short in these pathways including:
- Chronic stress
- Hyperactive immune function
- Drugs and medications
- Gut microbiome imbalance
We cover most of these at our CBD and GABA or CBD and serotonin reviews.
The problem is that alcohol giveth (short term) and taketh away (long term).
The brain pushes back and actually reduces all the affected pathways.
Dopamine also spikes up (addiction) so basic reward circuits are re-written to respond only to alcohol.
We showed how CBD, on the other hand, supports all these pathways but doesn't push them too high so that a tolerance response is triggered.
This is SO important.
Interestingly, there's powerful research on how CBD can help unwind the downregulation of these pathways from alcohol.
It can also help with withdrawals and literally re-write, or over-write, the existing addiction pathways marbelized in the brain.
That process is called neurogenesis and it's at the heart of healthy brains.
It's key player is BDNF, our brain's fertilizer.
The two most common triggers for relapse??
- Reduced BDNF levels
Let's just say that it supports both!
We've spent 1000's of hours in NIH studies and the argument for CBD instead of alcohol is overwhelming.
One other question that comes up.
Does CBD oil contain alcohol?
In fact, just two ingredients:
- CBD isolate (no THC which builds tolerance)
- MCT oil from organic coconut oil
Some brands may use alcohol but it really shouldn't be needed since CBD isolate doesn't breakdown readily.
Think of it like salt in that respect.
What about amounts?
How much CBD to replace alcohol
This depends on how long alcohol has been in the mix.
If it's just casual and you're looking for a better option for the above pathways, 50-100 mg is probably a good range to start with.
Neurogenesis, the real star behind feeling good, peaks at 300 mg so that's probably the max amount if facing anxiety, depression, etc.
For withdrawals from alcohol use, that's a different story.
We can look at studies on CBD and opioid withdrawals as a good indicator.
There are two phases really:
- Initial withdrawal period - first 10 days - 600 mgs (3 x 200mg daily after meals)
- Recovery period - day 11 to 2 months (or longer depending on how you feel) 300 mg daily for peak neurogenesis
What about the type of CBD instead of alcohol?
What's the best CBD to use instead of alcohol
We have basic requirements with any CBD:
- Organically grown in the US at FDA registered farms
- CO2 processed
- 3rd party tested
- No THC (builds tolerance)
- No pesticides
- No solvents
- No heavy metals
- No mold
- No bacteria
Then there's the question of CBD isolate versus full spectrum.
We did a whole review here but all the research is based on CBD isolate.
The bigger issue is that 40-60% of the population has a histamine issue and this number goes up for women and as we get older.
Many people have bad responses from full-spectrum CBD for this reason even though it's pushed everywhere.
This is really going to hit women hard when they're running low on progesterone (40's and older) and as we mentioned above, that's a big subset of the population self-medicating with alcohol.
Finally, there's affordability.
If research is showing 300 mg as peak neurogenesis (the real goal), then we have to be able to afford it.
We price our 6000 mg bottles at 2-3 cents per mg (the real measure) before discounts of 30% or higher.
The reason is simple.
Our founder discovered CBD during a brutal perimenopause (story is here) at age 47.
GABA was gone (progesterone left the station) and estrogen was on a roller coaster (serotonin as well).
If we can help anyone through a similar situation, then it's all worth it.
Be well. Take care of each other. Take care of yourself.
Always work with a doctor or naturopath with any supplement!
The information provided here is not intended to treat an illness or substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.