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Study breakdown

The Endocannabinoid Signal Linked to Wanting Alcohol Was Suppressed in Abstinent Alcoholics

Cross SectionalPreliminary evidence
The takeaway

In healthy social drinkers, alcohol cue imagery increased blood anandamide levels and correlated with alcohol craving, but this endocannabinoid signal was absent in recently abstinent alcoholics who had markedly reduced baseline anandamide.

Read this if you are interested in how the endocannabinoid system connects to alcohol craving and addiction.

Anandamide response to alcohol cues was present in social drinkers but absent in alcoholics

What the researchers found

Researchers compared endocannabinoid responses in 11 healthy social drinkers and 12 recently abstinent alcoholics during guided imagery of alcohol cues, stress, and neutral relaxation.

In social drinkers, alcohol cue imagery specifically increased circulating anandamide levels (neutral and stress imagery did not). Baseline anandamide was negatively correlated with craving, while cue-triggered anandamide increases were positively correlated with craving and heart rate changes.

In abstinent alcoholics, no imagery condition triggered anandamide mobilization. Their baseline anandamide levels were markedly reduced compared to healthy drinkers and showed no correlation with craving or heart rate.

This suggests the endocannabinoid system participates in normal alcohol desire but becomes dysregulated in alcoholism.

Why it matters

This was one of the first studies to directly link endocannabinoid levels to alcohol craving in humans, suggesting the endocannabinoid system may be a target for treating alcohol use disorders.

The numbers in context

11 social drinkers and 12 abstinent alcoholics. Alcohol cue imagery increased anandamide in social drinkers but not alcoholics. Baseline anandamide was markedly reduced in alcoholics.

How the study worked

Laboratory study using guided imagery procedures (stress, alcohol cue, neutral) in 11 healthy social drinkers and 12 treatment-engaged abstinent alcoholics. Blood anandamide levels, alcohol craving, heart rate, and anxiety were measured.

What this study cannot tell us

Very small sample sizes (11 and 12). Cross-sectional design cannot determine whether low anandamide preceded alcoholism or resulted from it. Plasma anandamide may not reflect brain endocannabinoid levels. Recently abstinent alcoholics may differ from active drinkers.

How to read the evidence

Small cross-sectional study (n=23 total) measuring a novel biomarker. Preliminary but the first to directly link endocannabinoid levels to human alcohol craving.

When this study was published

Published in 2009. The relationship between the endocannabinoid system and alcohol use disorders has continued to be studied, with growing evidence supporting endocannabinoid dysregulation in addiction.

The bigger picture

The finding that alcoholics have suppressed endocannabinoid signaling connects to broader evidence that chronic substance use can dysregulate the endocannabinoid system. This dysregulation may contribute to the altered motivational states seen in addiction.

Questions still open

  • Does endocannabinoid dysregulation precede alcoholism or result from chronic alcohol use? Could endocannabinoid-targeting medications help reduce alcohol craving? Do cannabis users show similar endocannabinoid system changes?

Common questions

What does this tell us about cannabis and alcohol?
The study shows that the endocannabinoid system (which cannabis acts on) is naturally involved in alcohol desire. Chronic alcohol use appears to dysregulate this system, which could partly explain why some people use cannabis to manage alcohol-related issues.
Could this lead to new alcoholism treatments?
Potentially. If endocannabinoid dysregulation contributes to persistent alcohol craving, medications that normalize endocannabinoid signaling could theoretically help. However, this would require clinical trials to validate.

Read the original research

An endocannabinoid signal associated with desire for alcohol is suppressed in recently abstinent alcoholics.

Psychopharmacology, 205(1), 63-72

Citation

Mangieri, Regina A; Hong, Kwang-Ik A; Piomelli, Daniele; Sinha, Rajita. (2009). An endocannabinoid signal associated with desire for alcohol is suppressed in recently abstinent alcoholics.. Psychopharmacology, 205(1), 63-72. https://doi.org/10.1007/s00213-009-1518-3

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